The provision of labor and delivery services by graduates of four Kansas family practice residencies.

The provision of labor and delivery services by family physicians is especially important in largely rural states such as Kansas. The decline in the number of family physicians offering labor and delivery services threatens those who depend on access to primary health care in rural areas. A survey was mailed to all 370 of the University of Kansas School of Medicine-Wichita (UKSM-W) family practice residency graduates. Two hundred sixty-five (72%) graduates responded, of whom 206 are in private practice. Eighty percent of responding graduates practice in communities of less than 100,000, and 72% of those physicians provide labor and delivery services. Although 48 of 206 graduates have ceased delivering babies, 131 still do so, averaging 41 deliveries per year. Sixty-five graduates perform C-sections, averaging 12 per year. CONCLUSIONS. UKSM-W graduates afford rural patients considerable access to care. Income, work hours, and practice satisfaction were similar in all three groups (no delivery, delivery without cesarean section, and cesarean section). Policy makers are justified in expanding educational programs in family practice that emphasize complete care of the pregnant woman.