American medical pioneers make groundbreaking advances every year, from growing organs in petri dishes to performing robot-assisted surgeries. Yet the United States has some of the worst maternal and infant mortality rates in the developed world. Though multiple measures exist, approximately 700 women lose their lives to complications during pregnancy and delivery every year, and research shows that more than half of these deaths are preventable. For every woman that dies in childbirth, 70 more experience complications that threaten their post-maternity health and may require expensive medical treatment well into the future. The total cost of care for treating preeclampsia, a condition characterized by high blood pressure that is a leading cause of death for mothers in the year after giving birth, exceeded $2 billion in 2012.
Though women of all races and ethnicities face childbirth complications, the crisis of maternal death and near-death disproportionately impacts black women. In 2014, the rate of preeclampsia and eclampsia was 50 percent higher among black women than among women of any other group. Overall, black women face a risk of pregnancy-related death that is three to four times higher than that for white women.
It is critical that the United States find ways to improve maternal care quality, reduce inequities in outcomes, and ensure that women can access the kinds of care that work best for them. In an effort to make child birth safer and less costly, some health care systems across the country have taken steps to encourage greater collaboration among health professionals by incorporating midwifery into maternal care. Midwives—health professionals that assist women with prenatal care and delivery—attend around 10 percent of all births in the U.S.
In rural areas where maternal care services are scarce—more than half of rural counties do not have a hospital with obstetric services—midwifery can help fill the void. Certified nurse midwives, the most common credentialed category of midwife, already play an integral role in the rural maternity care workforce in nine states, attending births at one-third of rural maternity hospitals. And in New Mexico, midwives attend to more than a quarter of all births.
Increasing access to midwives could lead to improved health and economic outcomes for mothers and babies. New evidence suggests that the incorporation of midwives into state health care systems has significant health benefits, including lower rates of cesarean section, preterm and low birth weight infants, and infant mortality, as well as higher breastfeeding rates. Other research shows that greater access to midwifery could lower medical costs by reducing the likelihood of life-threatening complications that keep women and babies in the hospital.
Between 1987 and 2014, the maternal mortality rate more than doubled. This worsening trend puts thousands of women’s lives at risk and burdens women and their families with expensive medical bills. The growing need for better maternal and infant health care services presents an opportunity for midwifery to play a pivotal role in improving outcomes for mothers and babies in the United States.
