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New Report Shows That Midwife-attended Births Are on the Rise in the United States

A new study, published last month in the Journal of Midwifery & Women’s Health, shares an analysis of two decades of CDC data showing that midwife-attended deliveries are on the rise in the United States. In fact, the report shows that the rate of midwife-attended deliveries more than doubled between 1989 and 2002 and have remained steady since.

A piece in Time Magazine on June 25th discussed the new study and some of the various reasons for the increasing trend of midwife-attended births in the United States:

In other developed nations, midwives are routinely tasked with bringing new life into the world. Not so in the U.S., where delivery is largely presided over by obstetricians. But a new study finds that midwives are getting busier, delivering 8.1% of the country’s babies in 2009 — a record high.

Slice the data differently and the proportion rises even further. Consider vaginal births only — midwives don’t do cesarean sections — and the figure rises to 12.1%, or about one of every eight deliveries, according to statistics from the U.S. Centers for Disease Control and Prevention (CDC).

“If this trend continues, it will bring us more in line with the rest of the world in giving midwives a central role in prenatal care and birth,” says study author Eugene Declercq, professor of community-health sciences at the Boston University School of Public Health. “Given that other countries have lower costs and better outcomes, it would be a positive thing for this country.”

Read the full story in Time Magazine’s Health and Family section.

More about the study (from the study abstract):

Introduction: Data on attendance at birth by midwives in the United States have been available on the national level since 1989. Rates of certified nurse-midwife (CNM)–attended births more than doubled between 1989 (3.3% of all births) and 2002 (7.7%) and have remained steady since. This article examines trends in midwife-attended births from 1989 to 2009.

Methods: The data in this report are based on records gathered as part of the US National Standard Certificate of Live Birth from a public use Web site, Vital Stats (http://www.cdc.gov/nchs/VitalStats.htm), that allows users to create and download specialized tables.

Results: Between 2007 and 2009, the proportion of all births attended by CNMs increased by 4% from 7.3% of all births to 7.6% and a total of 313,516. This represents a decline in total births attended by CNMs from 2008 but a higher proportion of all births because total US births dropped at a faster rate. The proportion of vaginal births attended by CNMs reached an all-time high of 11.4% in 2009. There were strong regional patterns to the distribution of CNM-attended births. Births attended by “other midwives” rose to 21,787 or 0.5% of all US births, and the total proportion of all births attended by midwives reached an all-time high of 8.1%. The race/ethnicity of mothers attended by CNMs has shifted over the years. In 1990, CNMs attended a disproportionately high number of births to non-white mothers, whereas in 2009, the profile of CNM births mirrors the national distribution in race/ethnicity.

Discussion: Midwife-attended births in the United States are increasing. The geographic patterns in the distribution of midwife-attended births warrant further study.

The full text of the study is available here but requires a subscription to the Journal of Midwifery and Women’s Health.

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