Maternal and Child Health Journal

, Volume 20, Issue 7, pp 1341–1348

Obstetric Provider Trainees in Georgia: Characteristics and Attitudes About Practice in Obstetric Provider Shortage Areas

  • Elizabeth A. Smulian
  • Leilah Zahedi
  • Julie Hurvitz
  • Abigail Talbot
  • Audra Williams
  • Zoë Julian
  • Adrienne D. Zertuche
  • Roger Rochat
Article

Abstract

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.

Keywords

Access Obstetrics Training programs OB/GYN residents Certified nurse midwives 

References

  1. 1.
    Angood, P., et al. (2010). Blueprint for action: Steps toward a high-quality, high-value maternity care system. Women’s Health Issues, 20(1), S18–S49.CrossRefPubMedGoogle Scholar
  2. 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. 3.
    Centers for Disease Control and Prevention. (2010). Births: Final data for 2010. National Vital Statistics Report, 61(1), 1–71.Google Scholar
  4. 4.
    Duffrin, C., et al. (2014). Factors associated with placement of rural primary care physicians in North Carolina. Southern Medical Journal, 107(11), 728–733.CrossRefPubMedGoogle Scholar
  5. 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. 6.
    Georgia Board for Physician Workforce. Report Information. Physician Workforce Resource Center. https://gbpw.georgia.gov/report-information. Accessed June 2015.
  7. 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. 8.
    Kaiser Family Foundation. (2010). State health facts, infant mortality rate. www.kff.org/other/state-indicator/infant-death-rate. Accessed June 2015.
  9. 9.
    March of Dimes. (2015). Premature birth report cards. http://www.marchofdimes.org/materials/premature-birth-report-card-georgia.pdf. Accessed January 2016.
  10. 10.
    Rayburn, W. F. (2011). The obstetrician-gynecologist workforce in the United StatesFacts, figures and implications. Washington, DC: American Congress of Obstetricians and Gynecologists.Google Scholar
  11. 11.
    Ronsmans, C., & Graham, W. (2006). Maternal mortality: Who, when, where, and why. Lancet, 368(9542), 1189–1200.CrossRefPubMedGoogle Scholar
  12. 12.
    Spelke, B., Zertuche, A., & Rochat, R. (2016). Obstetric provider shortage—Georgia, 2011. Maternal and Child Health Journal (submitted).Google Scholar
  13. 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 20072013, 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. 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

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Elizabeth A. Smulian
    • 1
  • Leilah Zahedi
    • 2
  • Julie Hurvitz
    • 2
  • Abigail Talbot
    • 1
    • 2
  • Audra Williams
    • 1
    • 2
  • Zoë Julian
    • 1
    • 2
  • Adrienne D. Zertuche
    • 1
    • 2
    • 3
  • Roger Rochat
    • 1
  1. 1.Emory University Rollins School of Public HealthAtlantaUSA
  2. 2.Emory University School of MedicineAtlantaUSA
  3. 3.Department of Gynecology and ObstetricsEmory University School of MedicineAtlantaUSA

Personalised recommendations