How An Increase In Nurse Midwives Can Potentially Decrease America’s High Rates Of Maternal Mortality

It’s no secret we are experiencing a tumultuous healthcare landscape in America today. While the looming threat of certain healthcare protections and policies being gutted on a federal level and many people looking at losing coverage, there is also the added burden of healthcare “deserts” in certain parts of the country, most notably rural areas.

While a number of battles are being fought on a policy level, it is the health workers serving patients every day who are the real heroes in this fight. But there is a need for more people to join the medical profession in particular roles as it becomes clear the number of under-served areas is increasing. The National Rural Health Association estimates that 77% of rural counties are considered “Primary Care Health Professional Shortage Areas” and 9% have no physicians at all. In 2015 a bill was introduced in Congress called Save the Rural Hospitals Act, but it has yet to be brought to the floor for a vote.

The Center for Advancing Health also goes further to explain that many of these healthcare “deserts” in low income neighborhoods have a majority Black or Hispanic populations. It should also be noted that America spends more than any other country on healthcare, but Americans get fewer results. Something needs to change and one organization dedicated to improving healthcare in this country is Nursing America.

Nursing America understands that as the population ages over the next decade and healthcare needs increase, the shortage of healthcare providers is going to be exacerbated. Fortunately, there is a way to improve access to quality healthcare. Advanced Practice Registered Nurses have the ability to serve in areas where there is a lack of physician choices. APRNs have advanced medical degrees and countless hours of clinical training, making them an important part of everyday healthcare in America today.

There are 4 types of APRNs: nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, and certified nurse midwife. That last one is especially notable to us as we are champions of reproductive and maternal health. But unlike other developed nations, the percentage of nurse midwives present in the delivery room is fairly low – less than 10% according to the most recent data available.

Alongside our current healthcare crisis, America is experiencing alarmingly high rates of maternal mortality, rates that have not been this high since the late 1800s. Research has shown one of the key factors in these recent rising rates is the lack of midwives present, due to legislation that in some parts of the country, especially in the south, has all but shut out midwives from doing the work that they almost exclusively did before childbirth and delivery became part of the mainstream healthcare system and was integrated into hospital care.

America has a long history of racism toward the midwifery industry, as many of the women delivering babies back in the day were African-American and as a result became entangled in laws and cultural restrictions that had more to do with the color of their skin than with their abilities. But as the maternal mortality problem has seen a resurgence in awareness of late thanks to extensive reporting by Pro Publica and NPR in particular, there are renewed calls for the presence of certified nurse midwifes as it could potentially be a solution to this problem.

Racism still exists as part of healthcare and its outcomes, however. Black women are 3-4 times more likely to die from childbirth-related complications than white women. This relates to the aforementioned healthcare deserts and lack of health options in low-income areas. Black women also only make up 5% of nurse midwives today. Although there is a potential solution to maternal mortality outcomes, the barriers of healthcare deserts along with systemic racism make it difficult to see headway in the way the most powerful country on earth should.

And as Nursing America points out, outdated laws and restrictive legislation prevent APRNs, including nurse midwives, from doing the jobs they are qualified to do. These laws impact where, when, how and in what settings APRNs can practice. To date, only 22 states allow them to practice to the full extent of their training, and it’s not surprise that patients in those states see better health outcomes.

When it comes to maternal mortality specifically, as this Vox Media video points out, the increased presence of nurse midwives has been known to lower rates but due to the way the profession has been shunned by other parts of the healthcare industry is only going to affect patients.

We are at a tipping point when we can no longer afford to see this type of power struggle in a profession designed to serve people at their most vulnerable. Facing the lack of healthcare facilities and professionals across the country, there has never been a better time to support the work of APRNs, and join them in the fight to raise awareness of restrictive and outdated laws that hold them back from doing their work. And it should go without saying, but if you are reading this and feel called to the profession, you can be part of the solution too.

If you visit the Nursing America website today, there is a section where you can type in the name of your state and find out the specific problem that needs addressing, and find the sobering facts on the impact of healthcare deserts. Sharing the Nursing America advancing healthcare campaign, sponsored by the National Council of State Boards of Nursing (NCSBN) is also a great way to share with those in your social circle about how they can learn about this particular problem and get involved.

Additionally, you can take it one step further and contact your elected representatives so they know why they should be fighting for legislation that best serves our interests and lives. Healthcare affects every single one of us and it is something we all need. We believe quality healthcare is a human right, and when it comes to maternal health specifically, supporting APRNs can literally change health outcomes for mothers and babies at a time when we need it most.

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