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The Theoretical Basis for Nurse-Midwifery Practice in the United States: A Critical Analysis of Three Theories


  • Leslie Cragin CNM, PhD

    Corresponding authorSearch for more papers by this author
    • Leslie Cragin, CNM, PhD, is an Assistant Clinical Professor in the Department of Obstetrician/Gynecologist and Reproductive Science at UCSF. She is the Director of Administration and Practice of the Nurse-Midwives of San Francisco where she is beginning to develop clinical research projects.

  • This work was supported by a National Research Service Award from the National Institute of Nursing Research/National Institutes of Health (F31 NR07496-01A1) and by a Student Research Award from the Graduate Division at UCSF.

University of California, San Francisco, San Francisco General Hospital, 1001 Potrero Ave., Rm 6D-29, San Francisco, CA 94110. E-mail:


The relatively recent effort of midwifery scholars has resulted in the development of three middle-range midwifery theories in the United States. This article examines the three theoretical models that have been developed to describe the essential components of midwifery practice. The three theorists demonstrate remarkable consistency in the identification of concepts important to the discipline, which includes the following essential characteristics of the midwifery paradigm of care: 1) acknowledgment of connections between the mind and body and the person to the person's life and world; 2) assuming the perspective of the woman to investigate meaning and her experience of symptoms or conditions, so that a plan of care is developed by midwife and woman together; and 3) protection and nurturance of the “normal” in processes related to women's health, implying a judicious use of technology and intervention.