The Access and Integration Maternity care Mapping (AIMM) Study brought together a multidisciplinary group of experts to develop the Midwifery Integration Scoring System (MISS) that rates the key indicators of integration of midwives in the United States. Each state was ranked on the 50-item scale, with no state achieving 100, the highest possible score.

State Ranking of Midwifery Integration Scores 2014-2015

A MISS score of 100 would indicate that a family in that state would have full access to high quality maternity care in all settings without third-party payer (or health insurance/Medicaid) restrictions. All maternity care providers, including midwives, in that state would be regulated and have the legislative authority to practice to their full scope in homes, birth centers and hospitals, and collaborate with or refer to other health professionals. Currently, the highest ranking state is Washington state. The lowest ranking state is North Carolina.

States Ranked From Most to Least Integrated (based on 2014-2015 data)

Click on a state to find their report card.

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Washington 61
New Mexico 59
Oregon 58
New Jersey 55
New York 54
Rhode Island 53
Arizona 52
Idaho 51
Montana 51
Minnesota 50
New Hampshire 50
Utah 50
Vermont 48
Alaska 46
California 46
Wyoming 46
Texas 43
Wisconsin 43
Delaware 42
Florida 42
Colorado 41
Tennessee 41
Virginia 41
Maryland 39
Missouri 39
Maine 37
Indiana 36
Michigan 34
South Carolina 34
Arkansas 32
West Virginia 32
Massachusetts 31
Georgia 30
North Dakota 30
Washington, D.C. 29
Nevada 29
Connecticut 28
Louisiana 28
Pennsylvania 26
Hawaii 25
Illinois 25
Iowa 25
Kentucky 25
Oklahoma 24
Nebraska 23
Kansas 22
Mississippi 22
Ohio 20
South Dakota 19
Alabama 18
North Carolina 17

Do you have feedback on one or more of the State Report Cards? Share your input here.