Expert Cites Crisis in Midwife Recruitment and Retention
Dr. Maria Santiago, DNP, CNM, speaking on the “Nurse Leaders Today” podcast, described the national midwifery shortage as a crisis in recruitment, education, and retention. "We’re not just facing a shortage of midwives — we’re confronting a crisis in how we recruit, educate, and retain these professionals," Santiago stated. She emphasized that the next decade will be critical for meeting the demands of rising birth rates and maternal complexity.
- A significant factor in the midwife shortage is the burnout experienced by the current workforce, with studies showing prevalence rates ranging from 25% to 58% among the perinatal workforce in the United States. Compounding this, over half of all U.S. counties (55.1%) have no practicing midwife at all. - Globally, there is a shortage of approximately 900,000 midwives, a deficit that has been exacerbated by the COVID-19 pandemic. Fully investing in midwifery could prevent an estimated 4.3 million deaths per year, including 67% of maternal deaths and 64% of newborn deaths. - In Virginia, a licensed certified midwife who has practiced for less than 1,000 hours is required to have a practice agreement with a licensed physician or an independent practice midwife for consultation. After completing 1,000 hours, they may practice independently upon receiving an attestation from their consulting provider. - Evidence-based practices utilized by midwives, such as continuous support during labor and encouraging spontaneous pushing, have been shown to improve outcomes, including a lower rate of Cesarean sections. Studies have demonstrated that midwifery-led care is associated with higher rates of breastfeeding and increased patient satisfaction. - Emerging technologies are playing a greater role in maternal care, with digital health platforms, remote monitoring devices, and telehealth applications helping to bridge gaps in access. Artificial intelligence and machine learning are also being integrated to analyze data and provide early detection of potential complications. - The American College of Nurse-Midwives (ACNM), founded in 1955, is the professional association for certified nurse-midwives (CNMs) and certified midwives (CMs) in the U.S. The organization advocates for the profession, provides continuing education, and publishes the *Journal of Midwifery & Women's Health*. - Gender inequality is a significant driver of the global midwife shortage, as chronic under-investment in the field reflects a broader neglect of women's health needs and the skills of a predominantly female workforce. This often results in gendered disparities in pay and limitations on professional autonomy for midwives. - Over a third of U.S. counties are classified as "maternity care deserts," meaning they lack any hospital or birthing center offering obstetric care and have no practicing obstetricians. This affects over 2.3 million women of reproductive age and contributes to poorer maternal health outcomes.
