Maternal–Fetal Medicine Workforce Survey: Are We Ready for Regionalized Levels of Maternal Care?

Abstract

Objective To conduct a survey of the members of the Society for Maternal-Fetal Medicine (SMFM) to determine the practice patterns of maternal–fetal medicine (MFM) subspecialists in the United States and to estimate the likelihood that our work force is sufficient to support the proposed MFM staffing requirements for level III and IV maternity centers.

Study Design All regular SMFM members in the United States were invited to answer a 26 question survey by email. The survey queried demographic characteristics, practice type, night call arrangements, and whether the respondent's hospital was currently equipped with the services and personnel described in the requirements for level III or IV centers.

Results Of the MFM specialists working full time in what would be considered a level III or IV maternity center, only 47.5% took in-house call. Of those taking only call from home or back-up call, the majority reported that during call hours, MFM antepartum and laboring patients are cared for by generalist obstetrician gynecologists; only 6.4% work with MFM hospitalists. Respondents from level III or IV centers also reported that many of their centers did not meet the criteria for nursing support, anesthesia support, or intensive care services.

Conclusion These data, if confirmed, indicate that work needs to be done to upgrade services and achieve appropriate staffing to meet the proposed level III and IV criteria for maternity care.

Keywords

maternal–fetal medicine workforce - maternity levels of care

• References

• 1 The American College of Obstetricians and Gynecologist and the Society for Maternal Fetal Medicine. Obstetric Care Consensus No. 2. Levels of Maternal Care. February 2015, reaffirmed 2016
• 2 Wenstrom K, Erickson K, Schulkin J. Are obstetrician-gynecologists satisfied with their maternal-fetal medicine consultants? A survey. Am J Perinatol 2012; 29 (08) 599-608
• 3 Centers for Disease Control and Prevention. Pregnancy Mortality Surveillance System. Available at: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pmss.html . Accessed February 5, 2018
• 4 Sciscione A, Berghella V, Blackwell S. , et al; Society for Maternal-Fetal Medicine (SMFM). Society for maternal-fetal medicine (SMFM) special report: the maternal-fetal medicine subspecialists' role within a health care system. Am J Obstet Gynecol 2014; 211 (06) 607-616
• 5 Rayburn WF, Klagholz JC, Elwell EC, Strunk AL. Maternal-fetal medicine workforce in the United States. Am J Perinatol 2012; 29 (09) 741-746
• 6 Sullivan SA, Hill EG, Newman RB, Menard MK. Maternal-fetal medicine specialist density is inversely associated with maternal mortality ratios. Am J Obstet Gynecol 2005; 193 (Pt 2): 1083-1088
• 7 D'Alton ME, Bonanno CA, Berkowitz RL. , et al. Putting the “M” back in maternal-fetal medicine. Am J Obstet Gynecol 2013; 208 (06) 442-448
• 8 Rayburn WF. The Obstetrician–Gynecologist Workforce Facts, Figures, and Implications in the United States 2017. Washington DC: The American Congress of Obstetrics and Gynecologists; acog.org/workforce
• 9 The American Board of Obstetrics and Gynecology, Inc. 2018 Bulletin for the Certifying Examination in Obstetrics and Gynecology. Available at: https://www.abog.org/new/publication.aspx . Accessed February 5, 2018
• 10 D'Alton ME. Where is the “M” in maternal-fetal medicine?. Obstet Gynecol 2010; 116 (06) 1401-1404