Though not as widespread as it is in the UK, where midwives routinely attend low-risk births, midwifery in the US has grown sharply. From 1990 to 2003, the number of US births attended by midwives almost doubled, reaching 8%, and that number has held reasonably steady since, with 8.1% of births attended by midwives in 2013.
One reason might be a reaction against the rise in C-section rates in the US, which hovers around one-third of all US births at 32%. This is significantly higher than an assessment by the World Health Organization, which says that the ideal target rate for C-sections in a country’s population should be somewhere around 10 to 15%.
Midwives don’t routinely use medical interventions like C-sections, episiotomies, or forceps during birth. Instead, they recommend these procedures only when they’ve been evaluated to be necessary. Because of this, shifting primary labor care from obstetricians to midwives is often seen as a way of limiting the chances of major surgery during birth.
Midwives are also more likely to support mothers who are looking for “natural” birth experiences. Midwives are also more likely to spend the entirety of labor with the parents-to-be, while an obstetrician may happen not to be on the schedule for the eventual birthday, or may switch with a change in shift.
Another change which may contribute to the growing popularity of midwives is their growing credibility. The term “midwife” is still as likely to call to mind a woman from a hundred years ago as it is a modern medical professional. But since the mid-’90s, professional midwifery in the US has grown more formal and regulated. As a result, it’s become easier to trust.
One of the biggest draws of midwifery over other medical care during birth, though, is just a question of philosophy. One of the theories that supports midwifery over more clinical medical care is that doctors treat illnesses, and while pregnant women can have medical problems related to pregnancy that require a doctor’s care, pregnancy itself isn’t an illness. As the theory goes, pregnancy itself is a natural process, and women might need a doctor if there are problems with the way that natural progress is going, but a doctor doesn’t need to be a part of the routine.
Midwives are still definitely on the fringes of birth in the U.S., and are much more prevalent in urban areas with higher population centers. But if there’s one thing that seems clear from their rise back into the conversation around birth, it’s that midwives aren’t going anywhere.
- “Essential competencies for basic midwifery practice.” InternationalMidwives. International Confederation of Midwives, 2013. Web.
- E Declercq. “Trends in midwife-attended births in the United States, 1989-2009.” J Midwifery Womens Health. 57(4):321-6. Web. Jul-Aug 2012.
- “CNM-CM-attended Birth Statistics.” Midwife. American College of Nurse-Midwives, Mar 2016. Web.
- “ACNM Healthy Birth Initiative Promotes Benefits, Tools for Achieving Healthy Childbirth.” Midwife. American College of Nurse-Midwives, nd. Web.