title: Is direct access to obstetricians/gynecologists effective at improving maternal health behaviors?
abstract: OBJECTIVE
  To examine the effects of state legislation mandating direct access to obstetricians and gynecologists (OB/GYNs) on maternal health behaviors and infant health outcomes.
  
  
  METHODS
  1992-2002 Natality Detail File; 1994-2002 Pregnancy Assessment and Monitoring Survey (PRAMS).
  
  
  METHODS
  Using variation in state policy over time, we use individual-level data from two sources to consider the effects of direct access legislation on prenatal care utilization, maternal health behaviors during pregnancy, and infant health outcomes.
  
  
  RESULTS
  Our results suggest that there is little evidence that direct access laws are effective at improving prenatal care access or conferring benefits to mothers and infants. These results are consistent across two data sets, a variety of specifications, and specific subgroups of women who are most likely to be affected by direct access legislation.
  
  
  CONCLUSIONS
  We conclude that direct access to OB/GYNs is not related to improvements in maternal health behaviors or infant health outcomes. If policy makers are interested in reforms that improve maternal and infant health, we recommend a focus on alternative policies.
authors: Department of Public Policy, University of North Carolina at Chapel Hill, NC, USA. christine.durrance@unc.edu
authors: Christine Piette
authors: CP
authors: Durrance
authors: Scott
authors: S
authors: Hankins
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D005260:Female; D015438:Health Behavior; D006291:Health Policy; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007229:Infant Welfare / Q000706:statistics & numerical data; D007231:Infant, Newborn; D008425:Maternal Behavior; D008429:Maternal Welfare / Q000706:statistics & numerical data*; D009774:Obstetrics / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data; D012907:Smoking; D012959:Socioeconomic Factors