The Geographic Distribution of Family Physicians Providing Maternity Care and Opportunities for Expanding Access to Care in Rural Areas.

Abstract

Family physicians (FPs) are an important segment of the maternity workforce, particularly in rural areas. This research explores the geographic distribution of family physicians providing maternity care and identifies opportunities for family physicians to expand access to maternity care. This cross-sectional study used a co-location mapping approach to identify 3 types of counties based on the following: (1) family physicians as the only clinician provider of maternity care along with at least 1 hospital providing obstetric care (FP with Hospital); (2) family physicians as the only clinician provider of maternity care with no hospital providing obstetric care (FP Only); (3) no clinician providers of maternity care but county has at least 1 hospital providing obstetric services (Only Hospital). Most of the 325 counties across the 3 types are rural and concentrated in the central United States, the upper Midwest, and in Mississippi. More than one-third of these counties are found in just 4 states-Texas, Iowa, Nebraska, and Kansas. Although there are not clear differences in the geographic distribution of FP Only and FP with Hospital counties, Only Hospital counties are located primarily in a few states, including Mississippi, Missouri, Oklahoma, and Texas, and have significantly higher percentages of Black populations. Our findings demonstrate that while FPs are providing maternity care in rural areas across the United States, opportunities exist to expand their reach, particularly in Mississippi, Texas, and Oklahoma.