A new study from the University of Minnesota’s School of Public Health finds that the growing presence of certified nurse-midwives (CNMs) in rural U.S. hospitals has the potential to improve access to high-quality maternity care for a population of women that is currently underserved.
[Photo: Dr. Katy Kozhimannil]
The study findings were published online in the Journal of Midwifery & Women’s Health.
The researchers set out to describe the role of CNMs in providing maternity care in rural U.S. hospitals. They surveyed all rural hospitals with maternity services in nine U.S. states to understand their maternity care workforce. The team also asked obstetric unit managers at these hospitals about staffing plans, challenges, and opportunities.
“Many rural women face challenges accessing maternity care because of distance as well as clinician shortages,” said Dr. Katy Kozhimannil, lead author of the study and associate professor in the School of Public Health. “We found that midwives play a crucial role in the maternity care workforce in rural U.S. hospitals.”
The study found that CNMs currently attend births of one-third of rural maternity hospitals in the nine U.S. states, with significant variability across states. Specifically, states allowing autonomous midwifery practice had a greater proportion of rural hospitals with midwives attending births (34 percent vs 28 percent without autonomous midwifery practice).
The study also found:
“Our data indicates an important and growing role for midwifery in rural communities,” said Dr. Kozhimannil. “Nearly half a million women give birth each year in rural U.S. hospitals, and managers at these rural hospitals told us that they see midwives as a cornerstone of efforts to ensure access to high-quality care and meet patient needs.”
The researchers speculate that state and federal policy may influence the practice of rural midwifery in the future, especially via scope of practice policies as well as initiatives to address healthcare workforce shortages in rural areas.