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Improving maternalhealth care

The U.S ranks in last place for maternal health outcomes when compared to other developed countries. Using more midwifery care could help improve this statistic.

Midwives take a different approach to pregnancy care and support the normal physiological process of birth. Midwives are shown to have less interventions, lower cesarean section rates and less NICU admissions.

Only 8% of births in America are attended by a midwife compared to other high-income countries where 75% of all births are attended by a midwife. According to the CommonWealth Fund, the U.S. has an undersupply of midwives compared to peer countries.

The Strong Start Study was a federal five-year, multi-site project to test and evaluate enhanced prenatal care for women enrolled in Medicaid. The midwifery-led findings of this study, which involved 187 birth centers, showed infants were 26% less likely to be born prematurely, 20% less likely to have low birth weight, and the C-section rate was 40% lower in birth centers. Simply put, midwifery care is safe and leads to improved outcomes which save money and lives.

In the U.S., two women a day die from childbirth with many of these women being black or brown. Black and brown women are two to three times more likely to experience negative outcomes with pregnancy and birth. Strong Start results were exceptional in reducing racial inequities: there were no differences by race for rates of C-section and breastfeeding, or for the experience of care. Notably, participants reported feeling heard, being able to understand communications with the care team, having time for questions, being involved in decision-making, and being treated with respect.

Birth centers are also shown to have lower NICU admissions, less interventions and high patient satisfaction when compared to hospital care. Oregon is a leader in out-of-hospital birth with rates at 5% compared to the national average of 2%. Still, there are only just over 400 birth centers in the entire USA.

Maternal health is a basic human right. Increasing access to midwives and birth centers is key to improving our country’s maternal health crisis.


Crystal Massey, CNM, MSN


890 Beltline Road in Springfield


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