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United States
PAUL BETTINGS

Increasing the Number of Midwives Especially in Communities of Color

SoWMy Country Profile

Shortages of maternity care have reached critical levels in the U.S. Nearly half of U.S. counties don’t have a single practicing OB-GYN. The shortage hits rural women hardest, but the shortage is a nationwide problem with cities like Detroit, St. Louis, Dallas and Miami, also facing severe shortfalls. A landmark study in 2018 offers clear evidence that empowering midwives could significantly boost maternal and infant health. In the U.S. midwives only attend around 10% of births, and the extent to which they can legally participate in patient care varies widely from one state to the next. Many of the states where midwives face barriers also have large Black populations.

Black mothers in the U.S. die at three to four times the rate of white mothers. In a national study of five medical complications, including preeclampsia, that are common causes of maternal death, Black women were two to three times more likely to die than white women who had the same condition. The disproportionate toll on Black women is the main reason why the maternal mortality rate in the U.S. is so much higher than that of other industrialized countries. And, according to the CDC, three in five pregnancy-related deaths were preventable.

As part of Johnson & Johnson’s Our Race to Health Equity initiative, the Center is collaborating with the American College of Nurse Midwives (ACNM) on a two-year project to increase equity in access to midwifery education and care by identifying and addressing barriers and implementing solutions to tackle this complex issue. The project includes a comprehensive midwifery education landscape analysis and development of a strategic plan to increase the number of midwives of color by building partnerships with minority serving institutions such as historically black colleges and universities (HBCU) and tribal colleges.

Key partners: