With Midwives, Women Have Fewer Cesareans and More VBACs

Based on a review of 28 high-quality studies, the  Coalition for Improving Maternity Services Expert Work Group found that in comparison to care provided by physicians for similar populations, care provided by professional midwives resulted in fewer cesareans, more VBACs,  the same or better maternal and perinatal health benefits, and no worse outcomes.

The Cochrane Pregnancy and Childbirth Group states,”Most women should be offered midwife-led models of care and women should be encouraged to ask for this option although caution should be exercised in applying this advice to women with substantial medical or obstetric complications.”

In the United States there are three types of nationally recognized midwives. The Certified Nurse Midwife (CNM), Certified Professional Midwife (CPM), and the Certified Midwife (CM).
Midwives can attend births at hospitals, birth centers, or at home depending on their training and licensing status.

Benefits of Midwifery Care

The “midwifery model of care”  is the best model of care for the majority of healthy pregnant women.

The model of care provided by midwives is based on the concept that pregnancy and childbirth are normal life events that should be carefully monitored but not interfered with unless necessary. Midwifery care has been proven to reduce the rate of medical interventions  such as inductions of labor, electronic fetal monitoring, and episiotomy that may cause harm when used routinely. Midwifery care also reduces the need for a cesarean section. Midwives look to maximize health outcomes using a minimum number of medical interventions. They also address the emotional, psychological, and cultural concerns of women in their childbearing year.

Women cared for by professional midwives have :

  • Fewer hospital admissions during the antepartum period.
  • A lower incidence of hypertension during pregnancy and labor.
  • Fewer episodes of abnormal heart rate in labor.
  • Less need for pain medication in labor, including epidural analgesia.
  • A lower incidence of shoulder dystocia, in comparison to similar women cared for by physicians.
  • A lower rate of instrumental deliveries (use of forceps or vacuum extractors).
  • A lower incidence of retained placenta and fewer or equivalent postpartum hemorrhages.
  • Fewer perineal injuries and fewer 3rd and 4th degree lacerations.
  • Fewer cesareans and more vaginal births after cesarean section (VBACs).

With professional midwifery care, babies are:

  • Less likely to be born preterm or with a low birth weight.
  • Less likely to suffer from fetal distress (abnormal fetal heart tones) and birth   trauma during labor and birth.
  • Less likely to require newborn resuscitation or special care in the neonatal intensive care unit (NICU).
  • More likely to remain with their mothers throughout the hospital stay and be exclusively breastfed at two and four months.

To find out more about midwifery care,  visit these websites:

Watch the video, Debunking the Myth: Midwives are Uneducated. An interview with Eugene DeClercq, Ph.D., Boston School of Public Health.

American College of Nurse Midwives

Midwives Alliance of North America

Mothers Naturally

Citizens For Midwifery

The Big Push for Midwives

American College of Community Midwives

Where’s My Midwife?

Midwifery Today

Canadian Association of Midwives

Australian College of Midwives

New Zealand College of Midwives

Royal College of Midwives

International Confederation of Midwives


Updated January 3, 2014.