Reply to “Supporting Family Physician Maternity Care Providers”

Drs Avery, Reed, and Skinner’s letter regarding our article “Supporting Family Physician Maternity Care Providers” illustrates how collaboration between providers can improve outcomes in maternity care and reduce health care costs.1 Lack of access to care is a key contributor to the maternal mortality crisis, and supporting family physician (FP) maternity care providers is essential to improve access to care.2 FPs’ roles in rural maternity care have been well documented in other studies.3,4The innovative approach to maternity care in West Alabama as described by our colleagues is a success story in provision of care for a rural, underserved community, and provides an excellent example of the kind of collaboration to which our article refers.

Our article discusses a variety of modalities for achieving and maintaining the skills necessary for FPs to provide maternity care, including operative skills, and also includes a table with examples of innovations in training and retention for rural FPs. Rather than requiring fellowships for all FPs, we recommend that health care systems promote the tiered training model.5 The skill sets described in this model (Table 3 in our article) can be acquired during a family medicine residency or fellowship, depending on a given program’s structure. Some FPs may even acquire these skills in practice with appropriate collaboration and mentorship from physicians in the community.

It is essential that family medicine be included as a partner to improve maternity care outcomes in communities, especially those with pronounced disparities. FPs with and without advanced maternity care skills, midwives, and obstetricians all bring distinct contributions to solving maternal health disparities and access, and our collaboration is of paramount importance to the future of maternal health.