While the country struggles to provide affordable, quality health care to all Americans, a primary focus has been on women and children. However, one group of care providers is rarely discussed by health policymakers despite their significant contributions to health care: Midwives.
Certified nurse-midwives (CNMs) and certified midwives (CMs) provide high quality primary and maternity care to women and families. CNMs are recognized under federal law as primary care providers for women. They provide family planning services, gynecology services, primary care, childbirth and postpartum care, care of children for the first 28 days of life, and treatment of male partners for sexually transmitted infections. Midwives also use their credentials to prescribe medication, admit, manage and discharge patients, and interpret laboratory and diagnostic tests. These skills allow midwives to offset many of the primary and maternal care functions of MDs, and do so with lower costs.
The Institute of Medicine published in its report The Future of Nursing that critical workforce shortages are being seen across all health care systems, especially in primary and maternity care. There is a vast amount of literature that suggests CNM and CM professionals provide a high-value, cost-effective, patient-centered form of care in exactly those arenas. As 2014 and greater implementation of the Affordable Care Act nears, access to midwives is ever increasing, with the Affordable Care Act granting midwives 100% reimbursement under Medicare Part B. Further, new nondiscrimination requirements have been employed to ensure that individual and group health insurance plans must cover these services for women.
Nevertheless, many stakeholders including clinicians and policymakers are unaware of or fail to discuss the significant role midwives will play in health reform. Nor are they adequately addressing how barriers to their practicing medicine continue to play out in the medical world. It’s about time we make sure all women’s preventative and maternal services are given full attention and made effective.