Unlicensed midwifery practice in Washington state.

Area of Science:

• Maternal and Child Health
• Healthcare Access
• Alternative Birthing Practices

Background:

• The role of unlicensed midwives in out-of-hospital births remains under-examined.
• Understanding provider choice in home birth settings is crucial for maternal healthcare.
• Washington State provides a specific context for analyzing midwifery practices.

Purpose of the Study:

• To investigate the prevalence and characteristics of unlicensed midwife attendance in Washington State births.
• To understand the motivations behind mothers' choices to use unlicensed midwives for out-of-hospital births.
• To compare the utilization of unlicensed midwives with licensed and certified nurse-midwives in home birth settings.

Main Methods:

• Survey of mothers with infants born out-of-hospital attended by an unlicensed person.
• Analysis of birth statistics in Washington State.
• Qualitative exploration of reasons for choosing unlicensed midwifery care.

Main Results:

• Unlicensed midwives attended only 0.11% of all births in Washington State.
• They attended 7% of all home births, compared to 69% attended by licensed or certified nurse-midwives.
• Key reasons for choosing unlicensed midwives included shared religious beliefs and provider availability for home births.

Conclusions:

• Unlicensed midwives play a minimal role in the overall birth landscape of Washington State.
• Their utilization is concentrated in the home birth population, often driven by specific patient needs and provider accessibility.
• Further research is needed to understand the safety and implications of unlicensed midwifery care in out-of-hospital settings.