A new study published in the May issue of the Journal of Epidemiology and Community Health (1998:52:310-317) documents lower infant mortality rates for births attended by certified nurse midwives.  The study examined all singleton, vaginal births in the United States in 1991 delivered at 35 - 42 weeks of gestation and attended by either physicians or certified nurse midwives.  According to the National Center for Health Statistics, Center for Disease Control and Prevention, which released the study, this is the first study known to examine infant mortality risks for all certified nurse midwife attended births.

The authors, Mary F. MacDorman PhD, and Gopal K. Singh, PhD, found that the risk of infant death was 19% lower for certified nurse midwife attended births than those attended by physicians. the risk of neonatal mortality was 33% lower and the risk of delivering an infant with low birth weight was 31% lower.  In addition, the mean birth weight was 37 grams heavier for births attended by certified nurse midwives.  The findings were consistent even after controlling for a number of sociodemographic and medical risk factors.  The authors also found that certified nurse midwives cared for a greater number of women who were at a higher risk for poor birth outcomes given their socildemographic status and that physicians attended slightly more births with medical complications.

According to the authors, one possible explanation doe the findings may have to do with the difference between certified nurse midwives and physicians prenatal, labor and delivery practices.  Recent studies have shown that certified nurse midwives tend to spend more time with patients during prenatal visits, and provide a more personal counseling approach during labor.  Certified nurse midwives also put more emphasis on patient counseling and education, establishing trust, minimizing the use of unnecessary interventions and providing emotional support and empowerment to pregnant women.  Other studies have shown improved outcomes for women who received continuous emotional support during labor.

The study concluded by saying "certified nurse midwives have excellent birth outcomes and provide a safe and viable alternative to maternity care in the United States."  There are approximately 5,500 certified nurse midwives in the US attending close to 6% of the nations births.

The American College of Nurse Midwives (ACNM) incorporated in 1955, is dedicated to supporting and developing the profession of nurse midwifery in order to promote the health and well being of women and infants with their families and communities.  More information about ACNM can be found at the ACNM website (www.midwife.org) Consumers can also locate a certified nurse midwife by dialing 1-888-MIDWIFE from a touchtone phone.