Midwife Laura M. Perez at a rally to improve birth in 2013
Midwife Laura M. Perez at a Bay Area Rally to Improve Birth, 2013 / Photo: Wendy Kenin (cc)

Pregnancy & Birth: Evidence-Based Care

The vast majority of women in the United States have healthy pregnancies and births. However, far too often the care they receive is not based on the best available research.

As Diana Mason explains in “Transforming the Cost of U.S. Maternity Care,” the maternity care system is in crisis.

“Despite our current spending on birthing care,” writes Mason, “the United States ranks 46th in the world on maternal mortality — with a rate that has doubled since 1987 and is twice that of 31 other nations. Even our infant mortality rate, at 6.1 deaths per 1,000 live births, puts the United States 32nd of 34 other nations that belong to the Organization for Economic Co-operation and Development. And for both maternal and infant mortality, racial and ethnic disparities persist.”


Educate yourself and others.
OBOS has long supported a midwifery model of care as a way of encouraging adherence to evidence-based care that improves the health outcomes of both mothers and babies. The midwifery model is based on the assumption that most pregnancies, labors and births are normal biological processes. The focus, therefore, is on maximizing the health and wellness of a woman and her baby, identifying and managing medical problems early on, and attending to the emotional, social, and spiritual aspects of pregnancy and birth.

This differs from a strict medical model of care that views pregnancy, labor and birth as a risky act that must be managed with high-tech procedures and interventions, even when a pregnancy is low-risk. Read more about both models, along with other articles on pregnancy and birth.

Sign the Choices in Childbirth Statement.
Choices in Childbirth shows the growing support for evidence-based birth models. The statement supports: preserving the option for vaginal birth after cesarean (VBACs); hospital-based midwifery care; licensing and regulation of Certified Professional Midwives (CPMs); and adherence to evidence-based practices to reduce pre-term and low-weight births. Read it and add your name.

Massachusetts Residents: Support Licensing of Certified Professional Midwives.
OBOS encourages support for House bill 2008/Senate bill 1081, which would require all midwives practicing in out-of-hospital settings who are not already licensed to become Certified Professional Midwives (CPMs). This bill also creates state licensing requirements for all CPMs and establishes a Committee on Midwifery under the Board of Registration in Medicine. This Committee will issue all CPM licenses and will have regulatory oversight for all Massachusetts-based CPMs. It’s time for Massachusetts to join the 28 other states that already have adopted such regulation.

Get all the facts from Massachusetts Friends of Midwives. And read this post by OBOS’s former executive director Judy Norsigian, which includes excerpts from supporting letters submitted by pediatricians, obstetricians, midwives, and academic researchers.

As Judy writes, “Failure to license CPMs will make the several hundred home births that occur in Massachusetts every year less safe by failing to create an integrated maternal health care system with enhanced collaboration among all care providers. This bill would affirm that all Massachusetts maternal health care providers are committed to practicing with state oversight and public accountability.”