State-Level Associations Between Poverty, Rurality, Midwifery Care, and Birth Outcomes: A Secondary Data Analysis

This session will present findings from a state-level secondary data analysis examining associations among poverty, rurality, midwifery care, and adverse birth outcomes across the United States. The presentation will situate the study within current maternal and infant mortality trends and persistent rural and socioeconomic disparities in maternity care access. Participants will review the study design, analytic approach, regression findings, and exploratory interaction effects suggesting that the relationship between midwifery care and birth outcomes may differ by rurality. The session will also consider the implications of these findings for maternity care systems, workforce planning, and public health policy. Discussion will emphasize the potential role of midwifery care in strengthening maternal and infant health, particularly in rural communities.

1. Describe current U.S. and global trends in maternal and infant mortality
2. Identify key disparities related to poverty and rurality in the U.S.
3. Explain how poverty, rurality, and midwifery care function as a system-level determinants of birth outcomes within a state-level maternal health framework
4. Interpret findings from multiple linear regression and interaction models examining the association between midwifery care and adverse birth outcomes.
5. Discuss the evolving role of midwifery care as a public health strategy to improve birth outcomes, particularly in rural communities.

Myra DeLuca, MSN, CNM, FACNM