Why family physicians deliver babies.

BACKGROUND: Numerous factors have been hypothesized to explain the steady decline of family physicians providing maternity care. Rather than exploring reasons for departure, we sought to learn why many family physicians choose to deliver babies.
METHODS: A previously piloted questionnaire was mailed to 1300 family physicians who had attended continuing education programs related to pregnancy. The respondents were classified as: those who had always delivered babies (group 1: "Always Did"); those who had previously not delivered babies, but had started or planned to start doing deliveries (group 2: "Started Later or Plan"); and those who had never delivered babies or had previously delivered but stopped (group 3: "Will Not Do"). The study focused on the reasons respondents in the first two groups decided to deliver babies and contrasted their views with those of the third group.
RESULTS: Five hundred seventy-five valid responses were returned (421 "Always Did"; 92 "Started Later or Plan"; 62 "Will Not Do"). Response patterns were similar for all geographic regions. Reasons for delivering babies that appeared with statistically significant frequency included personal enjoyment, adequate obstetrical training in residency, desire to care for younger families, and supportive obstetricians during residency. Reasons for not delivering babies included unacceptable lifestyle, a community's saturation of maternity caregivers, fear of law-suit, and absence of need to build a practice.
CONCLUSIONS: Family physicians who deliver babies appear to be primarily motivated by personal enjoyment, followed by a desire to care for younger patients and adequate training in residency. Those who do not perform deliveries primarily cite the unacceptability of a maternity caregiver's lifestyle. The expectation of the practice and a lack of community need are also important influences on the decision of family physicians to deliver babies.