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Maternity care access in the United States is in crisis. The American Congress of Obstetrics and Gynecology projects that by 2030 there will be a nationwide shortage of 9,000 obstetrician-gynecologists (OB/GYNs). Midwives and OB/GYNs have been called upon to address this crisis, yet in underserved areas, family physicians are often providing a majority of this care. Family medicine maternity care, a natural fit for the discipline, has been on sharp decline in recent years for many reasons including difficulties cultivating interdisciplinary relationships, navigating privileging, developing and maintaining adequate volume/competency, and preventing burnout. In 2016 and 2017, workshops were held among family medicine educators with resultant recommendations for essential strategies to support family physician maternity care providers. This article summarizes these strategies, provides guidance, and highlights the role family physicians have in addressing maternity care access for the underserved as well as presenting innovative ideas to train and retain rural family physician maternity care providers.

PREFACE: This ‘‘In the Literature’’ column has a different genesis from previous columns. It emanates from a discussion that began on the Maternity Care Discussion Group (MCDG), an online group of more than 600 family physicians, obstetricians, midwives, nurses, and doulas that has been hosted on the College of Family Physicians of Canada website for 20 years. Although mainly a Canadian list, international participants are welcome to join in the struggle to improve maternity care and support those who provide it. To join the MCDG List, send an e-mail to mklein@interchange. ubc.ca.