Approximately 28 million reproductive-age women in the United States live in rural counties, yet over half of rural counties do not have an obstetrician/gynecologist. Family physicians play an important role in providing obstetric care in rural communities, with hospital based obstetric services often relying on the ability to offer cesarean sections. A recent study by the American Board of Family Medicine found that 6.7% of family physicians provided obstetric deliveries and 1.6% provided cesarean section deliveries as the primary surgeon. Of the family physicians who perform cesarean section as the primary surgeon, more than half provided this service in rural counties and 38.6% were in counties without an obstetrician/gynecologist.

Lack of adequate obstetric care is concerning for reproductive age women living in rural counties. The authors of the policy brief published in the Journal of the American Board of Family Medicine, The Essential Role of Family Physicians in Providing Cesarean Sections in Rural Communities, contend that renewed attention and resources for graduate and fellowship training as well as post-graduate retraining in advanced maternity care is needed to prepare family physicians to provide these services in rural communities and overcome a growing number of “obstetrical deserts.”