ABSTRACTA retrospective chart review was done to identify differences between nurse‐midwifery (CNM) and medical intrapartum management. Eighty‐five subjects were admitted to the hospital in labor at term with no history of medical or obstetrical complications. The clinic call schedule provided nonpurposeful assignment of such patients to either CNM or medical management. Age, gravidity, parity, and admission, and admission hematocrit values were similar in both groups. Major differences in management were less routine use of electronic monitoring and intravenous fluids and smaller doses of pain medication in the CNM group. The incidence of amniotomy and pitocin augmentation of labor was similar in the two groups, although amniotomies were performed later in labor by the CNMs. CNM management included a higher frequency of spontaneous vaginal delivery performed under local or no anesthesia, and a lower incidence of instrument‐assisted vaginal delivery, epidural anesthesia, episiotomy, and lacerations. Except for a shorter mean second stage in the CNM group, length of labor and length of hospitalization during labor were similar in two groups, as were infant Apgar scores. Implications for parturients, cost‐effectiveness, and health care planning are di