Nurse-midwifery in the United States started with nursing. Florence Nightingale talked about midwives and midwifery nurses in her book Introductory Notes on Lying-In Institutions. Public health nursing in the United States started with organized visiting nursing in the late 1800s under the auspices of the Women’s Branch of the New York City Mission in 1877. Number of public health policies and programs focused on the relationship among prenatal care, maternal health, infant outcomes, public health nursing and midwifery in the early 1900s. The first action undertaken by the Children’s Bureau was to study infant mortality, a task never undertaken before. Public health nurses were proponents of improving maternity care, decreasing maternal and infant mortality, promoting prenatal care, and preventing ophthalmia neonatorum. There was much debate among public health nurses about taking on the learning and practice of midwifery. Public health nurses were significant in the implementation of the Sheppard-Towner Act.