PT - JOURNAL ARTICLE AU - L F Smith TI - Predictors of the provision of intrapartum care by general practitioners: five-year cohort study. DP - 1997 Oct 01 TA - British Journal of General Practice PG - 627--630 VI - 47 IP - 423 4099 - http://bjgp.org/content/47/423/627.short 4100 - http://bjgp.org/content/47/423/627.full SO - Br J Gen Pract1997 Oct 01; 47 AB - BACKGROUND: There is little published evidence that any aspect of vocational training for general practice improves the quality of care provided by general practitioners (GPs). AIM: To investigate whether aspects of education and vocational training predict whether GPs provide intrapartum care. METHOD: A five-year prospective cohort study was carried out in the United Kingdom (UK) using responders to a 1990 national survey of GPs for whom a current UK address could be found. Main outcome measures were factors associated with provision of GP intrapartum care in 1995. RESULTS: In 1995, a minority of ex-trainees (65 out of 349, 18%) provided intrapartum care as GPs, although 28% would ideally have wished to do so; 8% provided home delivery care. Four education and training variables were associated with ex-trainees booking women for GP delivery in 1995: the number of partners in the ex-trainee's GP training practice providing GP intrapartum care (odds ratio (OR) = 1.30); performing forceps deliveries as an obstetric senior house officer (SHO) (OR = 1.24), witnessing episiotomies as a student (OR = 1.17), and witnessing twin deliveries as a student (OR = 0.75). CONCLUSIONS: In the case of GP intrapartum care, future service provision is associated with certain education and training variables. There is a mismatch between GPs' ideal and actual maternity care provision. Changes to enhance such care would be needed at least at three levels: selection and approval of training practices, content and base for SHO posts, and practice arrangements for maternity cover.