Obstetrics in family practice: a personal and political perspective

A heated debate is currently taking place concerning the style, methods and location of future obstetrical and neonatal care. On the one hand, there is a trend toward increasing technology of obstetrical and neonatal care with some professional groups favoring regionalization of these services to large regional centers. On the other hand, there are counterforces to such regionalization including community hospitals, many practicing obstetricians, nurse midwives, the women's liberation movement, the "alternative lifestyle movement," the Leboyer concept of delivery, the family-centered maternity care movement, and the family practice movement. This paper explores these issues and presents important reasons for family-oriented obstetric and neonatal care involving the family physician in community settings readily accessible to patients. The inclusion of obstetrical care as an integral part of family practice is important to the growth and development of the specialty.