This study reports a 5-year experience in a private practice team approach to obstetrical care. Two nurse-midwives during the 5-year study period delivered 66% of those clients who delivered vaginally. All normal clients had a choice of their birth attendant (nurse-midwife or obstetrician). Low birth weight infants (≤2500 g) and perinatal deaths decreased each year of the study except year 4. Family-centered maternity care and formal childbirth preparation were introduced into the practice and community. Each year noted an increase in the number of participants. Clients, their families, nurse-midwives, and obstetricians expressed satisfaction with this approach to childbearing.