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Nurse-Midwifery: A Developing Profession

Published online by Cambridge University Press:  27 April 2021

Extract

Consumer demand and federal support has caused the number of certified nurse-midwives to quadruple in the last decade, from 629 in 1970 to 2500 in 1982. Despite their record of reducing infant mortality and satisfying consumers, nurse-midwives are still an underutilized health resource. This article provides a brief history of nurse-midwifery. describes nurse-midwives’ education and current legal status, discusses obstacles to wider use of nurse-midwives, and examines the issues of safety and cost-effectiveness of nurse-midwifery practice.

The word “midwife” often evokes images of home births attended by “granny” or “lay” midwives who lack formal education in obstetrics. Yet, professionally educated nurse-midwives have practiced in this country since 1925, when an American nurse, educated in nurse-midwifery in England, came to the mountains of eastern Kentucky.

Type
Article
Copyright
Copyright © American Society of Law, Medicine and Ethics 1982

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References

American College of Nurse-Midwives, unpublished data (1982) (available from ACNM, 1552 K St., N.W., Suite 1120, Washington, D.C. 20005).Google Scholar
Metropolitan Life Insurance Co., Report on the Frontier Nursing Service of Hayden, Kentucky (May 9, 1932), as quoted in Stewart D., The Five Standards of Safe Child-Bearing (NAPSAC Reproductions, Marble Hill, Mo.) (1981).Google Scholar
Faison, J.B., Report on the Maternity Center Association Clinic of New York, 1952–1958, American Journal of Obstetrics and Gynecology 81(2): 395402 (1961); see also Laird M.D., Report on the Maternity Center Association Clinic of New York, 1931–1951, American Journal of Obstetrics and Gynecology 69:178 (1955).Google Scholar
American College of Nurse-Midwives, official definitions (1978).Google Scholar
American College of Nurse-Midwives, unpublished data (1981).Google Scholar
Hsia, L., Editorial: 50 Years of Nurse-Midwifery Education: Reflections and Perspectives, Journal of Nurse-Midwifery 27(4): 13 (July/August 1982) at 1.Google Scholar
Division of Examination, American College of Nurse-Midwives, unpublished survey (1981).Google Scholar
Letter to author, fromMeyers, Peter H., University of Mississippi, Nurse-Midwifery Education Program (Spring 1981).Google Scholar
Kobrin, F., The American Midwife Controversy: A Crisis of Professionalization, Bulletin of History of Medicine 40(4): 350 (July/August 1966).Google Scholar
American College of Nurse-Midwives, Survey of Legislation Pertaining to the Practice of Nurse-Midwives and Update Tables (1976).Google Scholar
Two jurisdictions that have this apparent conflict are North Dakota and District of Columbia. See Update Tables, supra note 10.Google Scholar
See, e.g., Ga. Code Ann. §88-1402 (requiring nurse-midwives to satisfactorily complete classes prescribed by the state department of human resources and pass an examination before applying for a certificate to practice); Ill Ann. Stat. ch. 91, §5 (requiring 12-month course). Other states with similar regulations are Maine and Vermont.Google Scholar
See, e.g., La. Rev. Stat. Ann. §37-1262 (defining practice of midwifery as attending a woman in childbirth without aid of licensed physician); La. Rev. Stat. Ann. §37-1277 (requiring application and examination followed by license issued by state board of medical examiners). Other states that have similar provisions are Minnesota and Texas.Google Scholar
These states are Connecticut and Iowa. See Update Tables, supra note 10.Google Scholar
These states are Alabama and Massachusetts. See Update Tables, supra note 10.Google Scholar
General Accounting Office, Better Management and More Resources Needed to Strengthen Federal Efforts to Improve Pregnancy Outcome (U.S. Gov't Printing Office, Washington, D.C.) (1979) at 96.Google Scholar
32 C.F.R. Part 199.12 (January 10, 1977).Google Scholar
42 C.F.R. Parts 405, 435-36, 440, 441, 447 (July 16, 1982).Google Scholar
