Practice Barriers Deter Family Physicians from Providing Obstetrical Care


Leslie Champlin
Senior Public Relations Strategist
(800) 274-2237, Ext. 5224 


WASHINGTON, DC — In an era when the maternal death rate is climbing and the number of obstetricians and hospital maternity units is falling, family physicians could help meet demand for prenatal and labor and delivery care. But they aren’t. Although one in four new family medicine graduates want to provide such care, most are blocked from doing so.

The culprit: lack of opportunity in their practices, according to Tyler Barreto, M.D., a Robert Graham Center visiting fellow alumna and assistant professor in the Department of Family and Community Medicine at the University of Texas Health San Antonio.

“Fewer family physicians are providing deliveries, which raises concern for access to obstetric care,” Barreto and her coauthors wrote in “Barriers Faced by Family Medicine Graduates Interested in Performing Obstetric Deliveries(” “We found that among recent family medicine graduates who would like to do deliveries, difficulty finding a position that supports including deliveries was a major barrier.”

The study was published in the May/June issue of the Journal of the American Board of Family Medicine.

Barreto analyzed data from the 2016 Family Medicine National Graduate Survey to determine whether recent graduates were currently delivering babies. Those who indicated they were not doing so then were asked why they were not, with a “select all that apply” list of nine response options.

Of the 2,018 respondents who provide patient care, nearly nine in 10 said they did not deliver babies. After excluding 889 respondents who were not interested, Barreto examined responses of the remaining 865 new family physicians. Six in 10 respondents said the opportunity to provide deliveries “was not available in the practice they joined” or expressed concerns about work-life balance.

“New family physicians who are interested in including deliveries in practice are poised to play a critical role in increasing access to obstetric care if the primary barriers are identified and addressed,” Barreto wrote. She recommended increasing the number of family medicine positions that include obstetrics and structuring on-call schedules to balance work demands.

“Removing barriers to family physicians who want to include obstetrics would increase access to care and may be part of the solution to the maternal morbidity problem,” she wrote.

Barreto’s current research builds on her earlier study( that confirmed a decline in the number of family physicians providing obstetric care and that pointed to the need for changes in insurance payment policies or hospital credentialing policies. 


About the Robert Graham Center

The Robert Graham Center for Policy Studies in Family Medicine and Primary Care works to improve individual and population health by enhancing the delivery of primary care. The Center staff generates and analyzes evidence that brings a family medicine and primary care perspective to health policy deliberations at local, state, and national levels.

Founded in 1999, the Robert Graham Center is an independent research unit affiliated with the American Academy of Family Physicians (AAFP). The information and opinions contained in research from the Center do not necessarily reflect the views or policy of the AAFP.