Benefits of midwife care

Despite being a high-income country, the United States has one of the highest maternal mortality rates in the world, according to the U.S. Department of Health and Human Services (HHS). The CDC states that over 80% of pregnancy-related deaths are preventable—a clear indicator that reform is needed. Preventing these deaths is a priority for both the HHS and the CDC.

The CDC defines a pregnancy-related death as “a death during pregnancy or within one year of the end of pregnancy from a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy.” There are many factors that contribute to maternal health. Medical conditions and social determinants of health play key roles in how a pregnancy progresses.

Research from the World Health Organization (WHO) links midwife care with improvements in more than 50 maternal and neonatal outcomes. The WHO recently called for global expansion of midwife models of care, projecting that 60% of maternal and newborn deaths could be prevented with universal access to skilled midwives.

The American College of Nurse-Midwives reports that midwifery is connected to birth outcomes that are the same as or better than physician care. In particular, the organization cites:

• Fewer interventions during labor (i.e., inductions, episiotomies, use of forceps, etc.)
• Fewer preterm births and infant deaths
• More vaginal births, fewer cesarean sections
• Fewer maternal deaths globally
• More instances of breastfeeding
• Greater satisfaction of care

The March of Dimes endorses midwifery as a key policy solution to the country’s lack of access to maternity care, a problem it issued a report on in 2022. In a separate blog post written that year, the March of Dimes stated that midwife care “can help improve access to maternity care in under-resourced areas, reduce interventions that contribute to risk of maternal mortality and morbidity in pregnancies, lower costs, and potentially improve the health of mothers and babies.”

Editor’s note: This article was excerpted from our Patient Safety Monitor Journal newsletter.