For Immediate Release  Contact: Shawn Farley
August 4, 2003   (202) 728-9876



Nurse-Midwives Provide Safe, Patient-Centered, Maternity Care


Washington, DC – A recent study published in the June 2003 edition of American Journal of Public Health documents that low-risk patients receiving collaborative midwifery care had birth success rates comparable to those who saw only physicians, with fewer interventions, more options, and lower cost to the health care system. [abstract full text pdf format]


The two and a half year prospective cohort study, funded by the US Agency for Health Care Research and Quality, utilizing concurrent comparison groups totaling 2,957 women, revealed that mothers receiving collaborative/birth center/midwifery care:


  • Spent less time in the birth center/hospital
  • Experienced fewer cesarean births
  • Experienced fewer vacuum or forceps assisted vaginal births
  • Underwent fewer episiotomies
  • Experienced less induction of labor
  • Experienced less technical intervention
  • Received more services from the California Comprehensive Perinatal Program


The study also revealed similar morbidity, preterm birth, and low-birth weight rates among women receiving collaborative midwifery care and those who saw only physicians. 


According to the researchers, “Because these resources and procedures are major determinants of the cost of perinatal care, managed care organizations, state and local governments, and obstetric providers should consider inclusion of collaborative management/birth center programs in their array of covered or offered services.”


ACNM Executive Director Deanne Williams, CNM, MS praised the study as yet another well-conducted, factual, validation of midwifery care as a modern, safe, and cost-effective women’s health care option.  “This study documents what we and many other countries have known for a long time.  Nurse-midwives, working in collaboration with physicians, should be caring for the majority of pregnant women in this country and must be supported in their commitment to practice midwifery, not medicine,” said Williams. “If you truly care about what is good for women and our nation’s economy we cannot afford to provide intensive medical intervention to women who don’t need it, while truly high risk women go without the care they deserve” said Williams.


The midwifery standard of care emphasizes research evidence and meeting the medical and emotional needs of women and their families.  Midwives are less likely to induce labor or perform episiotomies and believe that cesarean sections should only be performed for medical indications.  Midwives encourage women to walk during labor, use birthing balls, take showers or tub baths, all of which safely help manage pain. 


The study also showed that collaborative midwifery care used fewer hospital resources, resulting in lower cost to the health care system, with rates of morbidity, preterm delivery, and low-birth weight that compared favorably to the physicians-only group.


Researchers concluded, “Our study suggests that a collaborative care model and the traditional, physician-based, perinatal care model are different health care service routes to a common end point: safe outcomes for mother and infants.”


The number of nurse-midwife attended births has doubled in the past five years, now totaling over 10 percent of vaginal births nationwide.  Nurse-midwives are fully licensed in every state, and have prescriptive authority in 48 of the 50 states.


For more information on birth centers visit   To arrange an interview with a local ACNM member contact Shawn Farley at 202-728-9876 or


Debra J. Jackson, Janet M. Lang, William H. Swartz, Theodore G. Ganiats, Judith Fullerton, Jeffrey Ecker, and Uyensa Nguyen. (June 2003). Outcomes, Safety, and Resource Utilization in a Collaborative Care Birth Center Program Compared with Traditional Physician-Based Perinatal Care. American Journal of Public Health, 93: 999-1006. [abstract] [full text] [pdf format]