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For Immediate Release
March 13, 2013
Contact: Clare Lynam

Leading US Midwifery Organization Urges Federal Funding to Improve Maternity and Primary Care for Women

American College of Nurse-Midwives CEO Educates House Members About Midwife-led Care, Ability of Midwives to Meet Workforce Demands

Silver Spring, MD—American College of Nurse-Midwives (ACNM) Chief Executive Officer Lorrie Kline Kaplan, CAE represented the nation’s more than 12,000 certified nurse-midwives (CNMs) and certified midwives (CMs) in testimony today before the House of Representatives Committee on Appropriations of the Subcommittee on Labor/Health and Human Services/Education and Related Agencies. Kaplan’s remarks focused on the role of midwifery in providing maternity care and primary care for women, and 3 main areas of federal funding: Title VIII of the Public Health Service Act, the National Health Service Corps, and the National Institute for Nursing Research.

With more than 4 million births annually, maternity care represents nearly $100 billion of US health care expenditures each year, Kaplan said. More than 40% of these births occur within the Medicaid program.

“Midwives are more relevant than ever in these times of primary and maternity care provider shortages, sobering health disparities, and runaway costs,” she said. “In nearly all other developed countries, midwives are the primary providers of care for women in pregnancy and birth. If we want to one day afford and achieve the first-rate, high-value maternity care our daughters and granddaughters deserve—no matter where they live, regardless of their race or ethnicity or economic status—we need a larger, highly skilled midwifery workforce.”

In 2009, midwives attended more than 320,000 births in the United States—about 96% in hospitals, according to the Center for Disease Control. Midwives have a well-documented track record of excellence, Kaplan said, achieving excellent birth outcomes with low cesarean and medical intervention rates, which reduces health care costs. While midwives are best known as maternity care providers, CNMs and CMs, who are highly educated, are also primary care providers for women from adolescence through menopause, she added. Midwives often serve women with limited access to health services through Medicaid, the Indian Health Service, or federally qualified health centers.

As the shortage of maternity care providers continues to expand, as predicted by the American College of Obstetricians and Gynecologists and others, the ACNM CEO said funding for several important nursing education programs under Title VIII of the Public Health Service Act is vital to midwives meeting workforce demands. Kaplan said the Advanced Nursing Education Program and the Advanced Education Nursing Traineeship administered by the Health Resources and Services Administration (HRSA ) are of particular importance for midwifery. Funding for these programs helps establish new educational programs, aids in the growth of existing programs, and provides tuition support for nurse-midwifery students, she added.

“ACNM asks the committee to urge HRSA to identify maternity care shortage areas as it does now for primary care, mental health, and dental care,” Kaplan said. “This will allow us to directly address shortages, including developing new midwifery programs and services in urban and rural maternity care shortage areas.”

The CEO noted that a robust National Health Service Corps (NHSC) is also vital to meeting the health workforce demands of the future, as midwives are placed as primary care providers in many areas of the nation through the NHSC. Kaplan urged the committee to strengthen this program, enabling it to continue placing midwives in areas of critical need.

Finally, because the National Institute for Nursing Research (NINR) improves the health of Americans by funding nursing research and research training, Kaplan asked the committee to enhance NINR funding for fiscal year 2014 and to urge the NINR to focus additional efforts on maternity-related research.

“More than 30% of [US] babies are delivered by cesarean at twice the cost of a normal delivery, and experts agree that half to two-thirds of these surgeries are unnecessary. We can—and we must—do much better,” she concluded. “A recent report estimates that cutting the cesarean rate to 15% would save $5 billion a year. Let’s focus more research now on how best to promote normal healthy births in all families, in all communities. “


About the American College of Nurse-Midwives

The American College of Nurse-Midwives (ACNM) is the professional association that represents certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States. With roots dating to 1929, ACNM sets the standard for excellence in midwifery education and practice in the United States and strengthens the capacity of midwives in developing countries. Our members are primary care providers for women throughout the lifespan, with a special emphasis on pregnancy, childbirth, and gynecologic and reproductive health. ACNM reviews research, administers and promotes continuing education programs, and works with organizations, state and federal agencies, and members of Congress to advance the well-being of women and infants through the practice of midwifery.

For a complete copy of Kaplan’s testimony, please contact ACNM, 202-485-1826.


American College of Nurse-Midwives.
8403 Colesville Rd, Suite 1550 | Silver Spring MD 20910
Phone: 240-485-1800 | Fax: 240-485-1818
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