Family Medicine-Only Staffing at Birthing Hospitals Tied to Fewer C-Sections

THURSDAY, Sept. 26, 2024 (HealthDay News) — U.S. birthing hospitals staffed exclusively by family medicine (FM) physicians are more likely to have lower cesarean section rates, according to a study published online in the September/October issue of the Annals of Family Medicine.

Emily White VanGompel, M.D., from the University of Illinois at Chicago, and colleagues characterized the effect of the FM presence on unit culture and a key perinatal quality metric in Iowa hospital intrapartum units. The analysis included survey results from 849 Iowa clinicians (physicians, nurses, and midwives) delivering intrapartum care at 39 hospitals participating in a quality improvement initiative to decrease the incidence of cesarean delivery.

The researchers reported that 13 hospitals were FM-only (all rural), 11 OB-only, and 15 hospitals were both. They found that among hospitals with <1,000 annual births, births at FM-only hospitals had an adjusted lower risk for cesarean delivery (adjusted incident rate ratio, 0.66) versus hospitals with both. Nurses reported that at FM-only hospitals, unit norms were significantly more supportive of vaginal birth and had a stronger safety culture.

“Birthing hospitals staffed exclusively by FM physicians were more likely to have lower cesarean rates and stronger nursing-rated safety culture,” the authors write. “Both access and quality of care provide strong arguments for reinforcing the pipeline of FM physicians training in intrapartum care.”

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