Are CNM-Attended Births in Texas Hospitals Underreported?

Accurate data on the number of births attended by certified nurse-midwives and certified midwives (CNMs/CMs) are required to establish the public health benefits attributed to the midwifery model of care and the role of CNMs/CMs in the US health care system. However, the number of CNM/CM-attended births may be underreported in birth certificate data. The purpose of this project was to estimate the number of births CNM practices attended in Texas hospitals in 2014 and to describe Texas CNMs' knowledge about their hospitals' policies on naming CNMs as birth attendants.

CNMs from Texas practices employing CNMs completed a survey. Descriptive statistics were used to summarize respondent data. These results were used to impute data for practices that did not respond to the survey so that total estimates for the state could be calculated.

CNM-attended hospital births in Texas in 2014 may be underreported by 65%. Most CNMs (90%) keep records of births attended, but only 19% of practices receive facility reports with the births CNMs in the practice attended.

CNMs/CMs need to regularly verify that they are being named as the provider on birth certificates for births they attend and work with advocacy groups, hospital administrators, physicians, legislators, and policy makers to improve the accuracy of birth certificate data.