A new U.S.-wide “report card” ranks all 50 states on the quality of their maternity care. The first-of-its-kind study found a strong connection between the role of midwives in the health care system — what the researchers call “midwifery integration” — and birth outcomes. States with high midwifery integration, like Washington and Oregon, generally had better results, while states with the least integration, primarily in the Midwest and South, tended to do worse. The findings were published today in the journal PLOS ONE.
The research team created a midwifery integration score based on 50 criteria covering those and other factors that determine midwives’ availability, scope of practice and acceptance by other health care providers in each state. The study used higher rates of vaginal birth and breastfeeding as positive maternity care outcomes. Higher rates of caesarean birth, premature births, low birth weight and newborn deaths were indicators of poor outcomes.
- Mapping integration of midwives across the United States: Impact on access, equity, and outcomes. PLOS ONE, 2018; 13 (2): e0192523 DOI: 10.1371/journal.pone.0192523
- Midwifery linked to better birth outcomes in state-by-state report cards. Oregon State University. February 21, 2018
- View report card: Mapping Collaboration Across Birth Settings: