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Characteristics of nurse-midwife patients and visits, 1991.

L L Paine, J M Lang, D M Strobino, T R Johnson, J F DeJoseph, E R Declercq, D R Gagnon, A Scupholme and A Ross

Department of Maternal and Child Health, Boston University School of Public Health, MA 02118, USA. lpaine@bu.edu

OBJECTIVES: This study describes the patient populations served by and visits made to certified nurse-midwives (CNMs) in the United States. METHODS: Prospective data on 16,729 visits were collected from 369 CNMs randomly selected from a 1991 population survey. Population estimates were derived from a multistage survey design with probability sampling. RESULTS: We estimated that approximately 5.4 million visits were made to nearly 3000 CNMs nationwide in 1991. Most visits involved maternity care, although fully 20% were for care outside the maternity cycle. Patients considered vulnerable to poor access or outcomes made 7 of every 10 visits. CONCLUSIONS: Nurse-midwives substantially contribute to the health care of women nationwide, especially for vulnerable populations.