A case for nurse-midwives

Childbirth in the eighties: What next? When alternatives become mainstream

“…The Madera County Experiment in the late 1960s in California (though unsuccessful in overcoming the barriers to nurse‐midwifery practice in California), in the 3 years of its funding life, was able to lower the infant mortality and find widespread acceptance for nurse‐midwives among the women of Madera County 2 …”

“…Instead of searching out some new “otherness” with which to identify ourselves, let us increasingly document and give witness to the power of skilled caring of pregnant women. In the 1960s in Madera County, prematurity and infant mortality were drastically reduced by caring attention to a hitherto unserved group of women 2 . What element of care made the difference was not documented, but it was before the day of the fetal heart monitor and ultrasound.…”

Effectiveness of Policy Related Research: Nurse‐Midwifery as Case Study

“…The primary measurements were infant and maternal mortality rates. Study locales included Appalacia (Browne & Isaacs, 1976;Ernst & Gordon, 1979;Metropolitan Life Insurance Company, 1958), New York City (Maternity Center Association, 19551, rural andurban Sante Fe (Shean 1968;Smyth, 19681, rural California (Levy, 1971;Montgomery, 1969), urban Baltimore (Runnerstrom, 1969), rural Mississippi (Meglen, 1972Meglen & Burst, 1974;Slome, 1976;Thiede, 1971), and rural Georgia (Reid & Mor ris, 1979). Since the focus of the service projects was on increasing access for the underserved, the population being cared for by nurse-midwives was the indigent, lower socioeconomic, politically powerless and voiceless (unless championed, for example, by Robert F. Kennedy in Mississippi).…”

Special issues in nurse-midwifery A look at the past and future

“…During the program, prenatal care was given more frequently to a larger proportion of expectant mothers, and more mothers returned for routine postpartum examinations. The prematurity rate fell from 11 to 6.4%, with a decrease in neonatal mortality from 23.9 to 10.3 per 1000 births 9 . The second step of the project provides even more convincing data.…”

“…Another aspect in the book 8 that struck me particularly was nurse‐midwives' outstanding record in the care of the poor. The classic studies were published in the American Journal of Obstetrics and Gynecology , 9,10 with public health persons heading the research teams. I will cite the details of these studies because they represent a record of which nurse‐midwives can be especially proud.…”