Influences on Vaccine Decision-Making During Pregnancy.

Research has demonstrated an association between midwifery‐led care (ie, care provided by a midwife) and improved birth outcomes, including lower odds of low birth weight (LBW) births and cesarean births among people with low‐risk pregnancy as well as fewer obstetric interventions., , Midwifery‐led care, when compared with perinatal care provided by others (such as obstetrician‐gynecologists), is also associated with reduced disparities in birth outcomes, including reduced Black‐White disparities in LBW rates and lower odds of preterm and LBW births among people who are pregnant with low socioeconomic status., Certified nurse‐midwives (CNMs), practitioners who provide prenatal, birth, and postpartum care as well as other reproductive and gynecological services, are one type of midwife, among others, who provides midwifery‐led care. Attention and resources have focused on increasing the size and diversity of this workforce because of the known benefits of midwifery‐led care, with approximately 34 million dollars in federal funding provided to 56 grantees across the United States in 2022. These programs have likely contributed to the increasing number of new CNMs annually along with a high rate (85%) of eligible recertifications each year. Despite the growth of the CNM workforce, there is limited use of midwifery‐led care in the United States. In other high‐income countries, midwifery‐led care is viewed as the standard for perinatal care, with additional specialties providing care based on patient risk. These countries have better maternal, infant, and newborn health outcomes than the United States, including lower rates of maternal mortality, LBW, and infant mortality. In contrast, physicians predominantly provide perinatal care in the United States, with midwives attending only an estimated 11.6% of births., , Along with the lack of normalization of midwifery‐led care, the limited use of midwives in the United States may be due to workforce barriers such as state‐level restricted scope of practice and high rates of burnout, which, in turn, may decrease the availability of this workforce., , , , ,