Obstetric Provider Trainees in Georgia: Characteristics and Attitudes About Practice in Obstetric Provider Shortage Areas
Objectives In Georgia, 52 % of the primary care service areas outside metropolitan Atlanta have a deficit of obstetric providers. This study was designed to identify factors associated with the likelihood of Georgia’s obstetric trainees (obstetrics and gynecology (OB/GYN) residents and certified nurse midwifery (CNM) students) to practice in areas of Georgia that lack obstetric providers and services, i.e. rural Georgia. Methods Pilot-tested electronic and paper surveys were distributed to all of Georgia’s OB/GYN residents (N = 95) and CNM students (N = 28). Mixed-methods survey questions assessed characteristics, attitudes, and incentives that might be associated with trainee desire to practice in areas of Georgia that lack obstetric providers and services. Surveys also gathered information about concerns that may prevent trainees from practicing in shortage areas. Univariate and bivariate analyses were performed, and qualitative themes were abstracted from open-ended questions. Results The survey response rate was 87.8 % (108/123). Overall, 24.4 % (19/78) of residents and 53.6 % (15/28) of CNM students expressed interest in practicing in rural Georgia, and both residents and CNM students were more likely to desire to practice in rural Georgia with the offer of any of six financial incentives (P < 0.001). Qualitative themes highlighted trainees’ strong concerns about Georgia’s political environment as it relates to reproductive healthcare. Conclusions Increasing state-level, rurally-focused financial incentive programs and emphasizing the role of CNMs may alleviate obstetric provider shortages in Georgia.
KeywordsAccess Obstetrics Training programs OB/GYN residents Certified nurse midwives
The research team would like to thank the March of Dimes Georgia Chapter and the Georgia Department of Public Health for their generous funding in support of this research. We would also like to acknowledge the Georgia OB/GYN Society and Pat Cota, Dr. Andrew Dott, Bridget Spelke, and the Georgia Board for Physician Workforce for their guidance. The authors would also like to recognize the ongoing efforts of the GMIHRG research collaborative to address threats to maternal and infant health in Georgia.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 2.American Congress of Obstetrics and Gynecology. (2012). Health care systems for underserved women. Committee Opinion No. 516. Obstet Gynecology, 119, 206–209.Google Scholar
- 3.Centers for Disease Control and Prevention. (2010). Births: Final data for 2010. National Vital Statistics Report, 61(1), 1–71.Google Scholar
- 5.Fonkert, J. H. (2007). Rural Minnesota’s health care workforce: Demographics, geography, and strategies. Rural Minnesota Journal, 2(1), 53–71.Google Scholar
- 6.Georgia Board for Physician Workforce. Report Information. Physician Workforce Resource Center. https://gbpw.georgia.gov/report-information. Accessed June 2015.
- 7.Georgia Department of Public Health. (2015). Georgia maternal mortality: 2012 case review. http://dph.georgia.gov/sites/dph.georgia.gov/files/MCH/MMR_2012_Case_Review_June2015_final.pdf. Accessed Aug 2015.
- 8.Kaiser Family Foundation. (2010). State health facts, infant mortality rate. www.kff.org/other/state-indicator/infant-death-rate. Accessed June 2015.
- 9.March of Dimes. (2015). Premature birth report cards. http://www.marchofdimes.org/materials/premature-birth-report-card-georgia.pdf. Accessed January 2016.
- 10.Rayburn, W. F. (2011). The obstetrician-gynecologist workforce in the United States—Facts, figures and implications. Washington, DC: American Congress of Obstetricians and Gynecologists.Google Scholar
- 12.Spelke, B., Zertuche, A., & Rochat, R. (2016). Obstetric provider shortage—Georgia, 2011. Maternal and Child Health Journal (submitted).Google Scholar
- 13.United States Department of Health and Human Services (US DHHS). (2013). Centers of Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Division of Vital Statistics (DVS). Linked birth/infant death records 2007–2013, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program, on CDC WONDER Online Database. http://wonder.cdc.gov/lbd-current.html. Accessed January 2016.
- 14.Zertuche, A., et al. (2016). Georgia Maternal and Infant Health Research Group (GMIHRG): Mobilizing allied health students and community partners to put data into action. Maternal and Child Health Journal (submitted).Google Scholar