Involvement of Victorian general practitioners in obstetric and postnatal care

To assess the current nature and extent of general practice (obstetric) involvement and the effect of gender on the provision of maternity care in Victoria.

A postal survey to a community derived sample of 1104 Victorian general practitioners (with oversampling of female GPs) in August 1994 with hierarchical data analysis techniques used to account for the clustered (divisional) nature of the sampling frame.

A 70% response rate was achieved (715 out of an eligible sample of 1022). Three hundred and sixty-two (45.6%) GPs were providing shared care, 127 (17.7%) intrapartum care and 656 (92%) were involved in seeing women for their routine 6 week postnatal checkup. Male and female GPs were equally qualified and as likely to be vocationally registered (90% vs 92%). Female GPs were less likely than male GPs (11% vs 25%) to be involved in intrapartum care (OR = 0.4, 95% CI = 0.3-.06). Female GPs were more likely than male GPs (50% vs 41%) to be involved in shared care (OR = 1.4, 95% CI = 1.01-2.0), and postnatal care (OR = 3.7, 95% CI = 2.5-5.4). Provincial city (population > 15,000) GPs were more likely to provide shared care than other GPs. Fifty-two per cent of GPs providing shared care held a Diploma of Obstetrics. After accounting for the gender differences associated with practice location, rural GPs were more likely to provide intrapartum care (OR = 10.6, 95% CI = 3.5-32.4).

General practitioners play an important role in all facets of maternity care. Female and male GPs differ in their type of obstetric practice. If GPs are to maintain an intrapartum role, prompt action is required to increase the number of GPs involved in intrapartum care. The training requirements for shared care should be reviewed and a more suitable postnatal care curriculum should be developed.