PROCESSES OF CARE - COMPARISONS OF CERTIFIED NURSE-MIDWIVES AND OBSTETRICIANS

Prenatal and intrapartum care provided to 1,181 women, all meeting ris k requirements for nurse-midwifery care, by certified nurse-midwives ( n = 471) and obstetricians (n = 710) are compared using indicators of physical and of educational/psychosocial components of maternity care. Data are from clinical records and questionnaires completed by the wo men. Bivariate analyses show that the two provider groups differ on so me, but not all, processes of care. When the woman's evolving health s tatus, personal characteristics, and preferences are controlled, there are significant differences that confirm two models of care. The nurs e-midwifery approach emphasizes educational/psychosocial care and rest rained, individualized use of technology. The obstetrics approach emph asizes more routine use of state-of-the-art technology. This study con tributes new information to substantiate different models but also sho ws that both provider groups use elements of both. The difference in e mphasis should encourage collaborative practice, given the shared basi s for maternity care, whether it is provided by certified nurse-midwiv es or obstetricians.