Nurse-midwives and obstetricians: alternative models of care and client "fit"

Issues related to the fit between clients and providers were investigated using data on 244 women who received prenatal care at one of two health care facilities that offered both nurse-midwifery and obstetrician services. Characteristics of the women who received each type of care, as well as their perceptions of their health provider, were explored. No significant demographic differences were found between the nurse-midwifery (CNM) and obstetrician (OB) client groups. The CNM clients scored higher on internal locus of control and the OB clients scored higher on chance and powerful others locus of control. For five of six behaviors (prenatal care, diet, exercise, and abstaining from caffeine and alcohol), the CNM clients consistently viewed their providers as holding significantly stronger attitudes about the behavior and as being significantly more supportive of their engaging in them than did the OB clients. Findings from this study provide evidence in support of offering women alternatives in maternity care.