The purpose of this exchange is to share the experiences and practices of four nurse-midwifery services that are involved in aspects of newborn and child care. Some examples of historical developments that have influenced the divergent trends in newborn child care in midwifery today are given. The contributors describe special procedures, as well as extended care of newborns as they become infants, children, and young adults. The type and extent of care provided is responsive to the needs and expectations of the families served and to the community in which the service is located. It also reflects the philosophy of the midwifery practice.