Associations Between State Practice Regulations and Access to Midwifery Care.

Area of Science:

• Public Health
• Health Policy
• Maternal Health

Background:

• Access to midwifery care is influenced by state-level policies.
• Understanding these policy associations is vital for improving maternal healthcare access.

Purpose of the Study:

• To identify associations between state policies and access to midwifery care.
• To inform policymakers on effective strategies for expanding midwifery services.

Main Methods:

• Cross-sectional study using National Vital Statistics data (2019) at the county level.
• Analyzed associations between midwife licensure, prescribing, hospital access, Medicaid parity, and midwife-attended births.
• Poisson regression analysis was employed.

Main Results:

• Independent midwife licensing alone showed no association with increased access.
• Medicaid reimbursement rates correlated positively with midwife-attended births, irrespective of licensing status.
• In states with independent licensing, more favorable policies were linked to higher midwife attendance rates.

Conclusions:

• State regulatory policies beyond independent licensing are key drivers of access to midwifery services.
• Implementing supportive policies, especially regarding Medicaid, can enhance midwife utilization.
• Findings offer actionable insights for policymakers aiming to expand midwifery care access.