Midwifery Care Could Prevent 75,000 C-Sections Annually
Advocates highlight that one in four low-risk women in the U.S. receive a primary cesarean section. They argue that integrating community midwifery care could prevent an estimated 75,000 to 90,000 unnecessary C-sections each year, improving outcomes and reducing costs.
- States with higher integration of midwives into their healthcare systems show significantly lower rates of cesarean sections, preterm births, and low birthweight infants, alongside higher rates of vaginal births after a previous C-section (VBAC) and breastfeeding. - A systematic review of 1.4 million pregnancies found that midwife-led care was associated with a lower risk of unplanned cesarean deliveries, use of epidurals, and labor augmentation. Patients under midwifery care also experienced shorter hospital stays and lower risks of infection. - Access to midwifery care is inconsistent across the U.S. due to a patchwork of state-level regulations, insurance coverage limitations, and a lack of integration into hospital systems. Only about 10% of U.S. births are attended by midwives, compared to 50-75% in many other high-resource countries. - The U.S. Bureau of Labor Statistics projects a 12% growth rate for certified nurse-midwife jobs through 2032, much faster than the average for other professions, driven by an increased demand for personalized maternity care. However, the world currently faces a shortage of nearly one million midwives. - In Virginia, Licensed Certified Midwives with fewer than 1,000 hours of practice must have a practice agreement with a licensed physician or an experienced independent practice midwife that outlines terms of consultation. - The American College of Nurse-Midwives (ACNM) and the newly formed Association of Certified Midwives (ACM) advocate for the profession by working to remove practice barriers, achieve licensure in every state, and ensure equitable reimbursement and employment opportunities. - A significant challenge to accessing this type of care is the prevalence of "maternity care deserts." In Virginia, 47% of counties are considered maternity care deserts, lacking adequate access to obstetric services. - The Virginia Neonatal Perinatal Collaborative (VNPC) is a key state-level organization working to improve maternal and infant health outcomes through various initiatives, including those focused on perinatal mental health and supporting families impacted by substance use.
