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Nov/Dec 2024
Volume 11 | Issue No. 90
The United States is one of the most
dangerous places to give birth in the
industrialized world, with maternal mortality
rates rising over the last few decades. With
that in mind, it is critical to understand the
relationship between access to care and
overall outcomes. Overall, black women
are two to three times more likely than
white women to die during pregnancy or
childbirth. These discrepancies also apply
to newborn health outcomes. Enhancing
access to care, including care from
various providers such as midwives and
doulas, reduces inequities and improves
maternal health outcomes.
Unfortunately, the United States does
not practice midwifery as often as other
nations and cultures do, even though
having a midwife improves the outcomes
of childbirth.
Despite, and arguably, what appears to
be a robust healthcare system, in 2020, the
March of Dimes found that 1,095 counties
in the United States lack maternity care
(no hospital offering obstetric care, no
birth center, and no obstetric provider).
That included 57 counties in Missouri and
76 in Kansas. These maternity care deserts
span urban and rural areas of the country.
A report from the federal Centers for
Medicare and Medicaid Services (CMS)
found that counties with more significant
proportions of black and Hispanic
populations and those with an overall
lower median income were more likely to
lack a hospital with obstetric services.
Linda Marsa, "Labor Pains: The OB-
GYN Shortage," found that a midwife
workforce, integrated into health care
delivery systems, could provide 80 percent
of essential maternal care around the
world and potentially avert 41 percent of
maternal deaths, 39 percent of neonatal
deaths, and 26 percent of stillbirths.
Midwives could also help address the
workforce shortages that loom large in the
U.S. maternity care landscape: nearly half
of U.S. counties lack a single obstetrician-
gynecologist...
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"The best outcome, at the end of the day, is a healthy
mom, a healthy baby."
- Kim Onile, CPM, B.A., J.D., of Onile Midwifery
