Family Medicine Maternity Care Call to Action: Moving Toward National Standards for Training and Competency Assessment.

Maternity care is an integral part of family medicine, and the quality and cost-effectiveness of maternity care provided by family physicians is well documented. Considering the population health perspective, increasing the number of family physicians competent to provide maternity care is imperative, as is working to overcome the barriers discouraging maternity care practice. A standard that clearly defines maternity care competency and a systematic set of tools to assess competency levels could help overcome these barriers.

Has mifepristone medical abortion expanded abortion access in New Mexico? A survey of OB-GYN and Family Medicine physicians.

Background: The FDA approval of mifepristone in 2000 broadened the available options for abortion. The aim of this study was to evaluate whether physicians in New Mexico have integrated the use of mifepristone into their practice.

Study Design: We performed a mail-out survey of New Mexico Obstetrician Gynecologists (Ob-Gyn) and Family Medicine (FM) physicians in 2001 and 2008.

Compliance with mandated emergency contraception in New Mexico emergency departments.

Objective: New Mexico enacted a law in 2003 requiring that emergency departments (EDs) offer emergency contraception (EC) to survivors of sexual assault and that both doses be administered in the ED. This investigation sought to examine practices and knowledge of ED providers about EC in the setting of sexual assault.

Methods: We visited hospitals in New Mexico from July 2005 to December 2005 and administered an 18-item questionnaire to three providers-a physician, a nurse, and a clerk-in the ED.

Venous thromboembolism during pregnancy.

Venous thromboembolism is the leading cause of maternal death in the United States. Pregnancy is a risk factor for deep venous thrombosis, and risk is further increased with a personal or family history of thrombosis or thrombophilia. Screening for thrombophilia is not recommended for the general population; however, testing for inherited or acquired thrombophilic conditions is recommended when personal or family history suggests increased risk.

Abortion education in the medical curriculum: a survey of student attitudes.

Background: The purpose of this study was to evaluate student attitudes toward the inclusion of abortion education in the preclinical and clinical medical school curriculum.

Study Design: All students completing the OB-GYN rotation from May 2004 through January 2005 (n=118) were asked to complete a 21-item survey. Survey questions focused on students' attitudes about the appropriateness of abortion education, reasons for participation or nonparticipation in the abortion care experiences in the clinical curricula and the value of abortion education.

Why obstetrics/gynecology, and what if it were not an option? A survey of resident applicants.

Objective: The purpose of this study was to assess the secondary residency choice of obstetrics/gynecology and family medicine residency applicants and to determine the most and least appealing aspects of each specialty.

Study Design: This prospective cohort study surveyed residency applicants in obstetrics/gynecology and family medicine from 2004-2007 at the University of New Mexico (obstetrics/gynecology and family medicine) and the University of California-San Francisco (obstetrics/gynecology). Applicants completed an anonymous 5-question survey about their secondary choice of specialty, least likely residency choice, and the most and least appealing aspects of their chosen specialty.

Dystocia in nulliparous women.

Dystocia is common in nulliparous women and is responsible for more than 50 percent of primary cesarean deliveries. Because cesarean delivery rates continue to rise, physicians providing maternity care should be skilled in the diagnosis, management, and prevention of dystocia. If labor is not progressing, inadequate uterine contractions, fetal malposition, or cephalopelvic disproportion may be the cause.

Postpartum genitourinary changes.

Genitourinary changes following childbirth and pregnancy are common, and include urinary and anal incontinence, pelvic pain, sexual dysfunction, and pelvic organ prolapse. At present, it is unclear whether or not these changes are a result of the pregnancy itself or the mode of delivery (cesarean section or vaginal birth). In this article, the authors aim to describe genitourinary postpartum pelvic floor changes, and review the literature regarding the impact of pregnancy or childbirth on these changes.

Conformity with current guidelines on oral contraceptive prescribing for breastfeeding women: a New Mexico survey.

Background: National and international contraceptive guidelines reflect expert opinion that recommends against the use of estrogen-containing hormonal contraception in the early postpartum period. This study was undertaken to estimate providers' practices in prescribing hormonal contraception to breastfeeding women.

Methods: A 19-item survey was mailed to 397 obstetrician gynecologists, midwives and family physicians in the state of New Mexico.

A breastfeeding curriculum for residents and medical students: a multidisciplinary approach.

Medical school and residency training programs, in which practice patterns are established, frequently lack formal education in breastfeeding in the United States. This project, a curriculum based on the Wellstart Lactation Management Guide, was developed for resident physicians and medical students at the University of New Mexico to address the deficiency in formal education about breastfeeding. The curriculum, developed and implemented by faculty members from obstetrics/gynecology, pediatrics, and family medicine, includes formal interactive teaching sessions, discussion of breastfeeding issues on daily clinical rounds, and patient visits with lactation support personnel.