Trends in Family Physicians Performing Deliveries, 2003-2010

Objective: This observational study examined the proportion of family physicians continuing to perform deliveries from 2003-2010. Methods: Data were collected annually from the same census questionnaire completed by family physicians who passed their recertification examination. Aggregated responses began in 2003 when data first became available electronically and ended in 2009 before recertification changes. Using cross-sectional design and logistic regression analysis, we examined associations between physician demographic or geographic factors and performance of deliveries. Results: The sample consisted of 49,267 family physicians between 2003 and 2009, including 7,456 in 2009. The proportion performing any deliveries declined by 40.6 percent, from 17.0 percent in 2003 to 10.1 percent in 2009. Most recently, 5.5 percent of all family physicians delivered 1-25 babies per year, whereas 2.8 percent delivered 26-50, and 1.9 percent delivered ≥ 51. Those who performed deliveries were most likely to be junior members of a partnership or group practice, and provided prenatal and newborn care. Deliveries were more common in nonmetropolitan areas, where other obstetric practitioners were unavailable. Conclusions: The proportion of family physicians performing deliveries continues to decline with most delivering 25 or fewer babies per year. This change will require more effort by obstetrician-gynecologists and midwives in being primary birth attendants.