As the holiday season approaches – a time traditionally associated with joy and family gatherings – there’s a deeply concerning issue unfolding across the United States: a significant shortage of certified midwives.
- Mississippi tops the list with 78.66 births per midwife, over 220% higher than the national average of 24.5.
- Alabama follows closely with a 73.99 to 1 ratio, indicating severe strain on maternal health services.
- The top 10 states exceed the national average births-to-midwife ratio of 24.5.
A new study by Birth Injury Lawyers Group reveals top U.S. states where the gap between the number of births and the availability of midwives is alarmingly high.
The research analyzed the average monthly births from January to May 2023 and the number of certified midwives in each state as of May 2023. By dividing the monthly births by the number of midwives, the births-to-midwife ratio was identified for each state.
Mississippi leads the nation in Certified Nurse Midwife (CNM) shortages, with a troubling births-to-midwife ratio of 78.66 to 1. This is 221% above the national average of 24.5. Magnolia State’s monthly average birth rate of 2,753 between January and May 2023 is below the national average (5,767), yet it far outpaces the number of certified midwives, which stands at just 35 as of May 2023.
With a births-to-midwife ratio of 73.99 to 1, Alabama faces the second-highest midwife shortage in the nation. This is 202% above the national average of 24.5. Every month, the Yellowhammer State sees an average of 4,662 births. With only 63 certified midwives available, the state’s midwifery workforce is overwhelmed and unable to meet the increasing demand for maternal care.
Arkansas ranks third, with a births-to-midwife ratio of 57.33 to 1. This is 134% above the national average of 24.5. The state’s monthly average of 2,809 births may be lower than the national average, but with only 49 certified midwives, the shortage remains a critical concern.
With a births-to-midwife ratio of 52.96 to 1, Louisiana struggles with the fourth-highest midwife shortage in the country. This is 116% above the national average of 24.5. On average, the state records 4,395 births each month. With only 83 certified midwives to serve these growing numbers, the state’s maternal care system is under substantial pressure.
Oklahoma ranks fifth in terms of midwife shortages, with a ratio of 52.16 births per midwife. This is 113% above the national average of 24.5. While the state’s monthly average of 3,860 births remains below the national figure, the limited number of 74 certified midwives indicates a significant gap in maternal healthcare resources.
Texas, with one of the highest overall birth rates, is grappling with sixth-highest midwife shortage across the nation, reflected in its 50.01 to 1 births-to-midwife ratio. This is 104% above the national average of 24.5. Every month, the Lone Star State welcomes approximately 30,658 newborns, but with only 613 certified midwives available, providing adequate maternal care poses a significant challenge.
Nevada ranks seventh with a births-to-midwife ratio of 39.25 to 1. This is 60% above the national average of 24.5. Despite a relatively modest monthly average of 2,551 births, the state’s shortage of certified midwives—just 65 in total—raises serious concerns regarding timely and comprehensive maternal care.
Missouri ranks eighth with the births-to-midwife ratio at 39.18 to 1, marking a 60% increase above the national average of 24.5. The Show-Me State sees approximately 5,368 births each month. With only 137 certified midwives available to serve mothers and their newborns, critical gaps in maternal care and attention persist.
Taking the ninth spot, North Dakota reports a births-to-midwife ratio of 38.07 to 1. This is 55% above the national average of 24.5. Although the state’s monthly average of around 799 births is relatively low, the availability of just 21 certified midwives has led to critical shortage.
With a births-to-midwife ratio of 36.49 to 1, Nebraska rounds out the top ten with a shortage situation 49% above the national average of 24.5. Each month, the Cornhusker State welcomes approximately 1,970 newborns. However, with merely 54 certified midwives, the state’s maternal care system struggles to maintain high standards of care.
Top 10 U.S. states with the highest births-to-midwife ratio:
- Mississippi – 78.66 to 1
- Alabama – 73.99 to 1
- Arkansas – 57.33 to 1
- Louisiana – 52.96 to 1
- Oklahoma – 52.16 to 1
- Texas – 50.01 to 1
- Nevada – 39.25 to 1
- Missouri – 39.18 to 1
- North Dakota – 38.07 to 1
- Nebraska – 36.49 to 1
Looking at the study, a spokesperson from Birth Injury Lawyer commented,
“States like Mississippi, Alabama, and Arkansas have a particularly concerning births-to-midwife ratio, with Mississippi leading at 78.66 births per midwife. This shortage puts expectant mothers at risk, as there aren’t enough midwives to provide essential care during pregnancy and childbirth. As a result, complications like delayed interventions or inadequate monitoring can increase, affecting both maternal and neonatal health.
To tackle this issue, states need more trained midwives. Offering incentives like scholarships, loan forgiveness, and competitive salaries could attract people to the profession. Increasing access to midwifery education and promoting diversity in the field would help ensure all mothers receive the quality care they deserve.”
Table of Extended Results:
Births to Midwife Ratio in Each State
| Rank | US State | Number of CNMs/CMs | Average Birth | Births to Midwife Ratio |
| 1 | Mississippi | 35 | 2,753 | 78.66 |
| 2 | Alabama | 63 | 4,662 | 73.99 |
| 3 | Arkansas | 49 | 2,809 | 57.33 |
| 4 | Louisiana | 83 | 4,395 | 52.96 |
| 5 | Oklahoma | 74 | 3,860 | 52.16 |
| 6 | Texas | 613 | 30,658 | 50.01 |
| 7 | Nevada | 65 | 2,551 | 39.25 |
| 8 | Missouri | 137 | 5,368 | 39.18 |
| 9 | North Dakota | 21 | 799.4 | 38.07 |
| 10 | Nebraska | 54 | 1,970 | 36.49 |
The study was conducted by Birth Injury Lawyers Group, a nationwide group of lawyers that specializes in advocating for families whose children have suffered injuries at birth due to medical malpractice or errors.
ENDS
P.S. If using this story, please credit and link to www.birthinjurylawyer.com
Source
- Certified Midwife data → https://www.amcbmidwife.org/docs/default-source/reports/number-of-cnm-cm-by-state—may-2023.pdf?sfvrsn=5
- Birth data → https://www.cdc.gov/nchs/data/health_policy/2023-2022-2021-numbers-completeness-through-june.pdf
Research
- Dataset →
Methodology
The study gathered the average monthly births from January to May 2023 and the number of certified midwives in each state as of May 2023. By dividing the monthly births by the number of midwives, the births-to-midwife ratio for each state was identified to rank them based on midwife shortage.
Resources
- Map → https://drive.google.com/file/d/14WYAXXMLsOUfqPh1fCsWiINftpCXmnIG/view?usp=share_link