Midwives Could Be Key to Reversing Maternal Mortality Trends

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Midwives Could Be Key to Reversing Maternal Mortality Trends


The Connecticut Childbirth & Women’s Center in Danbury is a 50-minute drive from Evelyn DeGraf’s home in Westchester, N.Y. Pregnant with her second child, the 37-year-old didn’t hesitate to make the drive — she wanted her birth to be attended by a midwife, not a doctor.

DeGraf believed midwifery care to be more personal and less rushed than that delivered by obstetrics/gynecologists (OB/GYNs). She also knew an OB/GYN would deem her relatively advanced maternal age and previous cesarean section history too high-risk to attempt a VBAC, or vaginal birth after cesarean section.

But she had to drive roughly 35 miles to find a midwife because there aren’t many of them.

Despite the fact that an estimated 85 percent of women are appropriate for midwife care, midwives attend about 11 percent of births in Connecticut, said Holly Kennedy, professor of midwifery at Yale School of Nursing. By contrast, about half of all babies in England are delivered by midwives, according to National Health Services statistics. Kennedy sees a direct correlation between lower use of midwives and higher maternal mortality.

“If you scaled up midwives, you would avert over 80 percent of maternal deaths,” Kennedy said. In Connecticut, there are 211 licensed nurse-midwives, compared to 945 licensed OB/GYNs, according to state Department of Health records. Unlike some other states, which employ midwives who do not require nursing degrees, Connecticut recognizes only nurse-midwives, who hold advanced degrees in nursing and additional training in midwifery.

The United States has the highest rate of pregnancy- or childbirth-related deaths in the developed world. According to United Health Foundation, in 2018, the maternal mortality rate for the country is 20.7 deaths per 100,000 births from any cause related to or aggravated by pregnancy, excluding accidents. In Connecticut, the maternal mortality rate is 13.2.

Also, in Connecticut and nationwide, black women and their infants suffer disproportionately worse pregnancy-related health outcomes than white women.

Babies born to black women are more than twice as likely to die in the first year of life than babies born to white women, and black women are 243 percent more likely than white women to die from pregnancy-related complications, according to the Centers for Disease Control and Prevention.

DeGraf’s second child was born vaginally at Danbury Hospital, assisted by a nurse-midwife employed by the Connecticut Childbirth Center. Her low-intervention delivery is common of births attended by midwives…TO READ MORE CLICK HERE


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December 5, 2018

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