Introduction

Midwifery care is one of humanity’s oldest professions. For tens of thousands of years, midwives have supported people through pregnancy and childbirth, ensuring better outcomes for both mother and child.

Today, midwives care for low-risk pregnant people, supporting them through pregnancy, birth, and the postpartum period. The midwifery model of care views birth as a normal, physiological process. and midwives take a holistic approach to care, recognizing mental, emotional, and physical needs as interconnected.

But in the U.S.—where maternal death rates are almost twice those of other wealthy nations—centuries of discrimination and coordinated efforts forced midwives out of health systems. Today, as the country faces a growing shortage of maternal healthcare providers, it’s never been clearer: removing barriers to midwifery will save lives.

Here are five things to know about midwifery.

Bodily autonomy

1. Midwifery care emphasizes pregnant people’s bodily autonomy.

Midwives prioritize each pregnant person’s right to make decisions about their own body. They help identify problems and provide the information a pregnant person needs to choose their care throughout pregnancy, birth, and the postpartum period. If health complications do arise, midwives are trained to recognize them and will collaborate with, or refer to, other health professionals.

Empowered decision-making positively affects patient outcomes. People cared for by midwives are less likely to have cesarian surgeries, episiotomies, epidurals, and drug-induced labor—interventions that can lead to complications and increase costs.

Hospitals, homes & birth centers

2. Midwives work in hospitals, homes, and birth centers.

Midwives care for people giving birth in a variety of settings. A pregnant person may decide to give birth at home, in a hospital, or at a freestanding birth center. Midwives are trained to work in each of these settings, both alone and alongside physicians and nurses. Since midwives work within and outside hospitals, access to midwifery care ensures the pregnant person can decide where, and with whom, to give birth.  In the U.S.—where one-third of counties are considered maternity care deserts—midwives can also help fill crucial gaps in health systems, reaching people without access to birthing facilities.

History of exclusion

3. In the U.S., midwives have been systematically excluded from medical practice.

Before the 1800s, maternity care in the U.S. was centered around midwives. As more white, male physicians took interest in birth, laws and educational restrictions were enacted to dismantle the practice of midwifery. This discrimination had a lasting effect. In 2022, 65% of births in the U.S. were low-risk, yet midwives attended just 13% of them. By contrast, in other wealthy countries with better maternal and infant health outcomes, midwives are the primary providers of maternity care for low-risk patients. While most communities in the U.S. do not have sufficient access to midwives and birth centers, demand for them is growing, despite restrictive state laws.

Better health outcomes

4. States with laws that support midwives have better maternal and infant health outcomes.

States that have integrated midwifery care into their healthcare system have lower rates of premature births, cesarean surgeries, and newborn deaths than states that have not. Even so, many states still have misguided, prejudiced laws that restrict thousands of midwives’ ability to practice. This is particularly true for midwives in the Deep South, primarily affecting maternal care access for pregnant people of color. In fact, in 2022 and 2023, two different UN human rights bodies called on the United States to make improvements in access to midwifery care in Black and Indigenous communities.

Advancing rights

5. Midwives are key to advancing human rights and public health worldwide.

The World Health Organization (WHO) encourages all countries to transition to midwifery models of care to save lives, money, and improve individuals’ healthcare experiences. In fact, the WHO has partnered with The United Nations Population Fund (UNFPA) to try to increase the number of midwives worldwide. Internationally, midwifery care is a critical part of quality healthcare for pregnant people.

Ensuring access

Ensuring access to care

Midwives are experts in the process of birth, and their care has been shown to improve health outcomes for low-risk pregnant people and their babies.  As the U.S. faces an ongoing maternal health crisis that disproportionately impacts Black and Indigenous people, increasing access to midwifery care is essential for advancing reproductive rights.

In April 2026, the Center for Reproductive Rights filed a lawsuit against the state of Georgia, challenging two harmful laws that restrict the practice of midwives. This followed its 2024 lawsuit against Hawai’i, which led the state to expand access to midwifery care.

The Center continues to advocate for midwives and against midwifery restrictions to ensure all pregnant people have access to quality healthcare.