Title:
From Exclusion to Inclusion: Integrating Certified Professional Midwives for Maternal Survival
Authors:
Gwyn, Claire
Place:
Amsterdam, The Netherlands
Publisher:
KIT (Royal Tropical Institute)
Year:
2025
PAGE:
70
Language:
En
Subject:
Maternal Health – Lessons Learned
Keywords:
Certified Professional Midwives, maternity care deserts, maternal mortality
Abstract:
Introduction The United States ranks high among economically advanced countries in maternal mortality rates (MMR), especially in rural populations, underrepresented groups of color, and low-income-earning groups. The number of maternity care deserts (MCDs), or counties without obstetric providers, is growing across the country, hindering healthcare access. Certified Professional Midwives (CPMs) represent possible solutions, yet confront legal, financial, and systemic barriers. Methodology This study will look at accessibility and a^ordability of CPMs’ community-based birth services within the US, with the potential of minimizing MMR through the Levesque Framework of access to healthcare services. Secondary data analysis was conducted using a multivariate linear regression model to analyze state-level data on the density of CPMs, midwife-attended births, MCD proportion, prenatal care access, Medicaid policies, and MMR; as well as a systematic approach to a literature review. Results Findings indicated that the MMR was higher in states with greater MCD ratios and reduced prenatal care access. An association exists between the MMR and prenatal care (p < 0.001) and the MCD prevalence (p = 0.036). CPM density did not show significant association with MMR. However, CPMs have higher rural availability, and their service characteristics may contribute to improved outcomes. Financial barriers to the pregnant person and state-level policies constrain utilization. Discussion Although CPM density was not associated with a significant change in MMR, the integration of midwives into accessible, culturally sensitive care models may positively a^ect MMR in underserved areas by promoting Medicaid coverage, regulation, and referral frameworks.
Organization:
KIT (Royal Tropical Institute) Vrije Universiteit Amsterdam (VU)
Institute:
KIT Institute
Country:
United states
Region:
North America
Training:
Master of Science in Public Health and Health Equity
Right:
research
,
© 2025 Gwyn
Document type:
Thesis/dissertation
File:
BQKuexu8an_20251211135436309.pdf