Obstetrician and nurse-midwife collaboration: successful public health and private practice partnership.

Objective: To evaluate maternal and neonatal outcomes of collaborative maternity care for a socioeconomically diverse patient population in a California community hospital.

Methods: Collaborative practice structure and clinical guidelines were analyzed, as were de-identified electronic medical records for all primiparous women who delivered term singletons between 2000 and 2010 (N=4,426). Demographics, care processes, and perinatal outcomes were compared among women seen prenatally in a private collaborative practice compared with a Federally Qualified Health Center prenatal clinic run by nurse-midwives.

Step 7: educates staff in nondrug methods of pain relief and does not promote use of analgesic, anesthetic drugs: the coalition for improving maternity services:

Step 7 of the Ten Steps of Mother-Friendly Care insures that staff are knowledgeable about nondrug methods of pain relief and that analgesic or anesthetic drugs are not promoted unless required to correct a complication. The rationales for compliance and systematic reviews are presented on massage, hypnosis, hydrotherapy, and the use of opioids, regional analgesia, and anesthesia.