Certified Midwives: An Exploration of Their Impact on Maternal Health Outcomes – A Comprehensive Literature Review

Heather Hollister, University of Nebraska Medical Center


Maternal health outcomes in the United States have been consistently worse than other high-income countries, with a disproportionate impact on women of color. Midwives have long played an important role in maternal health worldwide. The literature review examines the evidence for midwives as key contributors to improving maternal health outcomes. The paper reviews the existing literature on midwifery, including the impact on maternal health, labor and delivery outcomes, and patient satisfaction. Electronic searches were conducted through Cochrane Library, CINAHL, Medline and Embase. Articles were screened according to inclusion and exclusion criteria including that they must be a randomized study; participants who were pregnant women; an experimental group with all phases of maternal care provided by only midwives; and a control group consisting of care from any combination of general physicians, obstetricians, and midwives. Outcomes including, cesarean section, induction, instrumental vaginal delivery, perinium not intact, use of analgesia epidural, postpartum hemorrhage and maternal satisfaction were compiled from the studies. The change in outcomes were examined to determine if the results were from chance and attributed to the use of midwife-led care. Fifteen randomized control studies were included in the literature review. The findings show that midwife-led care has lower rates of cesarean section, induction, epidural analgesia, episiotomy, and an increase in patient satisfaction. Ultimately, evidence from the review supports the integration of midwives into maternal healthcare teams to improve maternal health outcomes in the United States.