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.