Rebecca Williams, MD, MHPE, FAAFPMaternity Care Coordinator

Montefiore Department of Family and Social Medicine Bronx, New York

Full scope = diagnosis of pregnancy, prenatal, intrapartum, delivery & postpartum care.

Shared care = planned, structured involvement of two or more health care professionals. Typically, one provider renders prenatal, postpartum and newborn care while the other supplies intrapartum care.

Duration & Scope

There must be a minimum of 2 months ofexperience in maternity care, including theprinciples and techniques of prenatal care,management of labor and delivery, andpostpartum care.

Each resident must become capable of managing a normal pregnancy and delivery.

Total Deliveries

Each resident must perform a minimum of 40deliveries over the 3- year program, of which aminimum of ten must be continuity deliveries. Atleast 30 of the total deliveries must be vaginaldeliveries.

Two residents may be given credit for the same delivery if one of those residents is supervising. The experience of each resident must be documented as to the role played in the delivery.

For the minimum of 10 continuity patientdeliveries, each resident must assumeresponsibility for provision of antenatal, natal, and postnatal care during their three years of training. Whenever possible, these patients should be derived from the residents' panels of patients in the FMC. Where this is not possible, the continuity experiences may be met at other clinical sites with Appropriate supervision. A list of these patients must be available in the resident's file.

In 1997, Taylor & Hansen conducted aDelphi study of faculty at familypractice residencies that produce a large percentage of graduates doing OB.

Faculty provide maternity care Family medicine department credentials fps doing maternity care

FP residents have real responsility Curriculum encourages maternity care

Family physicians accepted in the community as maternity care providers

2 definitions for ideal volume:1. 40 deliveries w/ 10 continuity2. 100 deliveries w/20-30 continuity

2 months & 40 deliveries provides exposure Aim for 100 deliveries

FMDRL WIKI Maternity Care Electives

Boyle G, Banks Jr, Petrizzi M, Larimore W. Sharing maternity care. Fam Pract Manag 2003;10:37-40.

Maternity Care in New York City AAFP Practice Survey ACGME Taylor H, Hansen, G. Perceived characteristics of successful family

practice residency maternity care training programs. Fam Med 1997;29(10):709-14.