Characteristics of nurse-midwife patients and visits, 1991

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 16729 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.