title: Role of general practitioners in primary maternity care in South Australia and Victoria.
abstract: BACKGROUND
  Recent policy debates about the challenges facing maternity services in Australia provide an opportunity to reflect on current care practices.
  
  
  OBJECTIVE
  To identify the provision of primary maternity care models in two Australian states: South Australia (SA) and Victoria.
  
  
  METHODS
  All public and private hospitals with maternity facilities in SA and Victoria were mailed a survey requesting information about the organisation and provision of maternity care.
  
  
  RESULTS
  All hospitals in SA (35) and 99% (75/76) in Victoria completed the survey. Among public hospitals, approximately 50% (14/30 in SA and 29/56 in Victoria) reported primary care arrangements where all antenatal care is provided by medical practitioners working in the community. The vast majority of hospitals offering this type of care were located outside metropolitan areas. Twenty per cent of public hospitals in SA (6/30) and 36% in Victoria (20/59) reported offering primary midwifery models, such as team, caseload and/or birth centre care. In SA, hospitals offering these models were located in both metropolitan and regional areas. In Victoria, 60% of hospitals offering women primary midwifery care were large hospitals with more than 1000 births per annum.
  
  
  CONCLUSIONS
  This study shows that community-based medical practitioners, general practitioners in particular, are major providers of maternity care despite the emergence of primary midwifery models of care. With 25% of the population living outside metropolitan areas in both states, providing access to choice and continuity of care for women living in regional and rural areas will be a challenge for maternity reform.
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia. georgina.sutherland@mcri.edu.au
authors.forename: Georgina
authors.initials: G
authors.lastname: Sutherland
authors.forename: Jane
authors.initials: J
authors.lastname: Yelland
authors.forename: Jan
authors.initials: J
authors.lastname: Wiebe
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kelly
authors.forename: Penny
authors.initials: P
authors.lastname: Marlowe
authors.forename: Stephanie
authors.initials: S
authors.lastname: Brown
mesh_terms: D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008880:Midwifery / Q000458:organization & administration*; D009775:Obstetrics and Gynecology Department, Hospital / Q000458:organization & administration; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011295:Prenatal Care / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D013021:South Australia; D014739:Victoria