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Obstetrics & Gynecology 1989;74:112-116
© 1989 by The American College of Obstetricians and Gynecologists
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Certified Nurse-Midwife Effectiveness in the Health Maintenance Organization Obstetric Team

KENNETH E. BELL, MD and JACK I. MILLS, PhD

From the Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Anaheim; and the Department of Organization Effectiveness, Kaiser Permanente Medical Care Program, Southern California Region, Los Angeles, California

Abstract

This study of the effectiveness of certified nurse-midwives in a health maintenance organization (HMO) led to five conclusions: 1) Maternity patients accepted certified nurse-midwife care; 2) the general female HMO population had little awareness of certified nurse-midwives but was receptive to receiving certified nurse-midwife care once the role was explained; 3) certified nurse-midwives reduced inpatient cost; 4) the use of certified nurse-midwives did not affect perinatal outcomes; and 5) physicians and certified nurse-midwives worked well together as team members. Certified nurse-midwives proved to be an unqualified success as team members in this setting.






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