Certified nurse midwives: over twenty years of military service.

The Department of Defense has utilized certified nurse midwives (CNMs) for the delivery of primary women's health care for over 20 years. Although their numbers remain relatively small, their impact on quality, cost, choice, and access to care is substantial. CNMs are not merely physician extenders, but primary health providers who emphasize holistic and wellness-oriented care. This philosophy, based on both nursing and midwifery models of care, distinguishes as well as makes the CNMs' practice complementary to that of their medical contemporaries. This paper presents an overview of what CNMs are, their training, their philosophy of care, where they work, and some of the contributions they have made to the military health care system.