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Cesarean Delivery in Family Medicine

Mother holding baby aloft. The American Academy of Family Physicians (AAFP) recently published a position paper asserting that access to quality maternity care is a major public health priority in the United States. This assertion is based on an unfortunate fact: The maternal mortality rate in the U.S. is one of the highest in the developed world, with disproportionately high rates of mortality among black individuals, individuals with low income, and residents of rural areas. The AAFP believes that family physicians are well-equipped to help reduce these disparities in maternal morbidity and mortality, as they are trained to provide a continuum of care, including prenatal, perinatal, and postpartum, to the communities they serve.

Family physicians already provide a significant amount of perinatal care, particularly in rural and underserved areas. Of all specialties, family physicians have the highest percentage of practitioners living and working in rural communities, at 15.7%. Studies have shown that family physicians are indispensable for maintaining access to obstetric care in rural areas. For example, a study by the Journal of the American Board of Family Medicine in 2013 showed that family physicians were the primary practitioners performing both vaginal and abdominal deliveries in rural hospitals in 15 states.

Another study, published in the Journal of the American Board of Family Medicine in 2013, found that patients who received cesarean delivery from a family physician did not face increased overall risk. This is an important finding, not just for social and financial reasons, but also because cesarean delivery carries a significantly increased risk of maternal morbidity and mortality when compared with vaginal delivery. Additionally, the study suggests that individuals who receive perinatal care from family physicians may have lower cesarean delivery rates than those cared for by obstetrics subspecialists.

Board of Certification in Family Medicine Obstetrics® (BCFMO)

In 2009, the American Board of Physician Specialties (ABPS) launched its certification program for family medicine obstetrics through its Board of Certification in Family Medicine Obstetrics® (BCFMO). Recognized by the U.S. Department of Labor, the Council for Affordable Quality Healthcare (CAQH), and the Centers for Medicare & Medicaid Services, the BCFMO offers two options for certification—Family Medicine Obstetrics and Family Medicine Obstetrics With Surgical Qualification.

To be eligible to apply for initial board certification in family medicine obstetrics, an applicant must first satisfy the general requirements of the ABPS, which include being a graduate of a recognized U.S., Canadian, or international allopathic or osteopathic college of medicine, and holding a valid and unrestricted license to practice medicine in the United States, its territories, or Canada. The BCFMO has its own eligibility requirements for the two pathways, which include:

  • Completing an ACGME- or AOA-accredited residency in family medicine, or a family medicine residency accredited by the Royal College of Physicians and Surgeons of Canada (RCPSC) or the College of Family Physicians of Canada (CFPC).
  • Current board certification in family medicine granted by a Member Board of the ABPS, the American Board of Medical Specialties (ABMS), the AOA, the RCPSC, or the CFPC.

Like the AAFP, the ABPS believes that family medicine is an important specialty in today’s healthcare system. By providing comprehensive care across diverse populations and geographic settings, family physicians can address a wide range of medical needs, including providing safe and effective cesarean deliveries. Additionally, family physicians can help close the gap in healthcare access in rural communities, providing much-needed medical services and helping to reduce health disparities and the rates of maternal morbidity and mortality.

If you would like to learn more about board certification in family medicine obstetrics through the BCFMO, contact the ABPS today.

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Medical organizations throughout North America understand that our rigorous certification standards prove that ABPS Diplomates are capable of delivering the best patient care possible.

Far too often, medicine is led by less than 5% of non-practicing physicians taking away and replacing the voice of the 95% of physicians practicing and placing patient safety and care first on the front lines every day. The American Board of Physician Specialties has raised the standards in physician board certification not only in the quality of their boards of certification, but in hearing and allowing for the voice of those active physicians caring directly for patients. Having been a part of the ABPS over the last 28 years has allowed me to grow as a woman leader in a field often wrought with challenges. It helped me and others raise the bar of the standards of care in my specialty, Emergency Medicine, through their Board Certification in Emergency Medicine (BCEM). ABPS also helped raise the standards of care for 21st century medicine through their certifications in other specialties, particularly in Integrative Medicine & Disaster Medicine. Having physician voices heard matters to medicine and is essential in the betterment of patient safety and care.

Sarah E. Gilbert, MD, FAAEP
Sarah E. Gilbert, MD, FAAEP
Emergency Medicine
On October 18, 2007, President George W. Bush released Homeland Security Presidential Directive 21 (HSPD-21), calling on our nation, among other initiatives, to “collectively support and facilitate the establishment of a discipline of disaster health”. It is a great testament to the wisdom and foresight of the American Board of Physician Specialties that it immediately set to work and created, within the short span of only one year, an educational blueprint and set of certification examinations, both written and oral, for a new subspecialty of disaster medicine—and it is why I chose to be part this vital initiative and this wonderful organization. This is but one of the many innovative programs initiated by the American Board of Physician Specialties over the years, and why I am proud to support its work on behalf of our nation’s public health.

Art Cooper, MD
Disaster Medicine
When the American Board of Physician Specialties offered to host the American Board of Integrative Medicine, ABPS became a landmark organization working to move medicine into the twenty first century. Certifying physicians who have completed rigorous academic training in Integrative Medicine ensures that the field of Integrative Medicine will continue to develop academically, clinically, and professionally. The leadership of ABPS continues to impress me - they are diligent in constantly innovating to provide certifications for physicians who want to advance their careers and their areas of expertise. I am honored to be a part of this organization.

Ann Marie Chiasson, MD
Integrative Medicine
There are many ways board certification advances a physician career. ABPS Board examination verifies your accuracy, precision, and reflects your mastery of your residency training verifying your expertise. ABPS Board certification demonstrates your level of expertise beyond your practice experience, primary education degrees, and training which are necessary for insurance reimbursement and practice privilege requirements. Attaining your ABPS Board Certification will clarify your purpose, secure your practice growth, and expand into leadership positions. Board certification can serve as an indication of a physician’s commitment to medicine, beyond the minimal standards and competency of training, their measurement to quality of care, and attaining an award for excellence.

Chris Kunis MD
Internal Medicine
When I think historically, advancement in medicine and patient safety and care has been driven by the diversity of people and scientific thought. That’s what I found at the ABPS and more. For over 60 years that is just who we are. I found a physician certifying body that provides a choice and voice to all physicians ensuring that patients are always placed first.

Jerry Allison, MD
Emergency Medicine
When I decided to pursue a full time role as a physician executive it was important to me to obtain additional professional training, education and work experience. Board certification through the ABPS in Administrative Medicine is validation of my efforts and a demonstration of dedication to professional development. We need more physicians to become full time health care executives, knowing there is a board certification option in Administrative Medicine encourages physicians to take the leap from full time clinical practice to healthcare organizational leadership.

Richard Paula, MD
Administrative Medicine
The American Board of Physician Specialties has provided me with the opportunity to demonstrate mastery of internal medicine through board certification. As a hospitalist, board certification is an expected credential, and hospitals recognize the American Board of Physician Specialties (ABPS) as one of the three standard credentialling bodies for Internal Medicine. Additionally, the ABPS has helped me develop leadership skills as a Board member and Committee Chairperson. ABPS has also helped me sharpen critical thinking skills as a test question developer and reviewer. The Allopathic (MD) and Osteopathic (DO) physicians in the ABPS are lifelong learners and frequently pursue multiple board certifications. I enjoy the camaraderie of my peers in ABPS.

Loren Jay Chassels, DO
Internal Medicine
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