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Are rural family physicians comfortable performing cesarean sections?
T E Norris1, J W Reese, M J Pirani
1WAMI Rural Health Research Center, Department of Family Medicine, University of Washington, Seattle 98195-6340, USA.
The Journal of Family Practice
|November 1, 1996
Summary
Family physicians perform most cesarean sections in rural Washington hospitals lacking obstetricians. Their comfort with cesarean delivery is linked to residency training, highlighting the need for robust surgical training for rural physicians.
Area of Science:
- Obstetrics and Gynecology
- Rural Health Services
- Surgical Procedures
Background:
- Cesarean sections are essential for obstetric care in the US.
- The role of non-obstetricians in performing cesarean sections in rural hospitals is not well-defined.
- Physician comfort levels with performing cesarean sections in rural settings are unknown.
Purpose of the Study:
- To investigate who performs cesarean sections in rural Washington State hospitals.
- To assess the comfort level of non-obstetricians performing cesarean sections.
- To identify factors influencing comfort with cesarean section procedures.
Main Methods:
- A telephone survey of 41 rural hospitals in Washington State was conducted.
- A questionnaire was sent to 112 family physicians performing obstetrics in smaller rural hospitals.
- Response rates were 75% for the physician questionnaire.
Main Results:
- 31 (75%) rural hospitals offer obstetric services; 19 (61%) lack dedicated obstetricians.
- Family physicians perform the majority of cesarean sections in these rural hospitals.
- Physician comfort with cesarean sections strongly correlates with the number performed during residency training.
Conclusions:
- Rural hospitals frequently rely on family physicians for cesarean sections.
- Adequate residency training is crucial for physician confidence and competence in performing cesarean sections.
- Future rural physician training programs must prioritize comprehensive cesarean section training.