Evaluation of a public-private certified nurse-midwife maternity program for indigent women.
OBJECTIVE
This study assessed the impact of a public-private certified nurse-midwife program on prenatal and delivery outcomes among medically indigent women.


METHODS
A population-based quasi-experimental design was used to compare 1 intervention county with 2 nonintervention counties.


RESULTS
The program significantly reduced the number of women who received no prenatal care and the risk of acquiring less than adequate prenatal care. Reductions in the proportion of infants born premature or with low birth-weights were of borderline significance. The use of induction and/or stimulation of labor was statistically elevated.


CONCLUSIONS
These results suggest that the intervention program was instrumental in reducing some, but not all, negative prenatal and delivery outcomes.
Lenaway
D
D
Boulder County Health Department, CO 80304, USA.
Koepsell
T D
TD
Vaughan
T
T
van Belle
G
G
Shy
K
K
Cruz-Uribe
F
F
D000328:Adult; D002568:Certification; D003120:Colorado; D018672:Community Health Planning; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration*; D008489:Medical Indigency; D009721:Nurse Midwives / Q000458:organization & administration*; D011247:Pregnancy; D011256:Pregnancy Outcome; D017149:Private Sector; D015397:Program Evaluation; D011635:Public Health Administration; D017150:Public Sector