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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.

Nurse practice laws and regulations are specific to each state. Check out AANP's quick reference guide below for licensure and regulatory requirements, as well as practice environment details, for all 50 states and the U.S. Territories. Download State Regulatory Map Members get more! Log in for access to State Policy Fact Sheets.

This article discusses the Pros and Cons of using APRNs in both outpatient and inpatient settings. One of the positives is that there are more jobs for the APRN and now APRN's can specialize much like physicians. The downside to that is that there are not as many NPs doing primary care, which is leaving a gap.

This article addresses how Iowa APRNs in a state-sanctioned task force identified barriers for practicing at the top of their licensure in a full practice authority state including defending the right to control the scope of nursing practice in court.

Spoelstra, S. L., & Robbins, L. B. (2010). A qualitative study of role transition from RN to APN. International Journal of Nursing Education Scholarship, 7(1).

I found this article very interesting. It talks about the current challenges in midwifery in regards to legislation, reimbursement, physician restrictions, and many other restricting factors. It also discusses the challenges of the education required to become an APRN.

Connects efforts for full practice authority for NPs to the ratification of the Equal Rights Amendment by various states. States that ratified the ERA and therefore have a more egalitarian view of women are more likely to have full scope of practice laws for NPs, CNMs, and CRNAs

A very interesting article going in detail on the expansion of the role of advanced nurse practitioners and the potential rewards and risks associated with it. There is a shortage of primary care providers. Pondering upon the topic of role expansion brings about the important consideration of liability but also has a positive side that includes being able to provide primary care to more people. This article brings up great discussion points.

In reproductive endocrinology, there is no clear role for a CNM. I feel like this article has an undertone that doesn't seem to invite the CNM to the table for collaboration, though I still found it interesting.

This article describes the thought behind, process and goal of the Consensus Model for APRN Regulation, which aims to clarify and unify regulations for APRN licensure, accreditation, certification and education (LACE). This model was created in response to inconsistencies in APRN education and practice caused by a need for APRNs.