Related Experiment Video
Updated: Jun 3, 2026
A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Is direct access to obstetricians/gynecologists effective at improving maternal health behaviors?
Christine Piette Durrance1, Scott Hankins
1Department of Public Policy, University of North Carolina at Chapel Hill, NC, USA. christine.durrance@unc.edu
Objective:
To examine the effects of state legislation mandating direct access to obstetricians and gynecologists (OB/GYNs) on maternal health behaviors and infant health outcomes.
Data Sources:
1992-2002 Natality Detail File; 1994-2002 Pregnancy Assessment and Monitoring Survey (PRAMS).
Study Design:
Using variation in state policy over time, we use individual-level data from two sources to consider the effects of direct access legislation on prenatal care utilization, maternal health behaviors during pregnancy, and infant health outcomes.
Principal Findings:
Our results suggest that there is little evidence that direct access laws are effective at improving prenatal care access or conferring benefits to mothers and infants. These results are consistent across two data sets, a variety of specifications, and specific subgroups of women who are most likely to be affected by direct access legislation.
Conclusion:
We conclude that direct access to OB/GYNs is not related to improvements in maternal health behaviors or infant health outcomes. If policy makers are interested in reforms that improve maternal and infant health, we recommend a focus on alternative policies.
Related Concept Videos
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:28Development of the Oral Microbiota
01:20Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...
01:30Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
01:30Preventive Healthcare Services
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...