General Accounting Office, Availability of Nurse-Midwifery Services under Federal Health Care Programs (Washington, D.C.) (June 4, 1982) at 9.Google Scholar
These states are Alaska, Maryland, Mississippi, New Mexico, New York, Oregon, Pennsylvania, and Utah.Google Scholar
American College of Obstetricians and Gynecologists, American College of Nurse-Midwives, Joint Statement of Practice Relationships Between Obstetricians and Certified Nurse-Midwives (November 1, 1982).Google Scholar
Varney, H., Nurse-Midwifery (Blackwell Scientific Publications, London, England) (1980) at 5.Google Scholar
American College of Nurse-Midwives, unpublished data (1982).Google Scholar
Nurse-Midwifery Associates v. Hibbett, No. 82-3208 (M.D. Tenn. filed March 3, 1982). The judge recently denied a motion to dismiss portions of the Nashville suit involving State Volunteer Mutual Insurance Co., where three Nashville hospitals denied privileges to a private nurse-midwifery practice and the physician-owned malpractice insurance company refused to renew the collaborating physician's insurance.Google Scholar
See, e.g.,Levy, B.S. Wilkinson, F.S. Marine, W.M., Reducing Neonatal Mortality Rate with Nurse-Midwives, American Journal of Obstetrics and Gynecology 109(1): 5158 (January 1971);Meglen M.C., A Prototype of Health Services for Quality of Life in a Rural County, Bulletin of Nurse-Midwifery 17(4): 103–13 (November 1972); Slome C., Effectiveness of Certified Nurse-Midwives: A Prospective Evaluation Study, American Journal of Obstetrics and Gynecology 124:177–82 (January 15, 1976); Murdaugh A. ,Experiences of a New Migrant Health Clinic, Women and Health 1(6): 25–28 (November/December 1976); Haire D., Improving the Outcome of Pregnancy through the Increased Utilization of Midwives, Journal of Nurse-Midwifery 26(1): 5–8 (January/February 1981); Doyle Widhalm, Midwifing the Adolescents at Lincoln Hospital's Teenage Clinics. Journal of Nurse-Midwifery 24(4): 27–32 (July/August 1979).Google ScholarPubMed
Levy, B.S. Wilkinson, F.S. Marine, W.M., Reducing Neonatal Mortality Rate with Nurse-Midwives, American Journal of Obstetrics and Gynecology 109(1): 5158 (January 1, 1971).Google ScholarPubMed
Id. at 55.Google Scholar
The Five Standards of Childbearing, supra note 2, at 115.Google Scholar
Haire, D., Improving the Outcome of Pregnancy through the Increased Utilization of Midwives, Journal of Nurse-Midwifery 26(1): 58 (January/February 1981).Google ScholarPubMed
Doyle, Widhalm, , Midwifing the Adolescents at Lincoln Hospital, Journal of Nurse-Midwifery 24(4): 2732 (July/August 1979).Google Scholar
Slome, C., Effectiveness of Certified Nurse-Midwives: A Prospective Evaluation Study, American Journal of Obstetrics and Gynecology 124:177–82 (January 15, 1976).Google ScholarPubMed
Id. at 182.Google Scholar
Nurse-Midwifery: Consumers' Freedom of Choice: Hearings Before the Subcomm. on Oversight and Investigations, of the House Comm. on Interstate and Foreign Commerce, 96th Cong., 2nd Sess. (December 18, 1980) at 90 (testimony of C.A. Miller) [hereinafter referred to as Nurse-Midwifery Hearings].Google Scholar
Id. at 89–93 (testimony of Miller C.A.), 145-47 (testimony of Judith Rooks).Google Scholar
Id. at 72–77 (testimony ofLubic, E.).Reid, M.L. Morris, J.B., Perinatal Care and Cost Effectiveness: Changes in Health Expenditures and Birth Outcome Following the Establishment of Nurse-Midwifery Program, Medical Care 17(5): 491500 (May 1979) [hereinafter referred to as Reid & Morris]. See also Faison, supra note 3.Google Scholar
Bishop, B., A Guide to Assessing Parental Capabilities, American Journal of Nursing 76(11): 1784 (November 1976);Klaus, M.H. Kennell, J.H., Mothers Separated from their Newborn Infants, Pediatric Clinics of North America 17(4): 1015 (November 1970).Google Scholar
Reid Morris, supra note 35.Google Scholar
See Nurse-Midwifery Hearings, supra note 33, at 74–77 (Lubic R.).Google Scholar
Lazarus W., Report to the Federal Trade Commission: Competition among Health Practitioners: The Influence of the Medical Profession on the Health Manpower Market; Volume II: The Childbearing Center Case Study (February 1981) at 41–42.Google Scholar