San Francisco General Hospital nurse-midwifery practice: The first thousand births

The Yale Nurse-Midwifery PracticeAddressing the outcomes

“…It is difficult to make comparative statements about a process of care among different populations. However, Table 11 demonstrates clearly that nurse‐midwives provide care that yields excellent outcomes despite the fact that four of the studies 1–4 represented in Table 11 are based on populations that are relatively high risk. The women in those four studies are from a lower socioeconomic status, in a clinic type setting (ie, not private), with all the health problems associated with that population segment.…”

“…Specifically, there was an interest in determining norms for healthy women in pregnancy. Much of the data in the literature on pregnancy variables is based on samples taken from large clinic populations in teaching hospitals 1–4 . The following descriptive data were collected from a private practice that attracted well‐educated, healthy, and highly motivated middle‐class women.…”

Prevention of infant mortality An agenda for nurse-midwifery

“…Table 2 summarizes the reports of studies addressing nurse‐midwifery services that have appeared in the literature over the previous 20 years (88–117). Some of these reports demonstrate the effort to evaluate the process and/or outcome of care offered to the broad demographic variety of patients served, within the several settings in which care is delivered.…”

Great Minds Don't Think Alike

“…A nursemidwifery service was established in 1975 and was followed soon after by a nurse-midwifery education program. 1 Within the first year objectives of the collaborative were met: census was increased overall by 50%, there was access to an in-hospital midwifery model of care for the women of San Francisco, and plans were underway for a nurse-midwifery education program. Currently, there are approximately 1,250 births per year at San Francisco General Hospital, 46% of these to women who have received prenatal care with the nurse-midwifery service.…”