AHA Warns of Critical Staffing Shortages
The American Hospital Association issued a warning about "mounting and critical staffing shortages" in U.S. hospitals and health systems. The association stated that the shortages, which include maternity services, are threatening patient access to care due to increased demand and burnout.
- Over one-third of U.S. counties (35.6%) are classified as "maternity care deserts," lacking any hospitals with obstetric care, birth centers, or obstetric providers. In Virginia, approximately 36% of counties fit this description, highlighting significant gaps in access to care. - Midwife-led continuity of care is associated with better outcomes, including a higher likelihood of spontaneous vaginal birth and a lower likelihood of interventions like instrumental delivery and episiotomy. It has also been linked to a reduced risk of preterm birth and fetal loss. - Integrating midwives into health systems could potentially prevent 41% of maternal deaths and 39% of neonatal deaths. Despite this, certified nurse-midwives (CNMs) and certified midwives (CMs) attend only about 10.9% of U.S. births. - A new Virginia law, House Bill 1904, set to take effect July 1, 2025, directly addresses staffing shortages by allowing certified nurse-midwives and other advanced practice providers to staff 24-hour on-call rosters for nursery care when a physician is unavailable. - The same Virginia legislation (HB 1904) also authorizes the use of telehealth for physician consultations in nursery care, a move to extend specialized medical expertise to more remote or underserved areas of the state. - Barriers to expanding the midwifery workforce include state-level restrictions on practice, a shortage of clinical preceptors for students, and a lack of diversity within the profession. - Digital health innovations are emerging to help bridge care gaps, including remote monitoring systems like the FDA-approved INVU belt and Novii Patch, which allow expectant mothers to perform self-assessments and securely transmit data on fetal heart rate and uterine contractions to their providers. - In Virginia, the number of birthing hospitals has decreased by about 25% since 2012, increasing the travel burden on patients and correlating with higher rates of severe maternal morbidity and preterm births.
