10/01/2019
Welcome to 2019 National Midwifery Week: Let’s Talk Facts
The American Midwifery Certification Board provides national certification for CNMs and CMs. The most recent report in 2018 shows the total number of CNM/CMs with current certification is 12,212 (12,111 CNMs and 101 CMs). An overall increase of 1,000 midwives since 2015. https://bit.ly/2m5B4wf
The UK reports 36,916 registered midwives (March 2019). The UK has one-entry for registration of midwives working in England, Northern Ireland, Scotland and Wales. https://bit.ly/3042em5
The American College of Obstetricians and Gynecologists report the number of physicians in practice in 2017 was 35,586. https://bit.ly/2hyNPNI
The UK Royal College of Obstetricians and Gynaecologists reported in 2018 that obstetric and gynecologic services are delivered by 2,600 physicians. https://bit.ly/2mMzwr6
The American Academy of Family Physicians reported in 2017 that the percentage of family physicians attending deliveries decreased steadily from 2000 to 2010. Only 2% attend more than 50 deliveries/year. https://www.aafp.org/afp/2017/0615/p762.html
The American Association of Medical Colleges reported alarming findings in 2017, “Half of U.S. counties lack a single obstetrician-gynecologist. Those areas are home to more than 10 million women, many of whom may need OB-GYNs for primary care. And the problem is only going to worsen. By 2020, there will be up to 8,000 fewer OB-GYNs than needed, according to ACOG, and the number may rise to 22,000 by mid-century.” https://www.aamc.org/news-insights/labor-pains-ob-gyn-shortage
According to the Our World Data recent report, “The world region with the lowest maternal mortality is the European Union, where 8 women die per 100,000 live births (Finland, Sweden and Norway). https://ourworldindata.org/maternal-mortality In addition to universal access to comprehensive maternity care, what provider type attends the majority of births in Finland, Sweden and Norway?
Midwifery in those countries is, “…based on the idea that a healthy woman with an uncomplicated pregnancy (low-risk) is best taken care of by a midwife. This minimizes her chances of receiving unnecessary interventions of any kind, gives her a high standard of care and is cost-effective.” In the Netherlands (2017) there were 3,150 midwives and 805 active ob/gyns. Data shows 170,000 live births, 13.1% home births, 16.6% c-section rate, 54% VBAC rate, 21.8% epidural rate and maternal mortality of 4.8/100,000. Dutch midwives have not been trained as nurses. Midwifery education is university-based with a direct-entry pathway at the undergraduate level. Efforts are currently underway to bring midwifery training to a Master of Science degree. A Dutch nurse cannot work as a midwife and vice versa. https://bit.ly/2nA9Luq
What’s the point? Skilled midwives are safe, and part of the answer to address the US obstetric workforce shortage, as well as be situated as the primary provider of care for healthy, low-risk women. The US has created a top-heavy and expensive paradigm of highly trained surgeons (OB/GYNs) as primary providers of care for healthy women experiencing most often, a healthy life event. We have also created barriers to direct-entry midwifery in the US with regulatory barriers, while confusing the public with the question, “What’s a midwife?”
With integrated care, ‘right person, right place, right time’, the US could design a collaborative, integrated, seamless model according to levels of need and services. We can transform how women and families are supported and cared for…improving outcomes, cost of care and satisfaction. Are we willing?
Let’s talk facts. (infographic from WHO 2019/ https://bit.ly/2DRhNEg)
If you read this far and want to enter, today’s winner will receive a hand-turned Pinard from exotic wood crafted by Joseph Booth. (yes, they work!) To enter, simply post below in the comments one FB friend name in order to share the facts with others. Enter before 10:30 pm (cst). Let’s broaden the celebration of Day 1 of National Midwifery Week!
