title: Health care reform as an ongoing process.
abstract: Reform in maternal and infant health care is presented as an ongoing process. Three phases of reform occurring during the past 4 decades that have been initiated or involved nurses are discussed: the childbirth education movement, which signalled the beginning efforts of parents to regain responsibility and control of their birth experience; the acceptance of nurse-midwives as primary care providers working in concert with obstetrical specialists; and the free-standing birth center as a holistic environment for the practice of midwifery and the care of women anticipating a medically uncomplicated childbirth experience. These reforms represent a paradigm shift that fits all current proposals for reform of the health care system.
authors.affiliation: NACC Consulting Group, Perkiomenville, Pennsylvania.
authors.forename: E K
authors.initials: EK
authors.lastname: Ernst
mesh_terms: D016550:Birthing Centers / Q000639:trends; D001942:Breast Feeding; D005260:Female; D005544:Forecasting; D018166:Health Care Reform / Q000639:trends*; D006801:Humans; D007229:Infant Welfare / Q000639:trends*; D007231:Infant, Newborn; D007389:Internal-External Control; D007743:Labor, Obstetric; D008427:Maternal Health Services / Q000639:trends*; D009721:Nurse Midwives / Q000639:trends; D010290:Parents / Q000193:education; D010358:Patient Participation; D011247:Pregnancy; D014481:United States