'The weight of evidence indicates that, within their areas of competence, Certified Nurse Midwives (CNM) provide care whose quality is equivalent to that of care provided by physicians.  Moreover, CNM's are more adept that physicians at providing services that depend on communication with patients and preventive actions" - US Congress, Office of Technology Assessment, 1986

Recent research has also focused on the effectiveness of the routine interventions that nurse-midwives try to avoid.  A 1985 review in the Journal of Nurse-Midwifery of all studies on postdate pregnancies, for instance, found no evidence that outcomes for mother or baby were better when labor was automatically induced because the fetus had reached a predetermined gestational age.

In 1985, a study published in the journal Birth compared women who received epidural anesthesia with those who used other pain relief or no medication al all.  The study found that women who received epidural anesthesia had longer labors, needed pitocin, more frequently to augment labor, had a higher incidence of forceps deliveries and more bladder catherizations.  Two years later a study in the same journal found that among 70 women questioned, only 27 percent said the experience of labor matched their expectations.  Their most frequent surprise, getting less pain relief that expected from medication.

During the 1980's numerous studies looked into whether continuous electronic fetal monitoring truly had the expected benefits over checks of the baby's heartbeat with a fetoscope at regular intervals.  The author of a 1990 editorial in the New England Journal of Medicine summarized studies of continuous electronic fetal monitoring and concluded the answer was no.

"Clearly the hoped for benefit from intrapartum electronic fetal monitoring has not been realized," Dr. Roger Freeman of Memorial Medical Center in Long Beach, California wrote, "It is unfortunate that randomized, controlled trials were not carried out before this form of technology became universally applied...  The story of electronic fetal monitoring also illustrates the need for proper randomized clinical trials before new forms of practice with out clearly demonstrated benefit."

Traditional reasons for doing an episiotomies have been to avoid a dangerous tear for the mother and to limit trauma for the infant.  A 1981 study in the Journal of Nurse-Midwifery, however, showed that five minute Apgar scores were not notably different when the head was delivered slowly over an intact perineum.