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Midwifery could be key to addressing maternal health inequities

ProPublica story reports implications of MacDorman study

Writing in ProPublica, Nina Martin reports on a five-year study on which Faculty Associate Marian MacDorman worked that examines the impact of regulations on midwives in 50 U.S. states. Great Britain, Sweden, Norway, France, Canada, and New Zealand all "have much lower rates of maternal and infant mortality than the U.S.," she writes. "Here, severe maternal complications have more than doubled in the past 20 years. Shortages of maternity care have reached critical levels: Nearly half of U.S. counties don’t have a single practicing obstetrician-gynecologist, and in rural areas, the number of hospitals offering obstetric services has fallen more than 16 percent since 2004. Nevertheless, thanks in part to opposition from doctors and hospitals, midwives are far less prevalent in the U.S. than in other affluent countries, attending around 10 percent of births, and the extent to which they can legally participate in patient care varies widely from one state to the next. . . ."

"Many of the states characterized by poor health outcomes and hostility to midwives also have large black populations, raising the possibility that greater use of midwives could reduce racial disparities in maternity care," she added.

The report, "Mapping integration of midwives across the United States: Impact on access, equity, and outcomes," published February 21, 2018, in PLoSONE, gives a state-by-state resume of midwifery restrictions and potentially co-related health outcomes for children. Lead scientist on the study is Saraswathi Vedam, Associate Professor of Midwifery at the University of British Columbia.

See the complete article in ProPublica

See the PLoSONE article