Costs averted by providing comprehensive prenatal care to teenagers

Nurse-midwifery care to vulnerable populations Phase I: Demographic characteristics of the National CNM sample

“…The results indicate that 99% of all respondents serve at least one group of vulnerable women, and CNMs serving the inner city and rural populations provided services to women with several of these characteristics. Many studies (1–9) have validated the quality of care given by nurse‐midwives to women with these characteristics, indicating that their outcomes of pregnancy often are poorer than the national average, and demonstrating the improvement in outcomes that have been directly attributable to CNM care.…”

“…Nurse‐midwives have served vulnerable populations of mothers and babies in the United States for decades (1, 2). Indeed, several studies have reported high quality and cost‐effective maternity care provided by nurse‐midwives to pregnant women who are adolescent, poor, of refugee status, or who have language barriers (3–9). There are, nevertheless, no national data on the amount of care provided by nurse‐midwives to women from vulnerable populations, the characteristics of these women, the settings in which they receive nurse‐midwifery care, or the financing of their care.…”

Teen pregnancy service An interdisciplinary health care delivery system utilizing certified nurse-midwives

“…These four teen clinics with CNM care reported favorable data on a number of variables such as maternal weight gain and antenatal complications (anemia, preeclampsia), initiation of prenatal care and frequency of visits, percentage of normal spontaneous vaginal deliveries, incidence of low birth weight, and fetal mortality for population samples of primarily low SES adolescents between 12 and 19 years of age. The generally lower incidence of low birth weight babies, reported for CNM‐staffed clinics, may reduce health costs below that of more traditional medical care 18 . Kieffer and Woolley 19 also found higher patient satisfaction for adolescent clinics using CNM care compared with a clinic staffed by residents in obstetrics and gynecology.…”

Effectiveness of prenatal care and education for pregnant adolescents Nurse-midwifery intervention and team approach

“…Also, many studies have investigated methods to improve the poor outcomes. These methods included the use of nurse‐midwives, nurse practitioners, multi‐disciplinary teams, and special educational programs 1–13 …”

“…Infants also experienced fewer intensive care admissions and number of hospital days 2 . The cost of comprehensive care was more than recovered by reducing the incidence of low birth weight babies with less intensive care hospitalization 9 …”