For example, CNMs typically spend less on lab work because they customize care for each woman, rather than ordering the same routine of lab work regardless of a woman's lifestyle. Women under a CNM's care are less likely to have a cesarean section, which is a very expensive surgery. Unfortunately, CNMs salaries are lower than physicians, but this allows hospitals to charge patients less for a CNM's services. Some women simply do not want the medical model of care. The majority of the CNMs interviewed for this project work at PMH's Accent on Women, which was established in 1972 as the first nurse-midwifery practice in Arizona.
Many factors influence the future of midwifery in the Valley.
The three most important factors cited by CNMs and recent literature are public awareness, insurance companies, and the job market. CNMs are not advertised very much, and there are different levels of awareness throughout the country. For example, in the eastern U.S., more people know about CNMs because CNMs have been practicing longer there and many of the education programs are there. Insurance Companies Many of the managed care insurance plans in Arizona do not list CNMs in their care packages. Sometimes, only the back-up physician of the CNM is named, although the CNM and physician may work together in the same office.