Effect of COVID-19 on the Cultural Transition Towards the Use of Midwives Over Standard Doctors of Medicine [ID 2683504

Abstract

INTRODUCTION: In recent times, the use of midwives as obstetrical providers has become increasingly popular within the United States. Unsurprisingly, the SARS-CoV-2 pandemic (COVID-19) had a large effect on societal trust of health care, including providers, and thus this study aimed to determine whether the pandemic further accelerated the cultural transition towards utilizing midwives as birth attendants. METHODS: Using the CDC Natality Database, we reviewed deliveries from 2016 to 2021 of previously healthy mothers, ages 18–35, with singleton pregnancies, measuring incidence of birth attendants including MDs, DOs, nursing midwives, and non-nursing midwives. A binomial model was used to perform logistic regressions to assess whether COVID-19 correlated with alterations in rates of transition of birthing attendants. RESULTS: Rates of deliveries attended by MDs declined at a greater extent, whereas births attended by DOs increased at a lesser rate, and nursing midwives and non-nursing midwives increased at a greater rate (change in rates pre-to-post COVID-19: −0.390%, −0.084%, 0.044%, and 0.204%, respectively; P<2.2×10−16). Although this rate of change was small, since the start of COVID-19 there has been an 11% increase in non-MD-attended deliveries, nearly double the rate seen prior. CONCLUSION: There has been a significant increase in the number of deliveries attended by DOs, nursing midwives, and non-nursing midwives over the past several decades, even more so since the start of COVID-19. With the transition in the utilization of health care professionals, further investigation needs to be conducted to assess the effects this has on health outcomes of the mother and infant.