This document discusses trends in midwifery and obstetrical nursing. It begins by defining midwifery and obstetrics. It then outlines several trends, including economic issues like rising costs of childcare; technological advances in fertility treatments and testing; demographic shifts to urban areas; changes in healthcare settings like managed care and shorter hospital stays. It also discusses trends toward patient involvement and self-care. Current problems discussed are shorter hospital stays, higher patient acuity, lack of rural facilities, and changes to maternal-newborn nursing models.