Since the practice of nurse-midwifery was established in America in the 1920s, CNMs have been recognized for their contributions in reducing infant and maternal mortality, premature births and low birthweight rates. Numerous studies have been completed and reports released that document the success of certified nurse-midwives in their quest to improve maternal-child health.

CNMs Provide Personal Care

The weight of evidence indicates that, within their areas of competence,...CNMs provide care whose quality is equivalent to that of care provided by physicians. Moreover,...CNMs are more adept than physicians at providing services that depend on communication with patients and preventive actions...Patients are generally satisfied with the quality of care provided by...CNMs, particularly with the interpersonal aspects of care...

(Source: United States Congress, Office of Technology Assessment. Nurse-Practitioners, Physicians Assistants, and Certified Nurse-Midwives: A Policy Analysis. Washington, DC: U.S. Government Printing Office, 1986, pp. 5 - 6. [Health Technology Case Study 37])

CNMs Are Competent Healthcare Providers

The quality of CNM care is equivalent to physicians' care within their area of competence, according to a 1986 study by the Office of Technology Assessment. Further, they are better than physicians at providing services which depend on communication with patients and preventative action.

(Source: Department of Health and Human Services, Office of Inspector General, A Survey of Certified Nurse-Midwives, March 1992, p. F-2)

CNMs Have Proven Outstanding Birth Outcomes

Judged by the only two measures of outcome available on birth certificates, birthweight and Apgar score, mothers and babies have distinctly better than average outcomes when births are attended by midwives, either in or out of hospitals.

(Source: Eugene R. Declercq, PhD, The Transformation of American Midwifery: 1975 to 1988, American Journal of Public Health, May 1992, 82, 5, p. 683)

Patients Satisfied with CNM Care

The evidence to date, however, confirms the cost-effectiveness of these providers [CNMs], given the diversity of the populations they serve, often as substitutes for physicians; the fact that their care results in at least equivalent and sometimes better out comes, perhaps more quickly, given their patients' enhanced adherence to care regimes; the substantially lower cost of their training; and the collateral benefits of increased consumer choice and satisfaction.

(Source: Barbara J. Safriet, LL.M., Health Care Dollars and Regulatory Sense: The Role of Advanced Practice Nursing, Yale Journal on Regulation, Summer 1992, 9, 2. p. 434)

CNMs Recommended As Improvement to Healthcare System

We recommend that public and private leaders designing policies to draw pregnant women into prenatal care make certain that prenatal services are plentiful enough in a community to enable all women to secure appointments within 2 weeks with providers close to their homes.

We recommend...increased use of certified nurse-midwives

(CNMs) and obstetrical nurse-practitioners; state laws and physicians themselves should support hospital privileges for CNMs and collaboration between physicians and nurse-midwives or nurse-practitioners; eventually, large interstate variations in the laws governing the use of such midlevel practitioners should be eliminated.

(Source: Institute of Medicine. Prenatal Care: Reaching Mothers, Reaching Infants. Sarah S. Brown, Editor. Washington, D.C.: National Academy Press, 1988. p. 144)

CNMs Important Healthcare Providers to U.S. Healthcare System

More and more health-care providers, including obstetricians, are realizing that nurse-midwives may also help cut health-care costs and decrease infant death rates by improving access to prenatal care, and supporters say that giving nurse-midwives control over normal pregnancies and births allows obstetricians to focus their energies on what they're best trained to do -- handle problematic pregnancies and births.

(Source: Susan Chollar, A Personal Touch, The New Physician, May-June 1992. p.32)

CNMs Lower C-Section Rates

Kenneth Bell, MD, describes nurse-midwifery as "gentling the art of obstetrics" and "an enormous advantage to patients who expect normal vaginal delivery."...A total of 66 certified nurse-midwives, male and female, practice in the Southern California Region [of Kaiser Permanente] and manage the 70% of births which are low-risk...Dr. Bell has also been directly concerned with reducing the number of C-section deliveries and credits the hands-on approach of nurse-midwives with helping to keep the C-section rate to a low 12% in his Region.

(Source: Nurse-Midwifery: "Gentling the Art of Obstetrics," Kaiser Permanente Press Release, contacts Daniel Danzig and Linden Berry, March 30, 1992.)

Certified nurse-midwifery makes sense! CNMs offer the chance for mothers and families to have ultimate control over the course of their pregnancy and delivery. CNMs assist mothers in the normal, natural process of labor and delivery and help women realize the joy of bringing a life into the world.

©Copyright 1997, The American College of Nurse-Midwives