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Facts About Certified Nurse-Midwives.

Numbers:

* The American College of Nurse-Midwives currently has more than 6,400 members. Of those, approximately 5,200 are in clinical practice. The rest are students, faculty members, retired, or outside of clinical practice for a variety of reasons.[1]

* Each year, approximately 400 nurse-midwives pass the national certification exam. The number of nurse-midwives who are certified each year has increased by 25 percent since 1991.[2]

* In 1995, the most current year data are available from the National Center for Health Statistics, there were 216,768 CNM-attended births in the U.S. This accounts for 5.6 percent of the births that year. The number of CNM-attended births has increased every year since 1975, the first year the NCHS began collecting this data.[3]

Education:

* There are currently 50 ACNM accredited nurse-midwifery education programs in the U.S. Most of these programs offer a master's degree.[4]

* Approximately 68 percent of CNMS have a master's degree. Four percent have a doctoral degree.[5]

* The majority of CNMs have access to a personal computer. Half of these have access to a modern and approximately 40 percent have access to the Internet. A distance learning program that graduates approximately 100 nurse-midwives each year relies heavily upon computer-aided communication for linkage between students and faculty.[5]

Practice:

* Nurse-midwifery practice is legal in all 50 states and the District of Columbia.[13]

* Twenty-nine states mandate private insurance reimbursement for nurse-midwifery services and Medicaid reimbursement is mandatory in all states.[13]

* Over half of all CNMs work primarily in an office/clinic environment. Most list a hospital or physician's practice as their place of employment.[6]

* Most CNM-attended births occur in hospitals. In 1995, 96 percent of CNM-attended deliveries occurred in hospitals, 3 percent in freestanding birth centers, and 1 percent in the home.[3]

* The average nurse-midwife sees 140 clients a month and attends 10 births a month.[6]

* Most nurse-midwives have seen their practices grow over the last year (1993) and are reporting higher client populations.[6]

* Nurse-midwives have prescription writing authority in 47 states and jurisdictions.[12]

* The average nurse-midwife has an epidural rate of 14.6 percent and an episiotomy rate of 30.1 percent.[8]

* According to Public Citizen's Health Research Group, CNMs have a cesarean section rate of 11.6 percent and a vaginal birth after a previous cesarean rate of 68.9 percent. During the same period, the national rates were 23.3 and 24.9 percent respectively.[10,3]

* The 1991 infant mortality rate for nurse-midwives was 4.1 per 1,000, the national average for that year was 8.6 per 1,000.[9]

Client Interaction:

* Of all visits to CNMs, 90 percent are for primary, preventive care; 20 percent are for care outside the maternity cycle. Examples of this kind of care include annual exams and reproductive health visits.[6]

* The typical CNM spends about 40 minutes on a new client visit and 20 minutes on a return visit.[6]

* In a national survey, the majority of women who received care by a CNM reported being very satisfied.[7]

* Currently, 70 percent of the women seen by nurse-midwives are considered vulnerable by virtue of their age, socioeconomic status, education, ethnicity, or location of residence.[11]

* When asked in a national survey, women who are planning to have additional children and are 25-34 years old, have a college degree, and an income of approximately $20k per year report being likely to use a CNM in the future.[7]

References

[1.] ACNM membership department figures

[2.] ACNM Certification Council, Inc. figures

[3.] "Monthly Vital Statistics Report," vol. 45, no. 11(S)

[4.] ACNM education department figures

[5.] Evaluation survey of the ACNM Division of Research 1994

[6.] "Readership and Practice Profile of the ACNM: Findings of a Direct Mail Survey," Journal of Nurse-Midwifery, vol. 39, no. 1

[7.] ACNM Marketing and Public Relations Department

[8.] "Process of care: Comparisons of CNMS and Obstetricians," Journal of Nurse-Midwifery, vol. 40, no. 5

[9.] National Center for Health Statistics birth cohort study

[10.] "Ensuring the Use of Nurse-Midwives," Public Citizen's Health Research Group, 1995

[11.] "Nurse-Midwifery Care To Vulnerable Populations," Journal of Nurse-Midwifery, vol. 37, No. 5

[12.] "A Handbook of State Legislation," ACNM 1997 M&PR 97-10/28

--Source: ACNM web page, http://acnm.org
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No portion of this article can be reproduced without the express written permission from the copyright holder.
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Title Annotation:American College of Nurse-Midwives
Publication:Special Delivery
Geographic Code:1USA
Date:Sep 22, 1998
Words:717
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