title: Assessment of the process and outcomes of the first 1,000 births of a nurse-midwifery service.
abstract: This article is a retrospective descriptive analysis of the first 1,000 births conducted by the Nurse-Midwifery Group of Fresno County, California, over the period from 1980 to 1985. The multiethnic patient population was of mixed obstetric risk. Nurse-midwifery care was offered within the context of a comprehensive maternity care program in close collaboration with a perinatal health care team. Patient care outcomes were quite favorable when compared with county and state statistics. A perinatal mortality rate of 7.0/1,000 was observed. The incidence of low birth weight infants (5.7%) and the cesarean section rate (7.7%) were also lower than county and state statistics. These data add to the growing body of literature that suggests that nurse-midwifery care, within the structure of collaborative practice, can be effective and advantageous. The nurse-midwifery service made a contribution to access to perinatal care for the residents of this community.
authors.affiliation: Department of Community and Family Medicine, University of California, San Diego, La Jolla 92093.
authors.forename: C M
authors.initials: CM
authors.lastname: Cavero
authors.forename: J T
authors.initials: JT
authors.lastname: Fullerton
authors.forename: J A
authors.initials: JA
authors.lastname: Bartlòme
mesh_terms: D000293:Adolescent; D000328:Adult; D002140:California; D002648:Child; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D005313:Fetal Death; D006297:Health Services Accessibility; D006801:Humans; D015994:Incidence; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008427:Maternal Health Services; D009721:Nurse Midwives; D007744:Obstetric Labor Complications / Q000453:epidemiology; D010043:Outcome and Process Assessment, Health Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011295:Prenatal Care / Q000592:standards; D012189:Retrospective Studies