Certified nurse-midwife effectiveness in the health maintenance organization obstetric team.

This study of the effectiveness of certified nurse-midwives in a health maintenance organization (HMO) led to five conclusions: 1) Maternity patients accepted certified nurse-midwife care; 2) the general female HMO population had little awareness of certified nurse-midwives but was receptive to receiving certified nurse-midwife care once the role was explained; 3) certified nurse-midwives reduced inpatient cost; 4) the use of certified nurse-midwives did not affect perinatal outcomes; and 5) physicians and certified nurse-midwives worked well together as team members. Certified nurse-midwives proved to be an unqualified success as team members in this setting.