The Midwifery Model in 2026: Why More Hospitals are Integrating Midwives

The midwifery model of care is transforming maternity care in the U.S. Hospitals are increasingly integrating midwives to improve outcomes, lower costs, and meet growing demand for personalized care. Here is why this shift is happening:

• Improved Outcomes: Midwifery care reduces unnecessary interventions, lowers C-section rates, and improves breastfeeding success. Studies show it can prevent up to 41% of maternal deaths and 39% of newborn deaths¹.
• Cost Savings: Fewer interventions mean reduced healthcare costs. Midwives also help address OB-GYN shortages, especially in underserved areas.
• Patient Satisfaction: Midwives provide longer, relationship-based appointments, empowering parents with education and emotional support.
• Access to Care: With a projected OB-GYN shortage of 22,000 by 2050, midwifery fills critical gaps, particularly in rural and underserved communities².

Hospitals like Martin Luther King Jr. Community Hospital and Princeton Baptist Medical Center are leading the way, showing how midwifery programs can improve care for diverse populations while addressing health disparities. This approach is reshaping maternal healthcare across the U.S.

Why Hospitals Are Adding Midwives to Their Teams

Hospitals are increasingly incorporating midwives into their care teams to provide more personalized, low-intervention care. This shift aims to improve maternal health outcomes, reduce healthcare costs, and meet the growing demand for patient-centered care. By focusing on these goals, hospitals are solidifying their commitment to enhancing both patient experiences and operational efficiency.

Better Health Outcomes for Mothers and Babies

Midwives play a key role in improving outcomes for mothers and newborns. Studies show that midwifery care leads to higher rates of spontaneous vaginal births and increased breastfeeding success compared to traditional physician-led care. By prioritizing natural processes and avoiding unnecessary interventions — like non-essential C-sections, inductions, and the use of forceps — midwives help reduce complications in low-risk pregnancies. Research indicates that integrating midwives into healthcare systems could prevent 41% of maternal deaths, 39% of neonatal deaths, and 26% of stillbirths¹.

Lower Costs and Increased Efficiency

Midwifery care also offers financial advantages. By minimizing interventions such as C-sections, preterm births, and episiotomies, hospitals can significantly reduce costs. Additionally, midwives help address shortages in obstetric care, especially in underserved areas. In many healthcare systems, midwives handle up to 80% of essential maternal care tasks, including admitting, managing, and discharging patients. This not only streamlines hospital workflows but also eases the workload for specialized staff.

Expanding and investing in midwifery models of care is one of the most effective strategies to improve maternal and newborn health globally. These approaches improve outcomes, maximize resources, and can be adapted to all countries. — Dr. Anshu Banerjee, Director for Maternal, Newborn, Child and Adolescent Health and Ageing at WHO

Greater Patient Satisfaction

Patients report higher satisfaction with midwifery care, thanks to its emphasis on personalized, relationship-focused support. Midwives take the time to answer questions, provide emotional guidance, and offer tailored wellness education, fostering trust and confidence throughout the pregnancy. Research by P. Mimi Niles and Laurie C. Zephyrin from the Commonwealth Fund highlights how patients value these ongoing relationships and the opportunity to actively participate in decisions about their care³.

Hospitals That Have Successfully Added Midwifery Programs

Martin Luther King Jr. Community Hospital

Martin Luther King Jr. Community Hospital in South Los Angeles has achieved a remarkable 14.6% C-section rate in 2022 — far below California's average of 30.8% and the national rate of 32.1%. This success stems from a round-the-clock collaborative care model, where a registered nurse-midwife and an obstetrician are always on-site to provide support.

The hospital's efforts have earned it a spot on Cal Hospital Compare's Maternity Honor Roll for seven consecutive years as of 2023. Dr. Angela Sojobi, a registered nurse-midwife at the hospital, shared the philosophy behind their program:

Healthy, natural births should be every hospital's goal and every woman's prerogative. This recognition shows that if you trust women and give them the time and support they need, that goal is achievable.

Serving predominantly African American and Latina communities, the hospital has shown how midwifery care can help tackle health disparities in underserved populations. However, maintaining this high level of care comes with financial challenges — the program operates at an annual loss of about $2 million.

Princeton Baptist Medical Center

Princeton Baptist Medical Center in Birmingham, Alabama, provides another example of a successful midwifery program. As of December 2020, it was the only hospital in the Birmingham area using a midwifery model. The hospital restructured its approach to center the birthing person's needs, with midwives now managing nearly 90% of vaginal births, averaging about 30 births per month.

This model has improved outcomes even for high-risk patients. The program's success earned the hospital a spot on Newsweek's 2020 list of Best Maternity Care Hospitals, based on data from the Leapfrog Hospital Survey.

Data from Leading Maternity Hospitals in 2026

Nationwide data underscores the impact of midwifery programs. In 2026, 901 hospitals submitted maternity data for U.S. News ratings, reflecting growing transparency in maternal care quality. Hospitals with integrated midwifery programs consistently reported lower C-section rates for low-risk pregnancies, higher success rates for vaginal births after cesarean (VBAC), and increased rates of exclusive breastfeeding.

Additionally, 147 hospitals were designated as Maternity Care Access Hospitals in 2026 for their role in providing essential services in areas at risk of becoming maternity care deserts. Many of these hospitals rely heavily on midwifery models, with midwives managing up to 80% of essential maternal care tasks in some systems.

