Bothwell’s family doctors help fill maternal access gap

When I appear before my patients in scrubs in clinic after spending the night at the hospital delivering a baby, I commonly hear them say, “I had no idea you did all of those things!”

Specializing in family medicine means I have been trained in a wide range of medical management inside and outside of the hospital that many patients commonly know, such as diabetes, depression, hypertension (high blood pressure), rashes, pain and injuries.

What is surprising for some patients to learn is that family medicine residency training also includes obstetrics. However, not all family medicine physicians continue to provide prenatal care and deliver babies after residency for a variety of reasons.

In 2021, the American Academy of Family Physicians’ annual practice profile survey found that just 15% of respondents had practiced obstetrics. Those of us who do are passionate about evidenced-based medicine to help keep our families growing and healthy.

Missouri is a maternal health desert, which means it lacks adequate maternity care resources and it’s hard to find quality obstetric and newborn care. OB/GYN physicians are among the most difficult to recruit specialists right now, so family medicine physicians like me are uniquely qualified to help fill the gap in access to maternal care.

Family medicine physicians who practice obstetrics (FM/OB) at Bothwell include me, Dr. Alyssa Emery and our six resident physicians. Our services are appealing to patients because we can handle many issues for all family members on the same day – one-stop shopping!

For example, it’s not infrequent during prenatal visits that we also schedule other siblings’ well child checks on the same day so moms only have to make one trip to the same clinic. It’s also common at baby’s first doctor’s appointment after delivery where I’m checking weight and jaundice level for other family members to schedule appointments. Maybe it’s mom so I can help with sleep or breastfeeding or freezing off big brother’s wart or even a blood pressure visit for dad to review his home blood pressure log so we can repeat his lab work.

For me, taking care of entire families during pregnancy, delivery and as they grow in the clinic is one of my favorite parts of my job! It’s truly a privilege to be able to walk into a hospital room with expecting parents and grandparents and feel the anxiety lessen because we all know each other.

Families feel reassured that I’m not just there to deliver the baby. They know I’m invested in them and I’m there for the ear infections, broken bones and illnesses of the entire family. I am blessed to now care for many multiple generations of families, and they are some of my favorites! I love it when grandma and grandpa proudly show me pictures of their grandchildren I delivered while they’re in clinic for their own checkups.

As director of the Bothwell University of Missouri Rural Family Residency, it’s my priority that our residents have the same opportunities to make relationships with expecting families and have continuity of care across generations.

Because of this, we’ve started a Family Medicine Obstetric Clinic from 1 to 4:30 pm Thursday afternoons at Bothwell Family Medicine Associates where patients can make appointments for prenatal and postnatal care to create more access to our comprehensive abilities.

Dr. Misty Todd grew up on a farm in northeast Missouri, where she learned the values of diligence, community service and caring for others. She has been a family medicine and obstetric physician at Bothwell Cole Camp Clinic since 2020. As residency director, she and her colleagues strive to create a supportive community that provides stellar medical training for new doctors and encourages them to establish their practices locally.