[lsaferite]

My wife's obstetrician's office is about half ARPN-CNMs (Certified Nurse Midwife). She saw the Dr for a few appointments, but mostly the CNMs. A CNM delivered our son in the hospital. The CNM had the Dr available to her if things went badly. For our daughter, we came to the hospital with my wife 9cm dilated and the CNM was unable to get there fast enough. In the end it was good that the Dr was there instead as she was born not breathing and eventually ended up on life-support. Even in that case the CNM was the primary care provider for the entire pregnancy.

We live in the US. I think not enough women use CNMs, but it's not some universal thing that you have to use an obstetrician in the US.