Family practice obstetrics in a community hospital.

OBJECTIVE

To review obstetric care provided by family physicians and to determine why they transfer patients to obstetricians.

DESIGN

Retrospective chart review.

SETTING

Obstetrics department of a regional non-academic community hospital

PATIENTS

Of 683 women booked with family physicians for obstetrical care, 601 were admitted by family physicians and 82 were transferred to obstetricians before admission.

MAIN OUTCOME MEASURES

Risk score, induction, augmentation, consultation, forceps delivery, cesarean section, episiotomy, epidural anaesthesia, narcotic analgesia, neonatal birth weight and Apgar scores, and maternal complications.

RESULTS

Family physicians' patients had good maternal and neonatal outcomes; spontaneous delivery rate was 82%; cesarean section rate was 9%. Women transferred from family physicians to obstetricians before admission for delivery had a cesarean section rate of 63%.

CONCLUSIONS

Family physicians provided total obstetric care to most women in this community and transferred patients to obstetricians for expected reasons. Community hospitals with family physicians highly involved in providing obstetric care are likely ideal institutions for training future family physicians.