A crisis aborning in maternity and newborn care?

681 Participants attending a conference on maternity care in London, Ont., last November said Canada is heading for a crisis because a shortage looms in the number of professionals available to provide maternal and newborn care. British Columbia family physician Michael Klein noted that the percentage of births handled by FPs has been declining since 1975. Canadian Institute for Health Information (CIHI) data show that the percentage of vaginal delivery billings by family physicians fell from 55% of total births in 1985 to 45% in 1995. Prince Edward Island recorded the largest drop, from 57% to 24%, while Nova Scotia and BC showed little change. There are also marked variations across the country in the proportion of GP/FPs providing obstetrical care. In 1994/95, 22.5% of Canadian FPs were providing intranatal obstetrics, compared with only 8.9% of FPs in Quebec. However, that province recorded the largest number of deliveries per family physician — 46.9 deliveries per year — compared with 23.9 for Canada as a whole. Physician survey data collected by the CMA also show a decrease in the percentage of family physicians doing obstetrics, a drop from 36% in 1982 to 18% in 2000. Dr. Janusz Kaczorowski, a conference participant, said FPs stop doing obstetrics for reasons ranging from lifestyle issues to fear of litigation and concerns about insufficient training and shifts in consumer preferences. In a BC study, 45% of all family physicians currently performing obstetrics expect to leave the field within the next 5 years. Obstetricians/gynecologists at the conference did not feel they would be able to pick up the shortfall. Klein concluded that those who fail to recognize the importance of establishing call groups will be less likely to continue providing maternity care in the future. He suggested that a solution must be found between “martyrdom and quitting.” — Lynda Buske, [email protected] 1982 1986 199