A case for nurse-midwives

Chronic shortage of physicians in a rural county hospital in California resulted in many deliveries in the county hospital being medically unattended. This led to the development in July, 1960, of a demonstration project calling for qualified nurse-midwives to provide maternity care services for all normal deliveries. Initially, the physicians were skeptical about the quality of care that could be provided by nurse-midwives. Their skepticism soon changed and they became staunch supporters of the program. Maternity patients also became enthusiastic about nurse-midwife services. Although there were only about 360 deliveries per year at the county hospital (60 per cent of all deliveries in the county), the neonatal mortality rate fell from 23.9 per 1,000 live births to 10.3 per 1,000 live births. Prematurity dropped from 11 per cent of all live births to 6.4 per cent.