Files

Abstract

Midwives have been proposed as a potential avenue to combat adverse birth outcomes and severe racial disparities in maternal and child health in the United States, though policies that define midwives’ role vary widely between states. Few studies have evaluated how birth attendant type affects birth outcomes, or how midwifery policies across states influence this relationship. Drawing from national birth records, I (1) test the association between birth attendant (physician or midwife) and birth outcomes, (2) evaluate whether these associations vary by maternal race/ethnicity, and (3) explore if state-level midwifery policies impact these relationships. Even after controlling for the different risk profiles of physician- and midwife-attended births, I find that midwife attendant is associated with lower odds of various adverse outcomes. Midwives are particularly protective against some of these outcomes for Black mothers relative to White mothers. Moreover, states with integrative midwifery policy tend to have higher average birthweights than states with more restrictive policy. A more comprehensive effort to integrate midwives into the healthcare system may help advance maternal and child health and health equity in the US.

Details

Actions

PDF

from
to
Export
Download Full History