This is a report of the history and development of the Hennepin County Medical Center Nurse-Midwife Service in Minneapolis, Minnesota. Since its inception, the Nurse-Midwife Service has provided care to over 2400 childbearing families. Demographic data, pregnancy outcome, maternal complication, and neonatal morbidity statistics are presented from 496 consecutive singleton births during the period January 1978 to January 1979. Highlights of data include a 4.8% cesarean birth rate for all births from July 1973 to December 1980, and a 6% cesarean rate for 496 births presented in this study. For the 496 consecutive singleton births, 58% of women had no episiotomy or lacerations; 87% of women breastfed their infants; and 97% of infants weighed greater than 2500 g.