Philosophy of care A pilot study comparing certified nurse-midwives and physicians

Prenatal Health Promotion Content and Health Behaviors

“…Findings are consistent with previous studies (Oakley et al, 1995;Yankou et al, 1993). Variations in health promotion content might be related to variations in patient-provider communication.…”

“…Studies have shown that CNM patients were more likely to report receiving health promotion content (Oakley et al, 1995;Yankou, Peterson, Oakley, & Mayes, 1993) and more encouragement to engage in select health behaviors (Aaronson, 1987). Differences between CNMs and MDs have also been found with regard to the percentage of teaching personally conducted by the primary provider; CNMs reported 66% to 95% compared to MDs who reported 25% to 65% (Yankou et al, 1993).…”

Exercise and Pregnancy Knowledge Among Healthcare Providers

“…Similar results were shown by Yankou et al, 19 indicating that C.N.M.s schedule a first prenatal visit for an average of 49.3 minutes, whereas M.D.s first visits average 29.8 minutes. The authors also determined that although both subspecialty groups believed exercise to be a very important topic for prenatal teaching, C.N.M.s conducted 96% of the prenatal exercise teaching compared with M.D.s, who conducted 42% of the prenatal exercise teaching.…”

“…The authors also determined that although both subspecialty groups believed exercise to be a very important topic for prenatal teaching, C.N.M.s conducted 96% of the prenatal exercise teaching compared with M.D.s, who conducted 42% of the prenatal exercise teaching. 19 These findings are also supported by Zeanah and Schlosser, 20 who examined the effects of maternal adherence to ACOG guidelines on pregnancy outcomes. The authors found that few physicians referred to the ACOG guidelines when the study participants inquired about appropriate exercise levels during pregnancy.…”

“…During pregnancy, changes in heart rate (an increase in resting and decrease in maximal heart rate) render heart rate as a less precise way to monitor exercise intensity. 8 To address this issue, Canadian guidelines (PARmed-X for Pregnancy) advise using target heart rate zones representing 60%-80% of age-specific aerobic capacity along with Borg's Rating of Perceived Exertion scale (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) to monitor exercise intensity. 9 It is important to note that current ACOG and U.S. government recommendations for exercise during pregnancy advocate for at least moderate intensity activity and do not set an upper limit for intensity.…”