Maternity care practices of navy family practice residency graduates after leaving the military.

BACKGROUND: Nationwide, 32% of residency-trained family physicians deliver babies compared with 73% to 90% in the military. This study describes and defines issues that could ultimately help revive family practice maternity care. METHOD: We surveyed 112 family physicians who had left the navy. RESULTS: Ninety-one percent had delivered babies in the navy, 45% since leaving the military, and 25% currently. Principal maternity care incentives both in and out of the military were personal and professional satisfaction. Reasons for not providing civilian maternity care included malpractice risks, insurance costs, and lifestyle issues. The decision for providing maternity care was usually made before or during residency, whereas the decision against was most often made upon leaving the military. Among more recent graduates (1990-1995), 48% continued to deliver babies in civilian practice. (This is about 20% more than recent civilian graduates.) Malpractice concerns were less important to this group than to earlier graduates. CONCLUSIONS: Factors discouraging family physicians from providing maternity care arise from their practice environment and are not easily overcome with improved training and experience. Recent navy residency graduates are not as easily discouraged.

The maternity care practice of Navy family practice residency graduates while on active duty.

BACKGROUND AND OBJECTIVES: Military family practice residency programs produce a high percentage of graduates who provide maternity care. This study will define the scope of maternity care practice for one military family practice residency program's graduates while they were serving on active duty in the U.S. Navy. METHODS: Two hundred eight surviving graduates of the family practice residency at Naval Hospital, Jacksonville, Florida, from 1971 to 1995 were surveyed by mail regarding their maternity care practice while on active duty. One hundred eighty-one (87%) responded to the survey, and the data were analyzed with descriptive statistics. FINDINGS: The vast majority of these Navy family practice residency graduates provided prenatal care (88.4%) and routine vaginal delivery services (85.1%) while on active duty. The majority repaired third- and fourth-degree perineal lacerations and performed vacuum- or forceps-assisted vaginal delivery. Additionally, a significant minority provided more advanced maternity care services such as dilation and curettage, tubal ligation, and cesarean section. The overwhelming majority (97%) of these graduates felt that their residency education had adequately prepared them to provide these maternity care services while on active duty. CONCLUSIONS: During the past 25 years, Navy residency-trained family physicians provided a wide range of maternity care services while on active duty and felt that their Navy residency training program had prepared them well to meet this responsibility.