Family physicians in maternity care - Still in the game? Report from the CFPC's Janus Project

OBJECTIVE To describe family doctors' contribution to maternity care in Can ada and to observe the influence of age, sex, region of the country, and pr actice population on provision of maternity care. DESIGN Survey: College of Family Physicians of Canada's Janus Project natio nal family physician survey. SETTING All 10 provinces and two territories. PARTICIPANTS Random sample of family physicians and general practitioners, both members and non-members of the College. MAIN OUTCOME MEASURES Proportion of family doctors participating in prenata l, intrapartum, postpartum, and newborn care, and proportion of doctors inv olved in intrapartum care by age, sex, location in Canada, and practice pop ulation. RESULTS Overall response rate was 58%. Just over 50% of all family doctors in Canada are involved in some aspect of maternity care; 19% do intrapartum care; and 33% are involved in prenatal (shared) care. Similar proportions of men and women still do intrapartum care, but women care for more pregnan cies than men. More family doctors serving rural areas are doing intrapartu m care compared with doctors in urban areas, although those in urban areas tend to do more deliveries. The western provinces have the highest percenta ges of intrapartum caregivers. A gradual decline in percentage of intrapart um caregivers by age group increases among the 55- to 64-year-old cohort. A lmost a quarter of women doctors younger than 35 years are doing intrapartu m care. Most physicians doing prenatal (shared) care look after women until the third trimester. CONCLUSIONS Family doctors are still providing a large proportion of matern ity care in Canada. This contribution must be nurtured by the College throu gh its Maternity and Newborn Care Committee and other contacts to encourage family doctors to continue offering this essential service to childbearing women in Canada.