U.S. Midwife Workforce Far Behind Globally

The U.S. has one of the highest maternal mortality rates in the world relative to other wealthy, developed countries. At 17.4 maternal deaths for every 100,000 live births, they beat out other countries like France, Canada and the U.K. by over 100 percent. The U.S. is abysmally higher than in Germany, Norway and the Netherlands, where the mortality rates stands at 3.2 or lower per 100,000 live births. New data shows maternal mortality in the U.S. may be linked to their low number of midwives.

New data collected by the Commonwealth Fund shows there were only four midwives employed per 1,000 live births in the U.S. as of 2018. That’s astonishingly low compared to other wealthy, developed countries, with France, Switzerland and Germany all employing 25 or more midwives per 1,000 live births. Australia and Sweden have some of the most midwives per capita in the world, averaging 68 and 66, respectively, per 1,000 live births. Overall, Canada and the U.S. are some of the only developed nations with more OB-GYN doctors than midwives.

Despite the U.S. spending enormous amounts of money on maternity care, the high maternal death rate and lack of midwives is a question many still struggle to answer. According to Scientific American, cesarean sections are roughly 32 percent of all births in the country, much higher than the World Health Organization’s recommended 10 percent. Many rural areas simply lack the human resources for traditional midwife care, instead relying on doctors to manage the bulk of modern childbirth. State laws and policies surrounding midwifery as legal practitioners also varies, and education about the profession is scarce throughout communities.