Interspecialty differences in the obstetric care of low-risk women

R.A. Rosenblatt, S.A. Dobie, L.G. Hart, R. Schneeweiss, D. Gould, T.R. Raine, T.J. Benedetti, M.J. Pirani and E.B. Perrin

American Journal of Public Health, 1997, vol. 87, issue 3, 344-351

Abstract: Objectives. This study examined differences among obstetricians, family physicians, and certified nurse-midwives in the patterns of obstetric care provided to low-risk patients. Methods. For a random sample of Washington State obstetrician-gynecologists, family physicians, and certified nurse- midwives, records of a random sample of their low-risk patients beginning care between September 1, 1988, and August 31, 1989, were abstracted. Results. Certified nurse-midwives were less likely to use continuous electronic fetal monitoring and had lower rates of labor induction or augmentation than physicians. Certified nurse-midwives also were less likely than physicians to use epidural anesthesia. The cesarean section rate for patients of certified nurse-midwives was 8.8% vs 13.6% for obstetricians and 15.1% for family physicians. Certified nurse-midwives used 12.2% fewer resources. There was little difference between the practice patterns of obstetricians and family physicians. Conclusions. The low-risk patients of certified nurse-midwives in Washington State received fewer obstetrical interventions than similar patients cared for by obstetrician-gynecologists or family physicians. These differences are associated with lower cesarean section rates and less resource use.

Date: 1997
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:1997:87:3:344-351_4

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