Mapping Collaboration Across Birth Settings

When midwives are a part of the system that provides maternity care, how does it change health outcomes?

Are those outcomes impacted by race?

It’s important to know where families have the greatest access to high quality maternity care across birth settings. A multi-disciplinary team of experts in research, legislation, and birth came together to learn where midwives are most accessible and where they are most integrated into the maternal health care system.

The team scored each state on items like laws and regulations that support or limit midwifery, the ability to prescribe medicine, access to insurance coverage, and smooth access to advanced care when needed. They first developed a scoring system and then carefully ranked every US state; the results: no state got the maximum score of 100, reflecting the limited access many families experience today.

Equally importantly, states that scored higher at integrating midwives into the health care system were associated with improved outcomes for mothers and babies. This is the first time these important connections have been established.

The findings also highlight racial disparities that are affected by the level of integration, density, and access to midwives. This is particularly critical given that black families are more likely to experience complications and newborn death.

Increased access to and greater integration of midwives is associated with improved outcomes for families across birth settings, even when taking into account the impact of race.