Midwifery Legacy

Modern Midwifery and the Legacy of Mary Breckinridge A sweeping trend in rural areas has taken a toll on the health of the populations that live there; hospitals are closing or reducing their obstetric and maternity services. Reduced access to maternity services in rural areas affects the sustainability of communities as a whole (Miewald et al., 2011). Mary Breckinridge introduced midwives to rural Appalachia in the 1920s and brought about a significant decrease in maternal mortality. The broad return of modern midwifery could reduce economic burdens as well as decrease infant and maternal mortality in areas with limited access to care. The purpose of this paper paper is to discuss the life and legacy of Mary Breckinridge, examine the

Department of Health and Human Services [HHS], 2011). Many of these objectives are interrelated, where increasing prenatal care and reducing the number of cesarean births directly affect the maternal and infant mortality rates. Intervention Nurse-midwives provide essential services to women of childbearing age and are particularly suited to providing care to rural populations. The midwifery model of care is women-focused and typically has a higher normal birth rate and higher patient satisfaction rate than obstetrician led care for low-risk patients (Collins & Kingdon, 2014). Midwives attended only approximately 8% of U.S. hospital births in 2011, increasing the number of midwives attending and caring for pregnant women could have a significant impact on the maternity care landscape in the U.S. For low-risk pregnancies, midwife led care leads to fewer costly interventions like augmentation and cesarean, reduces the rates of third and fourth degree tears, and is related to higher rates of breastfeeding (American College of Nurse-Midwives [ACNM], 2012). Increasing the availability of midwives in rural clinics and hospitals can significantly reduce the cost of care and improve

is one that is slow to change. There are several regulatory barriers that exist in many states that prevent the widespread availability and ability of nurse-midwives to practice effectively and independently (Walker, Lannen, & Rossie, 2014). These differences in regulation has perpetuated a societal view that midwifery care is not the best care available although it is a valid and effective choice for many families. Policy Development Lobbying for the removal and edit of many restrictions for advanced practice nurse-midwives across the nation to allow for the more widespread use of midwives for prenatal and labor care could help improve maternal morbidity especially rural populations. Specifically, the current policies on supervision of practice and levels of education should be examined and standardized across the country. Complete and appropriate education must be ensured, regulated, and normalized across the country. There are many programs that train direct-entry midwives, which include Certified Professional Midwives, Certified Midwives, Licensed Midwives, and Registered Midwives, but not all states recognize the different training and designations and the states that do may impose different scopes of practice for each (Walker et al., 2014). Assuring that the term “midwife” is a universal indicator of training and ability is