This study compares the labor and delivery outcomes of certified nurse-midwives (CNMs) and physicians. For care processes, (e.g., epidural, labor induction, episiotomy), CNMs were found to have lower rates of application/use. For infant outcomes, (e.g., low Apgar, low birth weight, neonatal intensive care unit admission), there were no differences between physicians and CNMs. Perineal lacerations were lower and breastfeeding rates were higher among women cared for by CNMs compared with physicians.