Nurse-midwifery in New York City

The American College of Nurse-Midwives and Its Antecedents: A Historic Time Line

In celebration of the 50th anniversary of the American College of Nurse-Midwives, this time line presents a chronologic history of the development of nurse-midwifery in the United States. It places the introduction of nurse-midwifery in American health care into its historic context and follows the evolution of the profession through early attempts at forming a national organization, the eventual formation of the American College of Nurse-Midwifery, and the subsequent merger with the American Association of Nurse-Midwives, to create the American College of Nurse-Midwives. The work of the College between 1955 and the turn of the 21st century is highlighted.

The effectiveness of non-physicians as providers of family planning services

Population growth and advances in contraceptive technology are discussed in relation to changes in birth control attitudes and practices and the expansion of public family planning programs. The literature describing training, utilization, and effectiveness of non-physicians in providing family planning services is reviewed. Studies comparing physician and non-physician provision of oral contraceptives and IUD insertions are discussed. On the basis of extensive supporting data, the author concludes that many functions which formerly were in the physician's province are as safely and perhaps more appropriately performed by persons with less medical sophistication. Recommendations are made regarding the present and future role of nurses as primary care providers in family planning.

Midwifery, 1977

On January 1, 1974, an autonomous midwifery service was formed at Roosevelt Hospital in New York City to provide an obstetric service to "private" patients. While the autonomy was complete, physician consultation and participation provided by the "full-time or senior resident" staff were always available. We are now aware that this plan as opposed to any other, provided the ingredient of consumer-desired empathy of the midwife coupled with instant obstetric expertise that assured every patient the availability of modern obstetric practice. Four hundred and fifty-four patients cared for by midwives were compared to a random sample of 500 patients cared for by attending obstetricians. A striking similarity in the two groups was evident. Certain items, such as operative deliveries, were higher in the private patient group. The midwifery group had a low incidence of complications, but the incidence of acute complications made it apparent that an operating room suite must be immediately available. It is eminently clear that a low-risk group can be identified but there is no possible way to identify a "no risk" population.

Obstetricians and nurse-midwives: The team approach in private practice

Much has been written about the need for help for the overworked obstetrician. Two obstetricians delivering over 500 babies annuallay had insufficient time for their gynecology practice. Two nurse-midwives were employed and in the first year they delivered 61 per cent of those patients who delivered vaginally. All normal patients had the privilege of choosing their accoucheur; patients, nurse-midwives, and obstetricians were very well pleased with the team approach.