Online Program

Does provider choice matter? : Maternal experience with obstetricians, family medicine physicians, and midwives

Tuesday, November 5, 2013

Susan Fields Mead, MPH, Quantitative Methods, Harvard School of Public Health, Boston, MA
Eugene Declercq, PhD, Community Health Sciences Department, Boston University School of Public Health, Boston, MA
Background: Past research suggests that family physicians and midwives approach maternity care differently than obstetricians, without significant differences in the rates of maternal or neonatal complications. Methods: Listening to Mothers III (LTM3) is a 2012 United States national survey of 2,416 mothers concerning their childbirth experiences in the year prior to the survey. It was conducted by Harris Interactive. The objective of this analysis is to determine whether a mother's original choice of maternity care provider profession (obstetricians, family physician or midwife), had any impact on the profession of the provider from who attended the birth and factors that may have influenced these patterns. Results from LtM3 are not available until March, 2013 so results from LtM2 are used below to illustrate possible analyses. Results: Eighty percent of women chose an obstetrician for their prenatal care, and 93.4% of these women were attended by an obstetrician at delivery. 8.3% of women chose a family physician for their prenatal care, and only 68.8% of these women were attended by a family physician at delivery (21.1% by an obstetrician). 9.4% of women chose a midwife for their prenatal care, and 67.6% were attended by a midwife at the time of delivery (26.2% by an obstetrician). Preliminary analysis of maternal risk profiles suggests not all the variation can be accounted for by maternal prenatal health. Conclusion: This analysis will identify transfer levels and the likely causes for mothers to switch from family physicians and midwives in prenatal care to obstetricians for birth.

Learning Areas:

Provision of health care to the public
Public health or related research

Learning Objectives:
Identify provider transfer levels among women who chose family medicine physicians or midwives for prenatal care. Analyze maternal prenatal risk profiles to determine level of association with transfer to specialty care. Discuss likely causes for transfer of care from family medicine physicians and midwives to obstetricians at the time of delivery.

Keyword(s): Maternal Care, Providers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a fourth year medical student and will receive my master's degree in public health in quantitative methods in May 2013. My research interests include childbirth practices and maternal outcomes, specifically focusing on the differences in care provision depending on provider.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.