Nurse-Midwives and Physicians: A Team Approach to Obstetrical Care in a Perinatal Center


  • Anne Scupholme C.N.M.

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    • Anne Scupholme is the Clinical Director of the Nurse-Midwifery Service at the University of Miami–Jackson Memorial Medical Center. She gained her basic midwifery training in England and attended the refresher program at Booth Maternity Center in Philadelphia. Apart from practicing in perinatal centers, Ms. Scupholme has worked on the domicillary service in England and in the University Hospital of the West Indies in Kingston, Jamaica.

  • This paper is an updated version of a presentation entitled “The Impact of Nurse-Midwifery in a Tertiary Care Center” which the author delivered at the 24th Annual Convention of the American College of Nurse-Midwives in April, 1979.

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Controversy exists concerning the role of nurse-midwives in tertiary care centers. By tradition, preparation, and practice, nurse-midwives have not sought to work in the areas of high-risk obstetrics. However with the advent of modern technology and the prevailing economic and legal climate, many more women are finding themselves referred to high-risk centers for obstetrical care. All of these factors contributed to the formation of the nurse-midwifery service at the University of Miami, Jackson Memorial Hospital, Miami, Florida in January 1977. The service is described as it evolved over four and a half years. The success of the model led to the expansion of the philosophy and the development of the three principles of practice–independent management, comanagement, and collaborative management. The nurse-midwives have performed 8,145 deliveries. Selected data is reviewed and the continued role of nurse-midwives in perinatal centers is discussed.