MS

thesisBirth attendant have been described throughout recorded history. Professional birth attendants have usually been either female midwives or male physicians. Several studies from the last three decades have explored the relationship between certified nurse-midwives (CNMs) and MDs (medical doctors). This investigation examined Utah physicians' previous experiences with nurse-midwives, knowledge of nurse-midwifery and whether these factors impact perceptions and attitudes they hold toward nurse-midwifery. The study design was an exploratory survey using a written questionnaire. It was comprised of the total population of physicians thought to be currently practicing obstetrics in Utah. A 43% overall return rate was obtained, with a 39% unable rate to return. Mean scores were computed for knowledge, satisfaction, and perception. The mean knowledge score was 5.23 out of 8, indicating a generally good knowledge level concerning CNM practice and education. The overall man satisfaction score (n=211) falls between neutral and satisfied on the scale. The responses were positive overall. The overall mean perception score pertaining to competence of nurse-midwives was generally positive. Perception scores were compared between respondents with past/present association and those without such associations. Those with past/present associations consistently scored higher on questions with regard to perception of nurse-midwifery competence. When asked about benefits and liabilities of having a relationship with a CNM, physician saw benefits as out-weight liabilities. The two perceived benefits checked most frequently were increased patient satisfaction and attraction of new patients. The two liabilities most often perceived as detrimental in even a positive CNM/MD relationship were possible increased professional liability and increased malpractice insurance. Perception of physicians pertaining to appropriateness of employment modes, of CNMs as their employee or as fellow employees in the same institution. They were in less favor of being partners with CNMs in a practice or having a CNM contact with physicians. Areas which CNMs and physician might mutually address are: (a) increased knowledge about what each is prepared to do for clients; (b) mutual expectations of the collaborative relationship; and (c) education of young physicians regarding the role of the CNM