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Differences in labor and delivery experience in family physician- and obstetrician-supervised teaching services
1Department of Family Medicine, University of Wisconsin, Madison, USA.
Background:
Other studies have shown that family physicians' pregnancy management styles are different from obstetricians' styles. This study examines whether these differences also exist in teaching services supervised by family physicians and obstetricians.
Methods:
A retrospective study was done of deliveries performed by residents at five teaching hospitals in five states. A total of 4,558 women were admitted to teaching services supervised by either family physicians (n = 1,754) or obstetricians (n = 2,804). Medical records for women whose labor and delivery were supervised by family physicians and obstetricians were reviewed and compared for demographics, pregnancy history, delivery management, and outcome variables.
Results:
Women admitted to teaching services supervised by family physicians were more likely to be younger and have no insurance, compared with those on services supervised by obstetricians. Even after adjustment for pregnancy risk, obstetrician-supervised teaching services had an increased incidence of preterm labor, more frequent use of epidural anesthesia, and higher episiotomy and cesarean section rates than family practice teaching services.
Conclusions:
The demographic and clinical characteristics of family practice and obstetric teaching services differ. Patients on the services supervised by family physicians were more representative of the maternity practice of practicing family physicians.