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Policy Matters| Volume 26, ISSUE 3, P262-267, May 2016

State Scope of Practice Laws, Nurse-Midwifery Workforce, and Childbirth Procedures and Outcomes

Published:March 07, 2016DOI:https://doi.org/10.1016/j.whi.2016.02.003
State Scope of Practice Laws, Nurse-Midwifery Workforce, and Childbirth Procedures and Outcomes
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      Abstract

      Background

      Despite research indicating that health, cost, and quality of care outcomes in midwife-led maternity care are comparable with and in some case preferable to those for patients with physician-led care, midwifery plays a more important role in some U.S. states than in others. However, this variability is not well-understood.

      Objectives

      This study estimates the association between state scope of practice laws related to the autonomy of midwifery practice with the certified nurse-midwifery (CNM) workforce, access to midwife-attended births, and childbirth-related procedures and outcomes.

      Methods

      Using multivariate regression models, we analyzed Natality Detail File data from births occurring from 2009 to 2011. Each state was classified regarding autonomous midwifery practice (not requiring supervision or contractual agreements) based on Lexis legal search.

      Results

      States with autonomous practice laws had an average of 4.85 CNMs per 1,000 births, compared with 2.17 in states where CNM practice is subject to collaborative agreement. In states with autonomous CNM practice, women had higher odds of having a CNM-attended birth (adjusted odds ratio [AOR], 1.59; p = .004), compared with women in states where midwifery is subject to collaborative agreement. In addition, women in states with autonomous practice had lower odds of cesarean delivery (AOR, 0.87; p = .016), preterm birth (AOR, 0.87; p < .001), and low birth weight (AOR, 0.89; p = .001), compared with women in states without such practice.

      Conclusions

      States with regulations that support autonomous midwifery practice have a larger nurse-midwifery workforce, and a greater proportion of CNM-attended births. Correlations between autonomous practice laws and better birth outcomes suggest future policy efforts to enhance access to midwifery services may be beneficial to pregnancy outcomes and infant health.
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      References

        • Aliyu M.H.
        • Jolly P.E.
        • Ehiri J.E.
        • Salihu H.M.
        High parity and adverse birth outcomes: Exploring the maze.
        Birth. 2005; 32: 45-59
        View in Article

      2. American College of Nurse-Midwives. (2016). Fact sheet: Essential Facts about Midwives. Available: http://www.midwife.org/acnm/files/ccLibraryFiles/Filename/000000005948/EssentialFactsAboutMidwives-021116FINAL.pdf. Accessed: April 16, 2016.

        View in Article

      3. American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine. (2014). Obstetric consensus: Safe prevention of the primary cesarean delivery. Available: www.acog.org/Resources-And-Publications/Obstetric-Care-Consensus-Series/Safe-Prevention-of-the-Primary-Cesarean-Delivery. Accessed: June 22, 2015.

        View in Article

      4. Centers for Disease Control and Prevention (CDC). Births: Final data for 2014. (2015a). Available: www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_12.pdf. Accessed: January 18, 2016.

        View in Article

      5. Centers for Disease Control and Prevention (CDC). Births: Final data for 2013. (2015b). Available: www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf. Accessed: June 22, 2015.

        View in Article

      6. Congress. (2014). H.R.4385-To amend the Public Health Service Act to provide for the designation of maternity care health professional shortage areas. Available: www.congress.gov/bill/113th-congress/house-bill/4385/text. Accessed: June 22, 2015.

        View in Article
        • Davis-Floyd R.
        ACNM and MANA: Divergent histories and convergent trends.
        in: Davis-Floyd R. Johnson C. Mainstreaming midwives: The politics of change. Routledge, New York2006
        View in Article
        • Declercq E.R.
        Trends in midwife-attended births in the United States, 1989-2009.
        Journal of Midwifery and Womens Health. 2012; 57: 321-326
        View in Article
        • Declercq E.R.
        • Paine L.L.
        • Simmes D.R.
        • DeJoseph J.F.
        State regulation, payment policies, and nurse-midwife services.
        Health Affairs (Millwood). 1998; 17: 190-200
        View in Article
        • Declercq E.R.
        The transformation of American midwifery: 1975 to 1988.
        American Journal of Public Health. 1992; 82: 680-684
        View in Article
        • Diers D.
        Finding midwifery in administrative data systems.
        Journal of Midwifery and Womens Health. 2007; 52: 98-105
        View in Article
        • Geller E.J.
        • Wu J.M.
        • Jannelli M.L.
        • Nguyen T.V.
        • Visco A.G.
        Neonatal outcomes associated with planned vaginal versus planned primary cesarean delivery.
        Journal of Perinatology. 2010; 30: 258-264
        View in Article
        • Jolly M.
        • Sebire N.
        • Harris J.
        • Robinson S.
        • Regan L.
        The risks associated with pregnancy in women aged 35 years or older.
        Human Reproduction. 2000; 15: 2433-2437
        View in Article
        • Kabir A.A.
        • Pridjian G.
        • Steinmann W.C.
        • Herrera E.A.
        • Khan M.M.
        Racial differences in cesareans: An analysis of U.S. 2001 National Inpatient Sample Data.
        Obstetrics & Gynecology. 2005; 105: 710-718
        View in Article
        • Kozhimannil K.B.
        • Attanasio L.B.
        • Yang Y.T.
        • Avery M.D.
        • Declercq E.R.
        Midwifery care and patient-provider communication in maternity decisions.
        Maternal and Child Health Journal. 2015; 19: 1608-1615
        View in Article

