Abstract

U.S. perinatal morbidity and mortality rates are high and rising and feature sizeable racial and ethnic disparities. One underutilized yet proven approach to improving U.S. perinatal health involves policy reform to more widely use midwifery models of care. Increased access to midwifery care is correlated with improved outcomes for families, including lower rates of interventions, increased rates of vaginal births and breastfeeding, and lower rates of neonatal deaths. Attendees will gain an overview of current U.S. midwifery models of care, philosophy, and outcomes, as well as effective midwifery care models that can improve perinatal health, such as racially and culturally concordant care, team-based case, birth setting integration, and a focus on shared decision-making/patient autonomy. Six barriers to the growth and integration of midwifery care will be reviewed as well as critical health policy strategies to mitigate them.

Notes

References:

Alspaugh, A., Blumenfeld, J., Wright, L. V., Recalde, S., & Lindberg, L. D. (2024). "You and me do it for the love of teaching": Exploring the expansion of clinical training opportunities for midwives. The Journal of Perinatal & Neonatal Nursing, 38(2), 147–157. https://doi.org/10.1097/JPN.0000000000000815

American College of Nurse-Midwives. Access to Midwifery Care National Chartbook. 2023. https://www.midwife.org/acnm/files/cclibraryfiles/filename/000000009370/Access%20to%20Midwifery%20Care%20National_Chartbook_20241024.pdf

Carlson, N. S., Neal, J. L., Tilden, E. L., Smith, D. C., Breman, R. B., Lowe, N. K., Dietrich, M. S., & Phillippi, J. C. (2019). Influence of midwifery presence in United States centers on labor care and outcomes of low-risk parous women: A Consortium on Safe Labor study. Birth, 46(3), 487–499. https://doi.org/10.1111/birt.12405

Jeffers, N. K., Canty, L., Drew, M., Grayson, N., Amani, J., Marcelle, E., & Amore, A. D. (2023). Beyond "patient-provider race matching." Black midwives clarify a vision for race-concordant care to achieve equity in Black perinatal health: A commentary on "Do Black birthing persons prefer a Black health care provider during birth? Race concordance in birth". Birth, 50(2), 267–272. https://doi.org/10.1111/birt.12720

Vedam, S., Stoll, K., MacDorman, M., Declercq, E., Cramer, R., Cheyney, M., Fisher, T., Butt, E., Yang, Y. T., & Powell Kennedy, H. (2018). Mapping integration of midwives across the United States: Impact on access, equity, and outcomes. PloS one, 13(2), e0192523. https://doi.org/10.1371/journal.pone.0192523

Description

The U.S. perinatal morbidity and mortality rates are high and worsening. Increased access to midwifery care is correlated with improved perinatal outcomes. U.S. midwifery care is poised to improve perinatal health but has not yet been widely integrated as a care model due to historic and contemporary barriers. Six barriers to the growth and integration of midwifery care will be reviewed as well as critical health policy strategies to mitigate them.

Author Details

Heather Bradford, PhD, CNM, FACNM; Ellen Tilden, PhD, CNM, FACNM, FAAN; Jennifer Kaeser Jagger, PhD, CNM, WHNP-BC, FACNM; Ellen Chaney Solis, DNP, CNM, FACNM

Sigma Membership

Psi at-Large

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Workforce, Politics and Advocacy, Interprofessional, Interdisciplinary, Perinatal Morbidity, Perinatal Mortality

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the slide deck.

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How Can Midwifery Care Decrease Perinatal Morbidity and Mortality and Address Health Inequities?

Seattle, Washington, USA

U.S. perinatal morbidity and mortality rates are high and rising and feature sizeable racial and ethnic disparities. One underutilized yet proven approach to improving U.S. perinatal health involves policy reform to more widely use midwifery models of care. Increased access to midwifery care is correlated with improved outcomes for families, including lower rates of interventions, increased rates of vaginal births and breastfeeding, and lower rates of neonatal deaths. Attendees will gain an overview of current U.S. midwifery models of care, philosophy, and outcomes, as well as effective midwifery care models that can improve perinatal health, such as racially and culturally concordant care, team-based case, birth setting integration, and a focus on shared decision-making/patient autonomy. Six barriers to the growth and integration of midwifery care will be reviewed as well as critical health policy strategies to mitigate them.