Table 6 Illustrative participant quotes on the influence of sufficient training and exposure to obstetrics

"Given the time I’ve put into being able to do obstetrics, I’ve delivered way less babies than I think is reasonable. And so, I don’t have those skills. And so, I don’t do it anymore. It absolutely has been a problem." (Family Physician, man, ON)

Time in residency is a big factor… I was thinking of doing obstetrics but I’m not sure if I feel comfortable. Like based on my two months I had … I don’t know if I got enough deliveries. So, I have to look at some elective time. And I’d have to go away for that most likely. Which would normally be fine but like with a family, it’s a bit more challenging. (Resident, woman, NS)

… we had lots of opportunities to do obstetrics during our residency. So that was wonderful. Because I know that not all residents feel ready to practice obstetrics, especially in a place like here where it’s rural, where you have to like figure things out at night… it’s not like a great place for a brand-new person just because you have to be really independent and kind of confident in your skills… I was lucky in my residency training, we did do a lot of obstetrics. And that was sort of an expected skill set to have even if you didn’t plan on doing obstetrics. (Family Physician, woman, NS)

…in second year medical school… one of the things that you could do… was called Deliver a Baby. You could actually sign up and spend a night in the hospital working alongside a family doctor and help deliver a baby… it felt like an adrenaline rush in the most profound way for me following a woman through her entire labour and being present and witnessing the family doctor deliver the baby, and put the baby on the mom’s chest, and watching the emotion of the mother and her partner… I remember getting goosebumps … I went home the next morning, and I was invigorated that whatever I did as a career, it was going to involve that. (Family Physician, woman, NS)

I was actually planning on doing my third-year fellowship in obstetrics… I ended up not doing it because I had my daughter, and I didn’t want to be away from home… instead of that I chose to do a locum with family medicine with family medicine obstetrics support. I used that to further develop my skills in obstetrics during my locum time…now I have my practice, and… I’m part of a family medicine obstetrics group. And I also do emerg in like a small community where I trained. I did a rural family medicine program. So, like during our training, we did emerg cover and obstetrics and all that. So, I wanted to continue to maintain those skills. And so, I still do that. (Family Physician, woman, ON)

I think that like there’s different skill sets in a way. I think it’s always easier to move from acute care to like less acute care… it’s always a choice later on. But as I do less and less of… pediatrics and obstetrics, it becomes more difficult to go back into. (Family Physician, woman, ON)