Report Warns of 'Permanent Labor Scarcity'

- The global shortage of midwives is estimated at 900,000, a deficit that contributes to preventable maternal and newborn deaths. Fully funding midwifery could prevent 67% of maternal deaths, 64% of newborn deaths, and 65% of stillbirths, saving an estimated 4.3 million lives annually. - In Virginia, recent legislation (HB 1904, HB 1923, and SB 1352) taking effect July 1, 2025, is set to address care shortages by expanding the roles of certified nurse-midwives. These laws allow midwives to serve on 24-hour on-call rosters for nursery care when a physician is unavailable and grant insurance reimbursement parity for all licensed midwives, which is expected to improve access to care, especially in rural areas. - The U.S. Bureau of Labor Statistics projects a 7% growth for nurse-midwife positions by 2033. However, the National Center for Health Workforce Analysis projects that Virginia will face an 8% shortage of Registered Nurses by 2038, which could impact the pipeline for nurse-midwives. - Staffing shortages in maternity care have been linked to negative outcomes, including rushed prenatal appointments, a sense of fear and abandonment during labor, and the de-prioritization of postnatal support like lactation and mental health services. In some rural areas, a lack of resources has led to the permanent closure of maternity services, forcing patients to travel greater distances for care. - Digital health technologies are being increasingly integrated into midwifery to help bridge gaps in care. Tools like telehealth platforms for virtual consultations, remote patient monitoring devices, and electronic health records (EHRs) are used to enhance patient care and streamline documentation. - Artificial intelligence (AI) is an emerging tool in maternal healthcare with the potential to analyze large datasets to predict and identify at-risk pregnancies before complications arise. AI-powered telehealth is also seen as a way to expand access to care in remote and underserved communities. - Barriers to expanding the midwifery workforce include restrictions on practice at the state level, a lack of clinical preceptors to expand educational program capacity, and professional burnout. - In 2021, midwives attended approximately 12% of births in the United States. Research indicates that midwifery-led care is associated with lower rates of cesarean births, fewer preterm births, and higher birth weights for newborns.