Pregnancy, Perinatal, and Newborn Care by Family Physicians

Pregnancy, perinatal, and newborn care is a core discipline of the specialty of Family Medicine. The scope of practice for family physicians in pregnancy, perinatal, and newborn care is wide-ranging and may include preconception and prenatal care, management of medical complications during pregnancy, and comprehensive care of low- and high-risk pregnancies, including performing cesarean deliveries. Family physicians may provide immediate postpartum contraception, treatment for postpartum depression, permanent sterilization following delivery, and postpartum contraceptive management. Family physicians provide postpartum continuity of care to monitor and prevent sequelae of post-gestational conditions such as hypertension and diabetes mellitus. The American Academy of Family Physicians (AAFP) advocates that all Family Medicine residents receive basic pregnancy, perinatal, and newborn care training and that those residents who plan to practice the full scope of pregnancy, perinatal, and newborn care receive advanced training to include management of complications and surgical intervention.

The AAFP advocates that pregnancy, perinatal, and newborn care privileges should be based solely on the individual physician's training, experience, and demonstrated  current competence and not by specialty-specific designation alone. This may be accomplished by providing documentation of supervised training or experience received during residency or fellowship, or through successful completion of an approved recognized training course. See Education on Recognizing Obstetrical Emergencies section in policy on Striving for Birth Equity: Family Medicine's Role in Overcoming Disparities in Maternal Morbidity and Mortality. Family physicians should evaluate fellow family physicians in credentialing and privileging determinations.

The AAFP and the American College of Obstetrics and Gynecology (ACOG), recognize there are health care disparities for people living in both rural and urban underserved areas, including disparities in critical access to pregnancy, perinatal, and newborn care. People living in underserved areas are more likely to be uninsured or underinsured, have lower income levels, and receive Medicaid or Medicare. People living in rural areas also often travel farther for health care and receive less frequent care than people living in urban areas. In some rural areas, family physicians provide 100% of pregnancy care. The AAFP is committed to improving access to quality health care, including comprehensive pregnancy, perinatal, and newborn care, for all people regardless of where they live.

The AAFP continues in the following efforts to accomplish this goal: 

1. Aggressively promotes and supports family physicians to provide pregnancy, perinatal, and newborn care, especially in rural areas.
2. Promotes excellence in basic pregnancy, perinatal, and newborn care training for all family medicine residents by family physicians.
3. Maintains evidence-based national guidelines for quality pregnancy, perinatal, and newborn care by family physicians.
4. Encourages the expansion of pregnancy, perinatal, and newborn care residency training opportunities in rural areas.
5. Advocates with ACOG for active support of the joint AAFP-ACOG guidance on specialty-neutral credentialing at the state and local levels.
6. Continually seeks to reinforce and expand currents efforts to:
   

a. Promote  pregnancy, perinatal, and newborn care by family physicians to the public.
b. Advocate for national tort reform and specifically for relief in  pregnancy, perinatal, and newborn care critical access area.
c. Aggressively assist family physicians who have appropriate training and demonstrated competence in obtaining and maintaining privileges in  pregnancy, perinatal, and newborn care.
d. Encourage research in outcomes-based data in pregnancy, perinatal, and newborn care provided by family physicians.

Related Policies:  

                        1.       https://www.aafp.org/about/policies/all/aafp-acog-joint-statement.html

                        2.      https://www.aafp.org/about/policies/all/birth-equity-pos-paper.html

(1989 COD) (March 2023 BOD)