The significant challenges presented by the April 20, 2010 explosion, sinking, and subsequent oil spill of the Deepwater Horizon drilling platform in Canyon Block 252 about 52 miles southeast of Venice, LA, USA greatly impacted Louisiana's coastal ecosystem including the sea food industry, recreational fishing, and tourism. The short-term and long-term impact of this oil spill are significant, and the Deepwater Horizon spill is potentially both an economic and an ecological disaster. Microbes present in the water column and sediments have the potential to degrade the oil. Oil degradation could be enhanced by biostimulation method. The conventional approach to bioremediation of petroleum hydrocarbon is based on aerobic processes. Anaerobic bioremediation has been tested only in a very few cases and is still considered experimental. The currently practiced conventional in situ biorestoration of petroleum-contaminated soils and ground water relies on the supply of oxygen to the subsurface to enhance natural aerobic processes to remediate the contaminants. However, anaerobic microbial processes can be significant in oxygen-depleted subsurface environments and sediments that are contaminated with petroleum-based compounds such as oil-impacted marshes in Louisiana. The goal of this work was to identify the right conditions for the indigenous anaerobic bacteria present in the contaminated sites to enhance degradation of petroleum hydrocarbons. We evaluated the ability of microorganisms under a variety of electron acceptor conditions to degrade petroleum hydrocarbons. Researched microbial systems include sulfate-, nitrate-reducing bacteria, and fermenting bacteria. The results indicated that anaerobic bacteria are viable candidates for bioremediation. Enhanced biodegradation was attained under mixed electron acceptor conditions, where various electron-accepting anaerobes coexisted and aided in degrading complex petroleum hydrocarbon components of marsh sediments in the coastal Louisiana. Significant degradation of oil also occurred under sulfate-reducing and nitrate-reducing conditions.

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. (Fam Med. 2018;50(9):662-71.)

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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.