How Midwifery Supports Mothers in Late Pregnancy

Consistent Care from the Same Provider

Late pregnancy requires care that goes beyond quick check-ins. Midwifery appointments typically last 30-60 minutes, compared to the usual 10-15 minutes of traditional obstetric visits. This extra time allows midwives to address both physical and emotional needs, ensuring a more personalized experience.

The Continuity of Care model is central to midwifery. It ensures mothers see the same midwife — or a small, consistent team — throughout late pregnancy. This consistency builds trust and comfort, creating a strong bond before labor begins. Studies show that women in midwifery care are 46% less likely to hesitate when asking questions and 54% less likely to feel discouraged from sharing concerns⁴.

Fewer Medical Interventions During Birth

Midwives focus on supporting the natural birthing process, helping mothers feel prepared and confident. During the third trimester, they dedicate time to educating mothers about labor's physiological stages, boosting mental readiness and self-assurance. This partnership encourages mothers to create birth plans that reflect their values and priorities.

Planning for Cord Blood and Tissue Banking

Midwifery's extended consultations provide the perfect opportunity to discuss specialized birth options, such as cord blood and tissue banking. Midwives offer evidence-based information, helping families understand the differences between public donation and private banking.

Since the first successful transplant in 1988, umbilical cord blood stem cells have been used in over 35,000 transplants worldwide. These cells are FDA-approved for treating more than 80 diseases, including leukemias, lymphomas, and genetic disorders⁵. Midwives help families incorporate banking into their birth plans, balancing delayed cord clamping with the need to collect at least 40 mL of cord blood for potential future use.

For families considering private banking through providers like Americord Registry, midwives explain how banking cord blood, cord tissue, and placental tissue can work alongside natural birth practices. Pricing for these services is subject to change; please visit our pricing page for the most up-to-date information, including Annual Fees (in some cases). Midwives handle the collection process immediately after birth, ensuring everything is done smoothly. As Renece Waller-Wise, DNP, RNC-OB, points out:

Expectant families have been clear that their preference to receive education on cord blood banking and donation should be from healthcare professionals.

How Midwifery Works with Modern Medical Care

Midwives and Doctors Working Together

Midwives and obstetricians collaborate in a system designed to match the level of care to the specific needs of patients. Midwives handle the majority of low-risk pregnancies, with about 87% of their births occurring in hospital settings. When complications arise or risk factors emerge, doctors step in to provide specialized care.

This teamwork is supported by hospital bylaws and state regulations. In the U.S., 95% of midwives work in hospitals, where they have full privileges to admit, manage, and discharge patients. This setup allows midwives to focus on natural processes while ensuring emergency care is readily available if needed.

Using Technology to Improve Midwifery Care

The collaboration between midwives and doctors is further strengthened by advancements in technology. Hospitals now use advanced analytics to enhance midwifery care by converting midwives' experience-based insights into structured data. Remote monitoring and telehealth have also become game-changers, with 49% of health system executives reporting significant cost savings from these innovations⁶.

Improving Access to Quality Maternal Care

Expanding midwifery is crucial to addressing the provider shortage. Currently, the U.S. has only 4 midwives per 1,000 live births, falling short of the WHO goal of 6 per 1,000. Midwives can deliver 80% of essential maternal care, helping to bridge this gap and address health disparities. For example, Black women in the U.S. are 3.3 times as likely to die from pregnancy-related causes as white women⁷. Research shows that midwifery care fosters a greater sense of respect and autonomy, which is critical in tackling the maternal health crisis.

The Future of Midwifery in U.S. Hospitals

The growing presence of midwifery in hospitals marks a pivotal shift in maternal healthcare across the U.S. With an OB-GYN shortage on the horizon, hospitals are beginning to see midwifery as a critical component of care. This approach is particularly relevant as over 50 hospitals in California have shut down labor and delivery units since 2012 due to financial pressures. Midwives offer hospitals an efficient and sustainable staffing model while reducing disparities in care for Black and Indigenous communities.

FAQs

How do midwives enhance maternal and newborn health outcomes?

Midwives focus on personalized, evidence-based care with minimal medical interventions. Studies reveal that women receiving midwifery care are more likely to have vaginal births and are less likely to undergo procedures like labor induction or C-sections. This approach is associated with lower rates of preterm births and improved breastfeeding outcomes.

How can hospitals benefit financially from integrating midwifery care?

Integrating midwifery care can lead to significant cost savings by reducing unnecessary medical interventions, which are among the most expensive aspects of maternity care. This aligns with value-based payment models that prioritize quality and cost-effectiveness.

How do midwives improve access to maternity care in underserved areas?

Midwives bridge the gap in areas with physician shortages, offering care closer to home and reducing the burden of travel. They provide patient-centered care that respects cultural needs, fostering trust in historically marginalized groups.

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References

1. The Lancet Global Health: Potential impact of midwives in preventing maternal and newborn deaths
2. AAMC: The Growing OB-GYN Shortage
3. Commonwealth Fund: Community-Based Models to Improve Birth Equity
4. Cochrane Library: Midwife-led continuity models of care
5. FDA: Cord Blood: What You Need to Know
6. Deloitte: 2024 Health Care Outlook
7. CDC: Maternal Mortality Rates in the United States, 2021