Why We Need Certified Professional Midwives


Births in the US Paid by Medicaid

Maternity Care is a Key Driver of Healthcare Costs

  • Childbirth is the #1 reason for hospitalization in the U.S.

  • 23% of all hospital discharges are related to childbearing, accounting for $110 billion health care dollars

  • 48 percent of births in the U.S. were paid for by Medicaid in 2010, up from 40 percent of births in 2008

Childbirth in the U.S.: Dominated by Costly Interventions ~ Need for Quality Improvement

  • 31.9% of all births in 2016 are by cesarean section; 23.3% of births are medically induced

  • High mortality rates – U.S. is 37th in world rankings for neonates, 50th in the world for mothers

National physician shortage predictions are acute for the maternity care workforce

  • Number of births projected to rise from 2010 level of 4.3 million to 5.7 million in 2050

  • Anticipated shortage of OB/GYNs will be 18% (9,000) by 2030 and 25% (15,000) by 2050 based on years of post-residency practice, with a distinct trend to increasingly fewer post-residency practice years

Rural Access to OB providers is especially lacking

  • 49% of U.S. counties, representing 9.5 million people, had not a single OB/GYN in 2011

  • The number of OB/GYNs per 10,000 women drops from 2.9 in cities to 1.7 in smaller cities, to 0.7 in rural counties

Patient Choice of a Certified Professional Midwife = Greater Access, Lower Cost, Better Outcomes

  • Non-physician providers, including midwives, are helping to address the workforce shortage

  • Community-based providers, such as Certified Professional Midwives (CPMs), are needed to provide care in rural & underserved areas

  • Washington State data found the care of CPMs resulted in fewer low-birth-weight babies, many fewer cesarean sections, and similar rates of infant mortality when compared to low-risk hospital births, while delivering substantial savings to the state budget

  • Countries with the lowest infant mortality (and lower costs) rely on midwives as the primary maternity care providers for the majority of childbearing people.

  • Childbearing people in the care of CPMs experience a 5.2% cesarean section rate, compared to at least a 20% rate for healthy low-risk people in the hospital which increases costs without improving outcomes.

Solution: License Certified Professional Midwives

  • CPMs are licensed in 35 states and the number is growing.

  • The CPM is a credential administered by the North American Registry of Midwives and accredited by the National Commission for Certifying Agencies.

  • Relying on the national credentialing agency to set standards and administer examinations saves states money and provides assurance that midwives have met national psychometrically sound standards.