The Geographic Distribution of Family Physicians Providing Maternity Care and Opportunities for Expanding Access to Care in Rural Areas.
Level 4 - case-series / case-control
Cross-sectional ecological mapping study of county-level workforce and hospital distribution
PubMed 40721331 · doi:10.1370/afm.240073
What was done
This cross-sectional mapping study evaluated the geographic distribution of family physicians providing maternity care across the United States. Researchers categorized counties into three groups: (1) family physicians as the only maternity clinician providers alongside at least one hospital providing obstetric care, (2) family physicians as the only maternity clinician providers with no obstetric hospital, and (3) counties with an obstetric hospital but no clinician maternity care providers.
What was found
A total of 325 counties met criteria across the three types, the majority being rural and concentrated in the central United States, upper Midwest, and Mississippi. More than one-third of these counties were located in four states: Texas, Iowa, Nebraska, and Kansas. Counties with an obstetric hospital but no clinician providers were concentrated primarily in Mississippi, Missouri, Oklahoma, and Texas, and had significantly higher percentages of Black residents.
Why it matters
This study pinpoints specific geographic regions and racial disparities where hospital obstetric capacity exists without clinician maternity providers, highlighting targets for expanding family physician-led maternity care.
Limits
The abstract provides aggregated county counts rather than specific numerical breakdowns for each category, exact provider counts, or clinical outcomes. County-level boundary analysis does not capture cross-border patient travel or sub-county geographic barriers to care.