• J Kaczorowski and C Levitt.
• Department of Family Medicine at McMaster University, Hamilton. kaczorow@fhs.McMaster.ca
• Can Fam Physician. 2000 Mar 1; 46: 587-92, 595-7.

ObjectiveTo determine provincial trends in provision of intrapartum care by general practitioners and family physicians (GP/FPs) for the 11 years from 1984 to 1995.DesignAnalyses of provincial Medical Care Fee-for-Service Utilization data for births from 1984-1985 to 1994-1995.Setting10 provinces of Canada.Main Outcome MeasuresProportion of vaginal births billed by GP/FPs (expressed as total number of vaginal births billed by GP/FPs divided by total number of vaginal births).ResultsIn 1994-1995, the proportion of vaginal births billed by GP/FPs ranged from 77.2% in British Columbia and 70.8% in Nova Scotia to 28.9% in Ontario and 23.6% in Prince Edward Island. These proportions have remained relatively high and stable during the period studied in some provinces, such as British Columbia and Nova Scotia, and have declined steadily and notably in others.ConclusionsData show that GP/FPs' involvement in vaginal births in most Canadian provinces is decreasing. This trend demonstrates a shift in GP/FPs' practice patterns and could indicate a coming shortage of obstetrical care providers.

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