Nurse midwives keep cost, Caesarean rates lower, study finds

Low-risk women who choose nurse midwives for their deliveries have fewer Caesarean sections, receive less anesthesia, have a much lower rate of episiotomy and incur less expense, compared to similar women who choose physicians. At the same time, obstetricians, family physicians and nurse midwives all achieve excellent results, says a UW study reported in the April issue of the American Journal of Public Health.

“Nurse midwives establish a rela­tionship with their patients that leads to excellent outcomes with less use of medical resources,” says Family Medicine Professor Roger Rosenblatt.

The Caesarean-section rate for patients of nurse midwives was 8.8 percent, compared to 13.6 percent for obstetricians and 15.1 percent for family physicians. The study found that the patients of nurse midwives were less likely to receive continuous fetal monitoring or to have their labors induced or augmented. They were also less likely to receive epidural anesthesia. Overall, patients of midwives used 12 percent fewer resources than patients of physicians.

The researchers took a random sample of all the urban practitioners in Washington state who deliver babies in hospitals: nurse midwives, family doctors, and obstetricians.