Family medicine
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Comparative Study
Trends in maternity care by graduates and the effect of an intervention.
Only 24% of family physicians in the United States deliver babies, a figure that declined remarkably during the decade of the 1980s. This study examines the content of practice, with regard to maternity care, of graduates of the University of California, Davis Family Practice Residency Network over the past 20 years, and the effectiveness of residency training intervention designed to increase maternity care activity among graduates. ⋯ This study documents the decrease in interest in providing obstetrical services by recent family practice residency graduates when compared to graduates a decade earlier. Further, it suggests that residency programs, even with very low rates of participation in maternity care, can increase the interest and participation of residents to include these services in their practices after graduation.
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The proportion of infants in the United States adequately immunized with DTP (Diphtheria, Tetanus and Pertussis) vaccine is below other industrialized nations and lowest among infants living in urban areas. At present, predictors of poor immunization are not well developed. In particular, the relationship between prenatal care utilization and childhood vaccination is not clearly defined. ⋯ Maternal demographics and health care utilization predict infant immunization rates. Use of these variables may permit early identification and case management of mothers of infants at high risk for immunization delay.
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Since abortion has become a focus of increased public attention, it is important to assess family physicians' attitudes and scope of training regarding this outpatient procedure. ⋯ If the number of family physicians providing abortions is to be increased, residency programs must offer abortion training as a more fully recognized part of the family medicine curriculum.