Nurse-midwifery practice has grown steadily over the last two decades and in 1997 certified nurse-midwives (CNMs) attended 6.7% (258,227) of all births in the US, more than 40% of those to nonwhite mothers. This study analyzes selected results from a 1997-98 national survey mailed to over 6,000 CNMs that resulted in 2,405 completed returns and examined, among other factors, setting, practice patterns and clientele. Specifically it studied the relationships between CNMs� personal and work setting characteristics (age, race, length of time in practice, practice site and source of income) and the nature of his/her practice in terms of clientele (age, race, immigrant and insurance status); size (births attended and client contacts) and practice type (private practitioner, involved in managed care). Included among the findings were a number of relationships between CNM characteristics and practice. For example, CNMs serve a clientele that is equally divided between whites and nonwhites, but there was a linkage between a CNM�s race and the characteristics of mothers attended (e.g. 42% of the clientele of black midwives being black, compared to 18% for white midwives). Nationally, CNMs estimated that more than one-fourth (27%) of their clientele were immigrants while 39% of the clients served by Hispanic midwives were immigrants, including 1 in 6 being undocumented. Likewise, Black non-Hispanic midwives served a higher than average proportion of mothers on Medicaid (64% to 42%). Additional analyses identify other influences that work setting and personal characteristics have on midwifery practice and their ability to serve at-risk mothers.
Learning Objectives: 1. Participants will be able to describe the populations served by midwives. 2. Participants will be able to describe the impact of a midwife�s personal characteristics on the populations they serve. 3. Participants will be able to describe the relationship between a midwife�s personal characteristics and the nature of her/his work setting
Keywords: Midwifery, Maternal Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.