Who Uses a Midwife for Prenatal Care and for Birth in the United States? A Secondary Analysis of Listening to Mothers III

Abstract

BackgroundAlthough midwife care is slowly but consistently increasing in the United States, not much is known regarding women who use a midwife. Our objectives were to compare the sociodemographic and health history characteristics, and the quality of patient–provider communication, between women who used a midwife and those who used a physician for prenatal care and/or birth. MethodsWe performed a cross-sectional analysis of the nationally representative Listening to Mothers III survey. We report descriptive findings using weighted proportions and means with standard deviations. We used the two one-sided tests procedure to assess the equivalence of women who used midwives and those who used physicians. ResultsNearly 13% of women used a midwife for prenatal care or as a birth attendant. Women who used a midwife for prenatal care were similar to women who used a physician in most sociodemographic and health history characteristics, as well as their patient–provider communication scores, with the exception of the percentage of White (61.7 ± 5.0 [midwives], 54.3 ± 1.5 [physicians]) and married women (68.7 ± 4.9 [midwives], 60.6 ± 1.5 [physicians]). Women who used a midwife as a birth attendant were similar to women who used a physician as a birth attendant in most characteristics, with the exception of age over 35 years (7.5 ± 1.6 [midwives], 15.7 ± 1.1 [physicians]) and Special Supplemental Nutrition Program for Women, Infants, and Children support (56.8 ± 4.9 [midwives], 50.0 ± 1.6 [physicians]). ConclusionsWomen who use midwives are similar to those who use physicians and our findings do not confirm the common perception that midwife patients are a self-selected group of wealthier, more educated women.