The evolving practice of nurse-midwifery.

Increasingly, nurses nationwide are assuming expanded roles in the provision of health care. Certified nurse-midwives (CNMs) are one example. These practitioners function in varied settings from the home to the level three hospital. As with any change, the transition to this present role has been a long and, very often, a difficult one. Their efficacy, safety, and cost-effectiveness is today unquestioned; however, impediments to practice still exist. Whether the impediment be in securing hospital privileges or prescriptive capability, the CNM continues to strive to overcome these obstacles in order to ensure the accessibility of nurse-midwifery care to all women.