A Comparison of Pregnancy Care Delivered by Family Physicians Versus Obstetricians in Lebanon

Abyad. A, Homsi
Tripoli,Lebanon,P.O Box 618, Abyad Medical Center.
Family Medicine. 1993; 25( 7): 465-470.

Background. The provision of prenatal and intrapartum care is an important issue in family medicine. Physician specialty as a risk factor for adverse perinatal outcome is of interest to both educators and patients. The purpose of this study is to compare perinatal care for low-risk women that was provided by family medicine versus obstetrics residents in Lebanon.
Methods. A matched-pair study of low-risk pregnant women was conducted at the American University of Beirut Medical Center to compare the outcome of perinatal care provided by family physicians (FP) and obstetricians (OB). The medical records of women admitted for delivery at the American University of Beirut Medical Center (AUBMC) between October 1, 1986, to October 1, 1990 were reviewed. The total number of matched pairs was 400.
Results. OB utilized oxytocin induction significantly more frequently than FP (43% vs. 7%, p<.01). A similar significant difference was also noted for artificial rupture of membranes. There were similar episiotomy rates (63%), with a greater number of lacerations reported among women cared for by OB (28% vs. 15%, p<.05).
The use of forceps was similar in both groups. Vacuum extraction was not used by FP. Neonatal outcomes were comparable although meconium stained amniotic fluid was more common in the OB group (21% vs. 6%, p<.05). In the postpartum period, there were significantly more women breast feeding (62% vs. 45%, p<.01), and more women using birth control pills in the FP group.
Conclusions. When caring for low-risk pregnant women, FP appear to provide comparable care with less intervention than obstetricians.