Nurse-midwifery services in one multi-ethnic, underserved community

Through a nurse-midwifery service in a mixed urban and rural agricultural community, we compared maternal risk factors, prenatal care, labor and delivery, and adverse birth outcomes in low-income Mexican-American Hispanic, white (Caucasian), and Southeast Asian women--a three-way analysis rarely reported in the literature. Southeast Asian women were older and had more children. Hispanic women bore children at a younger age. Both Southeast Asians and Hispanics made fewer prenatal visits than did Caucasian women, and used less analgesia and anesthesia during delivery. The incidence of Cesarean section (7.7 percent) and low birthweight (5.9 percent) was compared to local, state, and national reference statistics. Prospective case-controlled studies and cost/benefit analyses of nurse-midwifery services could yield more definitive information. But until more precise data are collected for birth certificates, these studies will be difficult.