More hospitals turn to 'laborists' to deliver babies

A growing number of hospitals are using OB hospitalists, also called laborists, to deliver babies, according to an article in Kaiser Health News.

About 250 hospitals in the U.S. have hired laborists compared to only 10 a decade ago, according to the Society of OB/GYN Hospitalists. Several hospitals are adding the service each month, the trade group told the publication.

Instead of relying on on-call private practice obstetricians who come to the hospital as needed when their patients are in labor, hospitals hire laborists to work at their facilities to handle births, and obstetrical and gynecological emergencies.

The move is often welcome news to obstetricians who no longer have to worry about being on call for deliveries. The downside is that a patient who may have her baby delivered by a doctor she has never met before. But KHN reports that patients have the reassurance there will be a doctor available when they arrive in labor and they don't have to wait for an on-call physician or possibly have nurses handle the delivery.

Various hospitals have different models for using laborists. Some have laborists on duty 24 hours a day, while others use them on nights and weekends, according to the report. Many hire community doctors to work 12- or 24-hour shifts as laborists. Others hire doctors as laborists to work exclusively at the hospital. And some use a hybrid approach.

Although some worry about turning the obstetrical specialty into "shift" work similar to emergency physicians, the article noted the laborist trend continues to grow as hospitals seek to improve patient safety and physicians increasingly recognize they need help responding to emergencies.

Patient satisfaction, attempts to reduce malpractice risk and physicians who want to work for a salary instead of running their own practices are also some of the factors driving the trend, according to KHN

With maternity care at U.S. hospitals by far the most expensive in the world, hiring laborists doesn't come cheap. KHN reports that one hospital estimated a cost of about $1.5 million a year to pay obstetricians as hospitalists, along with the cost of their malpractice insurance. The trend toward hiring hospitals comes at a time when one patient safety group says hospitals in the U.S. have improved their maternity care, but less than 25 percent meet the group's standard for high-risk, low-birth-weight deliveries.

To learn more:
- read the article
- here are the statistics