Obstetricians - Shifting Demand

Demand for practitioners in obstetrics depends on the demographics of the population and the desire of women to have children.

In the overall pictures, there is some gloom. In June, 2003, the US Health and Human Services released a CDC report that found that the U.S. birth rate has fallenl to the lowest level since national data have been available. The report found that the birth rate was 13.9 per 1,000 persons in 2002, a decline of 1 percent from the rate of 14.1 per 1,000 in 2001 and down 17 percent from the recent peak in 1990 (16.7 per 1,000). They attributed the current low birth rate primarily to the smaller proportion of women of childbearing age in the U.S. population, as baby boomers age and Americans are living longer.

The report also found a recent downturn in the birth rate for women in the peak childbearing ages. Birth rates for women in their 20s and early 30s were generally down while births to older mothers (35-44) were still on the rise. Rates were stable for women over 45.

However, the increasing role of the OB/GYN can be seen in the statistics:
  • more than one fourth of all children born in 2002 were delivered by cesarean; the total cesarean delivery rate of 26.1 percent was the highest level ever reported in the United States. The number of cesarean births to women with no previous cesarean birth jumped 7 percent and the rate of vaginal births after previous cesarean delivery dropped 23 percent. The cesarean delivery rate declined during the late 1980s through the mid-1990s but has been on the rise since 1996.
  • The percent of low birthweight babies (infants born weighing less than 2,500 grams) increased to 7.8 percent, up from 7.7 percent in 2001 and the highest level in more than 30 years. In addition, the percent of preterm births (infants born at less than 37 weeks of gestation) increased slightly over 2001, from 11.9 percent to 12 percent.
  • Access to prenatal care continued a slow and steady increase. In 2002, 83.8 percent of women began receiving prenatal care in the first trimester of pregnancy, up from 83.4 percent in 2001 and 75.8 percent in 1990.
The key to a successful practice means finding an area where the local statistics buck the national trend. This includes avoiding areas where the population is aging into the retirement years and seeking out the areas where childbearing-capable women are. (Note that you should consider the growing percentage of women 35-44 who are having babies; furthermore, more than one-third of all births were to unmarried women, so the target population need not be married women.)

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Updated April 12, 2004 - return to our list of medical specialties or river2u home