Get access

NURSE-MIDWIFERY CARE TO VULNERABLE POPULATIONS Phase I: Demographic Characteristics of the National CNM Sample

Authors

  • Anne Scupholme CNM, MPH,

    Corresponding author
      Anne Scupholme, CNM, MPH, 9311 SW 4th Street, Apt. 217, Miami, FL 33174.
    Search for more papers by this author
    • Anne Scupholme, CNM, MPH, is the chief nurse-midwife at Jackson Memorial Hospital, Miami, Florida and an adjunct associate professor of obstetrics and gynecology. University of Miami School of Medicine. She is a board member of the ACNM Division of Research and Project Manager for the current ACNM–RWJ research project, “Nurse-Midwifery Care to Vulnerable Populations.” Her research and academic interests include health policy issues concerning access to health care and clinical issues relating to low birth weight.

  • Jeanne DeJoseph CNM, PHD, FAAN,

    Search for more papers by this author
    • Jeanne DeJoseph, CNM, PhD, FAAN, is an assistant professor at the University of California, San Francisco, and Co-Director of the Midwifery Program, Department of Family Health Care Nursing, University of California, San Francisco. She is Chairperson of the Professional Development Committee of the ACNM Division of Research and a coinvestigator of the current ACNM–RWJ research project, “Nurse-Midwifery Care to Vulnerable Populations.” Her research and academic interests include the women's work during pregnancy and social support interventions among African-American pregnant women.

  • Donna M. Strobino PhD,

    Search for more papers by this author
    • Donna M. Strobino, PhD, is an associate professor, Department of Maternal and Child Health, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland. She is a coinvestigator for the ACNM–RWJ research grant, “Nurse-Midwifery Care to Vulnerable Populations.” Her research interests are evaluation of perinatal programs and services, development of risk assessment instruments, and the impact of life-style and demographic factors on pregnancy outcomes.

  • Lisa L. Paine CNM, DrPH, FAAN

    Search for more papers by this author
    • Lisa L. Paine, CNM, DrPH, FAAN, is an associate professor and Director of the Nurse-Midwifery Education Program of the Boston University, School of Public Health, Boston, Massachusetts. She is the Chairperson of the ACNM Division of Research and Project Director for the ACNM–RWJ research grant, “Nurse-Midwifery Care to Vulnerable Populations.” Her research interests are low technology fetal assessment and health policy issues regarding nurse-midwifery practice and maternal and child health.


Anne Scupholme, CNM, MPH, 9311 SW 4th Street, Apt. 217, Miami, FL 33174.

ABSTRACT

The purpose of this article is to describe the extent to which certified nurse-midwives (CNMs) provide care to vulnerable populations in the United States and the source of reimbursement for this care. The data were obtained from the first phase of a national study to address the characteristics of women served and cost of care provided by CNMs. Results were analyzed nationally and by American College of Nurse-Midwives regions. Certified nurse-midwives in all types of practices are providing care to women from populations that are vulnerable to poorer than average outcomes of childbirth because of age, socioeconomic status, refugee status, and ethnicity. Ninety-nine percent of CNMs report serving at least one group of vulnerable women, and CNMs in the inner city and rural practices serve several groups. The vast majority of CNMs are salaried; only 11% receive their primary income from fee-for-service. Fifty percent of the payment for CNM services is from Medicaid and government-subsidized sources whereas less than 20% comes from private insurance. Source of income varies by type of setting in which the CNM attends births. The results suggest that CNMs, as a group, make a major contribution to the care of vulnerable populations.

Get access to the full text of this article

Ancillary