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Impact

Midwifery: much more than birth.

Midwifery is skilled clinical care across pregnancy, birth, postpartum and the early weeks of a baby’s life.

The World Health Organization describes midwifery as skilled, knowledgeable and compassionate care for women, newborns and families across the continuum from pre-pregnancy through postpartum. World Health Organization (opens in a new tab)

In the United States

≈4

midwives per 1,000 live births

Where midwives are integrated

25–70

midwives per 1,000 live births, across six countries compared

A new mother sits on her bed holding her swaddled newborn while her midwife kneels beside her, talking with her.

Midwives monitor physical recovery, blood pressure, bleeding, feeding, newborn health and emotional wellbeing.

But they also do something increasingly difficult to provide in a busy medical system:

They have time to know the woman.

  • Her history.
  • Her pregnancy.
  • Her family.
  • Her fears.
  • Her support system.
  • And what has changed since the last visit.

That relationship is not simply comforting; it is clinically important.

Closing the gap in maternal care: maternal healthcare in America needs midwives.

The United States has some of the most advanced hospitals, physicians and medical technology in the world. Yet among high-income countries, the U.S. continues to have the highest maternal mortality rate. And many of the countries achieving better outcomes have something deeply integrated into their healthcare systems that America has not fully embraced: Midwives. Commonwealth Fund (opens in a new tab)

And research suggests that maternity systems with greater integration of midwives have better outcomes, including higher rates of spontaneous vaginal birth and breastfeeding and lower rates of cesarean birth, preterm birth, low birthweight and neonatal mortality. National Academies (opens in a new tab)

Midwifery is not an alternative to modern medicine.
It is a missing layer of it.

Midwives per 1,000 live births · one dot = one midwife

≈4 United States

  • 70 Australia

  • 69 Sweden

  • 54 Norway

  • 49 New Zealand

  • 48 United Kingdom

  • 25 Netherlands

Most recent data available (U.S.: 2016) Commonwealth Fund (opens in a new tab)

With appropriate education and integration into interdisciplinary healthcare systems, midwives can provide approximately 90% of essential sexual, reproductive, maternal, newborn and adolescent health services.

World Health Organization (opens in a new tab)

Among the high‑income countries studied, the United States was the only one that did not guarantee postpartum home visits.

Commonwealth Fund (opens in a new tab) 2024 international comparison

Midwives provide care at home: this is a critical factor.

A home visit from a midwife allows a provider to see something that cannot always be seen during a short office appointment:

A midwife bends over a newborn on the family's bed, examining the baby at home while the father leans in to watch.

the mother’s real life.

  • Is she able to get out of bed?
  • Is she eating?
  • Is breastfeeding actually working?
  • Does she have help?
  • How is she sleeping?
  • How is she coping emotionally?
  • Is her blood pressure changing?
  • Is bleeding normal?
  • Is the baby feeding and gaining appropriately?
  • Is something simply not right?

A postpartum home visit creates time to ask questions, observe, listen and identify concerns that may otherwise go unnoticed until they become more serious. The Commonwealth Fund reports that postpartum home visits by midwives or nurses are associated with improved mental-health and breastfeeding outcomes and reduced healthcare costs.

Doctors and midwives work together to achieve wholistic maternal care.

Midwives and physicians bring different expertise to maternal healthcare. A strong system uses both.

A mother rests in a hospital bed with an IV line in her arm, holding her newborn skin to skin.

In the United States

Today, many mothers return home from the hospital and are expected to navigate physical recovery, feeding, newborn care, hormonal changes, sleep deprivation and mental health largely on their own. Sometimes the next traditional medical appointment isn’t for weeks.

A smiling midwife in blue gloves holds up a newborn at home as a family member looks on in the background.

Where midwives are integrated

The World Health Organization is calling for countries to transition toward midwifery models of care integrated within health systems—care that is continuous, person-centered and coordinated with interdisciplinary teams when additional medical expertise is needed. World Health Organization (opens in a new tab)

Connected care

= Hospital care + physician expertise + community midwifery + postpartum support.

A new mother cradles her newborn on the bed, her partner leaning in behind her and her midwife at her side.

Thrive Maternal Health Fund fills this gap.

We help bring skilled maternal care back into the community—while keeping women connected to the medical system when they need it.

Because better maternal healthcare is about what happens before birth, after birth, and at home.

When mothers are cared for, families thrive.

Learn about our programs Support a mother

Sources & further reading