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How Small Investments in Midwifery Can Have Big Impact

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Foundation for the Advancement of MidwiferyRobin Hutson

Executive Director

Grantmakers in Health, March 6, 2014

research

public education

public policy birth equity

+ Limited resources = focused strategy

Policy Change

ResearchPublic

Education

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Birth EquityPromoting birth equity among families of color who are

atthe greatest risk in our maternity care system.

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“When mothers are empowered, a community is transformed.”

Communities need their own perinatal paraprofessionals.

+Community Birthworkers Training Program in the DC area The CBW provides outreach, education, referrals,

advocacy, labor and birth support, and home visiting services to expectant women.

80% of trainees have expressed a desire to become a Certified Midwife, and 30% of the participants have been Registered Nurses.

Expanding to Philadelphia, Dallas, and Baton Rouge.

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The great thing about the midwifery model of care is that it is universally beneficial for healthy women. Three midwives provided Kate and Prince George continuous care throughout her labor and birth while the Queen’s OB and his partner remained behind a mirror-tinted window observing from next door.

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Despite the fact the midwives are the de facto provider for healthy women in most countries, most American women do not have access to midwifery care or even know what it is.

Less than 10% of US births are attended by midwives.

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Research

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We lack maternity care data collection in the US.

We do not track indicators that could help improve maternal and infant outcomes.

+Smaller foundations can play a big role with seed funding.

Our niche is seed funding for data collection to ensure quality control of midwife-attended births.

+Midwives lead in data collection

Maternity Data

Collective

MANA AABC

ACNM

+The MANA Statistics Project

• Launched a national registry of midwife-attended births in 2004.• It’s the largest data set of out-of-hospital birth and contains 60,000 records of care that follow a woman from her prenatal to her postpartum visits. • Demonstrates a benchmark for normal, physiologic birth without medical management

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Do different models of care affect outcomes?

What is normal,

physiologic birth?

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These data collection projects lead to peer-reviewed research

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Rates of out of hospital birth continue to rise from 2004 to 2010.

The rate women are choosing to leave the hospital serve as one more indicator of a broken system where mothers want to avoid unnecessary intervention.

43%

41%

Birth Center Births

Home Births

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Robin HutsonExecutive Director

Thank you.