Obstetrical consultations in a community hospital.

This paper describes the pattern of obstetrical consultations in a family practice oriented obstetric service to a mixed urban/farming community of 60,000 living within a 60 km radius of a well-equipped community hospital. Over the past few years the annual number of deliveries has been 700-750. Referral patterns are affected by changing patterns of practice, availability of diagnostic techniques, and consumer expectations. Early risk assessment by the family physician is the key to improved prenatal care. More than 60% of obstetrical patients in this community are totally managed by family physicians; the remainder involve collaboration with a consultant at some stage. Indications for referral occur throughout the phases of pregnancy. The success of this family physician service is the result of good family physician/consultant relationships in the small community hospital.