Document Type


Publication Date



Amber Todd and Jeanette Manger


The function of midwives in the context of maternal health is important, especially when understanding the role of midwives in a global context compared to in the United States. Globally, midwives have served as historically important members in the process of childbirth, but their role has experienced changes in response to increased medicalization over the years, especially in the United States.1 Based of their use and effectiveness in a global context, literature suggests that it may be beneficial for both the healthcare system, mothers, and infants to expand the role of midwives in the United States.2 The purpose of this research was to compare infant death rates within the United States between births supervised by physicians (both MD and DO) versus midwives to understand if differences exist between the groups. Furthermore, in order to assess the role of potentially moderating social determinants of health, the impact of the mother’s race and use of prenatal care was assessed in relation to which type of medical attendant supervised the birth. Data from between 2007 and 2017 was collected on infant birth and death records from the Centers for Disease Control and Prevention website ( for births that occurred in the United States to United States residents. Data was then categorized according to which type of medical attendant supervised the birth, mother’s race, and mother’s prenatal care. Data analysis showed that infant death rates were significantly higher when births were supervised by MD/DO physicians compared to midwives, and these differences persisted regardless of maternal race or prenatal care. These findings are relevant to helping understand the role of midwives within the United States healthcare system.

Included in

Public Health Commons