Midwives save money and user fewer medical interventions on low-risk moms

posted 5-2-97

Midwives assisting low-risk pregnant women in childbirth tend to use fewer medical interventions than physicians and have the same healthy outcomes, according to a study by researchers at the University of Washington.

“I see midwifery growing in this country and this study suggests the potential use of midwifery could be greater,” said Roger A. Rosenblatt, MD, MPH, professor and vice-chair in the Department of Family Medicine at the University of Washington and principal investigator on the study.

The study, published in The American Journal of Public Health, is the first of its kind to examine differences among births attended by midwives, obstetricians, and family practice physicians.

The study found that patients attended by midwives had 40 percent fewer Cesarean sections, 50 percent fewer episiotomies, and lower rates of induction, anesthesia, and fetal monitoring. According to Rosenblatt, costs of resources were 12 percent lower than physician resource costs.

The study, which analyzed medical records of 1,322 healthy, low-risk patients in the state of Washington, is the first to use a random sample of providers on a statewide basis.

It also is unique because all of the patients were low-risk and “biologically equivalent,” Rosenblatt said.

“What’s great about this study is that it just looked at low-risk pregnancies and the Cesarean-section rate was still lower,” said Kimberly Patamia, spokeswoman for the American College of Nurse-Midwives which represents more than 7,000 certified nurse-midwives in the United States.

“[The study] suggests that we can successfully take care of low-risk women with less intervention,” Rosenblatt said.

Interventions can be detrimental if used inappropriately, Patamia said. “With continuous fetal monitoring, women may be unable to walk around during labor to get away from the pain and work through the contractions,” she said. “An epidural given prematurely can increase the risk for a C-section.”

About 5 percent of births in the United States are attended by certified nurse-midwives, a growth of about 4 percent since the early 1980s, according to Rosenblatt. About 95 percent of births attended by midwives occur in hospitals. The remainder are attended at patient homes or birthing centers, Patamia said.

Related Sites
American College of Nurse-Midwives