Midwifery Workforce Sees High Growth
The U.S. Bureau of Labor Statistics is projecting a 35% growth in employment for nurse-midwives through 2034. This trend is highlighted amid significant workforce shortages, particularly in rural and underserved areas, with Virginia identified as a key state for targeted workforce development efforts.
- Research indicates that midwife-led care is associated with significantly lower rates of medical interventions. Studies have shown that patients under midwifery care have lower rates of cesarean sections, labor induction, and the use of epidurals compared to those managed by obstetricians. - While midwives attended 12% of U.S. births in 2021, a figure that has been increasing, nearly half of all counties in the United States lack a single obstetrician-gynecologist. Projections estimate the nation could be short by as many as 22,000 OB-GYNs by 2050, highlighting the critical role midwives can play in filling workforce gaps. - In Virginia, a significant policy change occurred in May 2025 when the governor signed HB1923. This legislation is part of the "Midwives and Maternal Access Insurance Parity" (MAMA) initiative and requires insurance companies to reimburse all licensed midwives at 100% of the fee schedule, achieving payment parity with Certified Nurse-Midwives. - Virginia law provides for the licensure of both Certified Nurse-Midwives (CNMs), who are regulated by the Joint Boards of Medicine and Nursing, and Certified Professional Midwives (CPMs), who are regulated by the Board of Medicine's Advisory Board on Midwifery. However, state regulations have historically restricted Licensed Midwives from administering certain medications that are considered within the national scope of practice for CPMs. - Digital health platforms and telehealth are increasingly integrated into midwifery to address care gaps, especially in rural areas. These technologies facilitate remote patient monitoring for conditions like hypertension, virtual prenatal and postpartum visits, and provide access to lactation support and mental health services. - The federal "Midwives for MOMS Act" proposes establishing grant programs to expand midwifery education and training. A key goal of this legislation is to increase the number of midwives from racially and ethnically diverse backgrounds to better serve communities disproportionately affected by maternal mortality. - Studies comparing birth outcomes show that midwifery care is associated with higher rates of spontaneous vaginal delivery and greater maternal satisfaction. Neonatal outcomes are comparable or sometimes better, with some research indicating reduced preterm births and NICU admissions.
