Gynecologic and Contraceptive Services Provided by Certified Nurse-Midwives in North Carolina

Gynecologic care by midwives has been little represented in the peer-reviewed literature despite the fact that the majority of midwives provide these services. Offering patients a variety of contraceptive options is important for informed choice and consent and for reducing the unintended pregnancy rate, which is nearly 50% in the United States. This study describes the volume of gynecologic care and the contraceptive methods provided by certified nurse-midwives (CNMs) in North Carolina. The study was conducted using a cross-sectional, confidential, self-administered mail questionnaire completed by 133 CNMs in clinical practice in North Carolina. The majority of the CNMs worked in private practice settings (67%), in urban areas (60%), and had 10 or fewer years of experience (62%). The median number of women seen weekly for gynecologic care was 15 (range 0-80), and 30% of CNMs provided gynecologic care to more than 25 women each week. The contraceptive methods discussed and provided by the CNMs were comprehensive. The high percentage of midwives providing gynecologic care merits further study of the content and quality of this care.