31% of Ore. obstetric providers to quit delivering: rural areas hardest hit.

NEW ORLEANS -- The cost of malpractice insurance is driving Oregon physicians to give up delivering babies, according to data presented at the annual meeting of the American Academy of Family Physicians.

Almost one-third (31%) of 511 current obstetric providers are planning to stop offering these services in the next 1-5 years, based on the results of a survey of 1,069 physicians statewide. The most commonly cited reason (59%) was the cost of professional liability insurance. Providers also cited the fear of lawsuits (43%), conflicts with family (29%), and interference with lifestyle (20%), said Dr. Ariel K. Smits, Oregon Health and Science University, Portland.

The location of providers quitting obstetric care may be an even more pressing issue. Of physicians planning to stop providing obstetric care, two-thirds practice in rural areas.

The survey was mailed to all licensed maternity providers in Oregon, including ob.gyns., family physicians, general practitioners, and certified nurse midwives. A total of 1,232 surveys (58%) were returned but this group accounted for 80% of deliveries in the state in 2001. The final analysis excluded 163 providers for a variety of reasons, leaving 1,069 responses.

Of these, 511 currently provided obstetric care and 367 had stopped this care. The remainder had never practiced obstetrics after training.

Roughly one-third of those who had stopped providing obstetric care did so between 1999--the year that the state supreme court ruled that a cap on liability insurance was unconstitutional--and 2002. These physicians were significantly more likely to cite insurance costs as a reason for quitting, while those ...