OBJECTIVES: This study examined differences among obstetricians, family physicians, and certified nurse-midwives in the patterns of obstetric care provided to low-risk patients. METHODS: For a random sample of Washington State obstetrician-gynecologists, family physicians, and certified nurse-midwives, records of a random sample of their low-risk patients beginning care between September 1, 1988, and August 31, 1989, were abstracted. RESULTS: Certified nurse-midwives were less likely to use continuous electronic fetal monitoring and had lower rates of labor induction or augmentation than physicians. Certified nurse-midwives also were less likely than physicians to use epidural anesthesia. The cesarean section rate for patients of certified nurse-midwives was 8.8% vs 13.6% for obstetricians and 15.1% for family physicians. Certified nurse-midwives used 12.2% fewer resources. There was little difference between the practice patterns of obstetricians and family physicians. CONCLUSIONS: The low-risk patients ...

Interspecialty differences in the obstetric care of low-risk women.

Objective. To define the prenatal care utilization pattern in Bornova and determine the factors affecting the amount and content of prenatal care. Design. Follow-up study. Setting. Bornova is an urban district in western Turkey. Study participants. Two hundred and forty-five pregnant women registered with primary care settings in Bornova during the year 2000. Response rate was 83.7%. Main outcome measure. We determined the amount of prenatal care using Adequacy of Prenatal Care Utilization Index. Criteria used to assess the content of services include number of checks for maternal weight gain, blood pressure and foetal heart-beat measurements, advice about healthy lifestyles, laboratory examinations, and tetanus immunization. Results. Rates of the women who visited public primary health care settings, private care sources, and public hospitals at least once were 76.0, 57.1, and 54.6%, respectively. As to prenatal care, 64.9% of the participants received an adequate amount and 25.9% an adequate content. Parity (P = 0.00), insurance coverage (P = 0.00), abortion history (P = 0.03), husband’s occupation (P = 0.00), maternal age (P = 0.04), and level of educational attainment (P = 0.03) were related to the amount of care. Employment status (P = 0.03), continuous use of private sources (P = 0.00) and public hospitals (P =0.01) were associated with the content. Conclusion. This study has highlighted considerable associations between the amount of prenatal care and individual features in addition to those among the content of care, individual features and type of care sources. Causes of variations in prenatal care delivered in urban and relatively wealthy populations of developing countries must be explored using the appropriate criteria.

Factors associated with the utilization and content of prenatal care in a western urban district of Turkey

Background: This retrospective study compared obstetrician and family physician patient population demographics, obstetric outcomes, delivery methods, and medical risk factors. Methods: Obstetricians and family practice faculty and residents provided delivery services at an urban community hospital. A retrospective case study of all deliveries by obstetrician-gynecologists and family physicians in a 20-month period was analyzed with descriptive statistics, chi-square analysis, logistic regression, and power analysis. A modified risk score analysis was completed on all patients to assess comparability between the obstetrician and family physician patients. Results: Risk score analysis of the two patient populations demonstrated no difference in high-risk patients (P=0.102). Family physicians9 patients had a lower incidence of Cesarean section, use of forceps, diagnosis of cephalopelvic disproportion, and low-birth-weight babies. They had a higher incidence of spontaneous vaginal delivery, vaginal birth after previous Cesarean section, and vacuum extraction use. The overall Cesarean section rate for family physicians was 15.4 percent, compared with 26.5 percent for obstetricians. Conclusions: These findings support the high-quality outcomes of perinatal care provided by family physicians. They also provide evidence for training and privileging family physicians to perform their own Cesarean sections.

Perinatal Outcomes: A Comparison Between Family Physicians And Obstetricians

To determine differences in practice style and to examine maternal and neonatal outcomes, we reviewed the hospital charts of 1115 women admitted by family physicians and 1250 women admitted by obstetricians who gave birth at one of three teaching hospitals in Toronto between April 1985 and March 1986. All the women in the two groups were categorized retrospectively as being at low risk at the onset of labour on the basis of their prenatal records and their admission histories and physical examination results. There were higher proportions of younger women and women of lower socioeconomic status in the family physician group than in the obstetrician group (p less than 0.001). The rates of interventions, including artificial rupture of the membranes, induction, augmentation, low forceps plus vacuum extraction, episiotomy and epidural anesthesia, were all higher in the obstetrician group. The mean birth weight and the cesarean section rate were the same in the two groups. Differences in labour and delivery outcomes between the two groups, including a higher rate of spontaneous vaginal delivery for the family physicians, reflected a more "expectant" practice style by family doctors. However, there were no significant differences in the rates of maternal or neonatal complications. A practice style characterized by a higher rate of interventions was not associated with improved maternal or newborn outcome in this low-risk setting.

Differences in intrapartum obstetric care provided to women at low risk by family physicians and obstetricians

BACKGROUND Continuity of care has long been considered a benefit to patients of family physicians, but quantifying these benefits has been problematic. Previous studies focused on patient preferences and relationship issues, whereas evidence regarding clinical endpoints has been lacking. This study reports differences in obstetric and neonatal outcomes related to continuity in prenatal care. METHODS Using an historical prospective design, data were collected on 494 maternal-fetal dyads in two groups. One (named GAP, n = 40) received a high degree of continuity in their prenatal care, and one (named NHC, n = 454) received relatively little. Analyses were performed to determine not only the outcome differences between the groups, but also to what factor(s) these differences were attributable. RESULTS The continuity in prenatal care group had better outcomes in neonatal morbidity, birth weight, maternal weight gain, and both Apgar scores. None of these differences was directly attributable to continuity. Rather, continuity in prenatal care was associated with the observed increase in the number of prenatal visits, which in turn was shown to be a significant factor in the greater birth weights and maternal weight gain. None of the factors examined appears to explain the difference in neonatal morbidity. CONCLUSIONS Women who receive prenatal care from a single physician are likely to receive more prenatal care, which is correlated with greater maternal weight gains and greater fetal birth weights.

Clinical obstetric outcomes related to continuity in prenatal care.

The purpose of this study was to compare the obstetrical care provided by three different groups of physicians. Deliveries between July 1975 and July 1977 were tabulated and all 211 deliveries of the family physician (FP) group, and all 199 of the family practice residency (FPR) group were reviewed, as were a randomly selected group of 193 obstetrician (OB) deliveries. All hospital charts were reviewed for 81 variables. The FPR group had more patients who were poor, single, and nulliparous. They presented later in pregnancy, were more often anemic, and had an increased incidence of venereal disease. The FPR and FP groups documented major psychological problems and depression more frequently. The obstetricians used caudal and epidural anesthesia more frequently, whereas the FP and FPR groups used more narcotics. Except for an increased incidence of third degree lacerations in the FP group, total maternal and fetal complications were few and similarly divided among the groups. The FPR and FP groups delivered 78 percent and the OB group 38 percent of their own patients. This paper is an addition to a limited literature base which deals with process and outcome of obstetrical care delivered by various provider groups and is unique in that the study was undertaken in a large prepaid group.

Obstetrical care in a prepaid cooperative: a comparison between family practice residents, family physicians, and obstetricians.

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Wanderer Mj

Author Tools

Chat about Author

Papers

Obstetrical care in a prepaid cooperative: a comparison between family practice residents, family physicians, and obstetricians.