An uncomplicated birth experience resulting in a healthy baby was all I wanted when I became pregnant. I decided that the best way to achieve this was to seek prenatal care from a midwife, understanding anecdotally that midwives advocate for minimal intervention and a natural, well-supported birth experience.
In late March, I achieved my goal—giving birth naturally to a healthy baby boy. I fit the typical profile of women cared for by midwives: white, highly educated, and relatively affluent. I have no medical, emotional, and social history that would put me at greater risk of complications; plus, I have already given birth naturally to two healthy children.
Research on the impacts of midwife care on moms and babies have typically studied women like me, since women like me are more likely to be seen by a midwife. Many argue that this has confounded findings that midwifery care results in improved birth outcomes. However, African American women and low-income women, who are disproportionately more likely to experience maternal and infant complications during birth, might actually benefit the most from approaches endorsed by midwives.
A study of the Family Health and Birth Center (FHBC) in Washington, D.C. offered us the opportunity to test this hypothesis. The FHBC is a freestanding birth center designed to provide comprehensive midwife-directed care to low-income, mainly African American women who live in the District’s Wards 7 and 8. Care delivered here is designed to meet the varied needs of women at risk of having poor birth outcomes because of stress, inadequate social and emotional support, poor education, and poverty.
Our recent research, which compares outcomes for women cared for at the birth center with similar women who gave birth in D.C., finds that women who received prenatal care at the FHBC were more likely to carry their babies to term, less likely to have a C-section, and, on average, had babies that weighed more than the babies of similar women in the District who were not cared for at the birth center.
These findings suggest that, by reducing C-sections, increasing average birth weight, and prolonging gestational age, the care delivered at the FHBC results in improved or as good maternal and infant outcomes. Given rising health care costs and a continued trend of increasing C-sections nationwide, these results suggest that alternative models of maternity care can be safe and effective in promoting non-interventionist approaches, can improve maternal and infant outcomes, and perhaps address the seemingly intractable problem of low-birth weight and preterm babies in the United States. Using this model more often among women with low medical-risk pregnancies, including those with increased social risk factors, could contribute to better outcomes for mothers and their babies.
Baby image from Shutterstock.