      16. Lancet. (2014). Midwifery. Available: www.thelancet.com/series/midwifery. Accessed: June 22, 2015.

        View in Article
        • Liu G.G.
        Birth outcomes and the effectiveness of prenatal care.
        Health Services Research. 1998; 32: 805-823
        View in Article
        • Luo Z.C.
        • Wilkins R.
        • Kramer M.S.
        • Fetal and Infant Health Study Group of the Canadian Perinatal Surveillance System
        Effect of neighbourhood income and maternal education on birth outcomes: A population-based study.
        CMAJ. 2006; 174: 1415-1420
        View in Article

      19. March of Dimes. (2013). Premature birth: The financial impact on business. Available: www.marchofdimes.org/materials/premature-birth-the-financial-impact-on-business.pdf. Accessed: June 22, 2015.

        View in Article
        • Martin J.A.
        • Wilson E.C.
        • Osterman M.J.
        • Saadi E.W.
        • Sutton S.R.
        • Hamilton B.E.
        Assessing the quality of medical and health data from the 2003 birth certificate revision: Results from two states.
        National Vital Statistics Report. 2013; 62: 1-19
        View in Article

      21. ME. Code R. § 02–373.

        View in Article

      22. ME. Code R. § 02–380.

        View in Article

      23. ME. Code R. § 02-380-8 et. seq.

        View in Article
        • National Center for Health Statistics
        Natality Detail File 2009–2011.
        Author, Hyattsville, MD2009-2011
        View in Article

      25. National Institute for Health and Care Excellence (NICE). (2014). Intrapartum care: Care of healthy women and their babies during childbirth. Available: www.nice.org.uk/guidance/CG190. Accessed: June 22, 2015.

        View in Article

      26. National Partnership for Women & Families. (2013). The cost of having a baby in the United States. Available: http://transform.childbirthconnection.org/reports/cost/. Accessed: June 22, 2015.

        View in Article

      27. Neb. Rev. Stat. § 38-607; 38–609.

        View in Article

      28. Neb. Rev. Stat. § 38–610.

        View in Article

      29. Neb. Rev. Stat. § 38–618.

        View in Article

      30. New York Times. (2014). Are midwives safer than doctors? Available: www.nytimes.com/2014/12/15/opinion/are-midwives-safer-than-doctors.html. Accessed: June 22, 2015.

        View in Article
        • Pollack H.
        • Lantz P.M.
        • Frohna J.G.
        Maternal smoking and adverse birth outcomes among singletons and twins.
        American Journal of Public Health. 2000; 90: 395-400
        View in Article
        • Reichman N.E.
        • Teitler J.O.
        Timing of enhanced prenatal care and birth outcomes in New Jersey's HealthStart program.
        Maternal and Child Health Journal. 2005; 9: 151-158
        View in Article
        • Renfrew M.J.
        • McFadden A.
        • Bastos M.H.
        • Campbell J.
        • Channon A.A.
        • Cheung N.F.
        • Declercq E.
        Midwifery and quality care: Findings from a new evidence-informed framework for maternal and newborn care.
        Lancet. 2014; 384: 1129-1145
        View in Article
        • Sandall J.
        • Soltani H.
        • Gates S.
        • Shennan A.
        • Devane D.
        Midwife-led continuity models versus other models of care for childbearing women.
        Cochrane Database of Systematic Reviews. 2013; : CD004667
        View in Article
        • Shah P.S.
        • Zao J.
        • Ali S.
        • Knowledge Synthesis Group of Determinants of preterm/LBW births
        Maternal marital status and birth outcomes: A systematic review and meta-analyses.
        Maternal and Child Health Journal. 2011; 15: 1097-1109
        View in Article
        • Yang Y.T.
        • Mello M.M.
        • Subramanian S.V.
        • Studdert D.S.
        Relationship between malpractice litigation pressure and rates of cesarean section and vaginal birth after cesarean section.
        Medical Care. 2009; 47: 234-242
        View in Article

      Biography

      Y. Tony Yang, ScD, LLM, MPH, has a main scholarly interest focused on policy issues at the intersection of the legal and health systems. He takes an empirical approach to most research, blending the statistical sciences with more traditional legal research methods.

      Biography

      Laura B. Attanasio, MS, is a PhD student in Health Services Research, Policy and Administration at the University of Minnesota School of Public Health. She received a BA in anthropology from Vassar College. Her research focuses on reproductive health.

      Biography

      Katy B. Kozhimannil, PhD, MPA, conducts research to inform the development, implementation, and evaluation of health policy impacting reproductive-age women and families. She researches the policy impact among special populations, including working mothers, racial and ethnic minorities, low-income women, and rural populations.

      Article info

      Publication history

      Published online: March 07, 2016
      Accepted: February 5, 2016
      Received in revised form: January 26, 2016
      Received: June 26, 2015

      Footnotes

      Funding statement: Office of Research on Women's Health at the National Institutes of Health K12-HD055887.

      Identification

      DOI: https://doi.org/10.1016/j.whi.2016.02.003

      Copyright

      © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc.

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