Our Philosophy

Pregnancy and birth are normal physiologic processes. The advancement of medical technology has helped us improve outcomes, however over medicalization can disrupt this physiologic process and create more harm. We believe there is a middle ground where we can respect and preserve this process, while also improving outcomes, and research shows that the best way to do this is by integrating midwives into the maternity care system.

Outcomes of planned home births with certified professional midwives: large prospective study in North America

Authors evaluated all low risk home births in the US and Canada in the year 2000 that were attended by Certified Professional Midwives. There were 5418 births total, 98% of them occurring in the US. They found similar rates of intrapartum and neonatal mortality compared to low risk hospital births, with substantially lower rates of medical intervention such as cesarean section, episiotomy, forceps and vacuum extractions. There were no maternal deaths.

Johnson K C, Daviss B. Outcomes of planned home births with certified professional midwives: large prospective study in North America BMJ 2005; 330 :1416 doi:10.1136/bmj.330.7505.1416

Perinatal or neonatal mortality among women who intend at the onset of labour to give birth at home compared to women of low obstetrical risk who intend to give birth in hospital: A systematic review and meta-analyses

Authors performed a meta analysis that included 500,000 intended home births in low risk patients. They found that when midwives were well integrated into the health care system there was no difference in perinatal mortality (stillbirth after the onset of labor to 7 days after birth), or neonatal mortality (death between 0 and 28 days of a live birth) between intended births at home or the hospital.

Hutton E, Reitsma A, Simioni J et al. Perinatal or neonatal mortality among women who intend at the onset of labour to give birth at home compared to women of low obstetrical risk who intend to give birth in hospital: A systematic review and meta-analyses. eClinicalMedicine, 2019; 14, 59-70

Mapping integration of midwives across the United States: Impact on access, equity, and outcomes

Midwifery laws vary significantly state to state. These authors evaluated levels of integration of midwifery in each state and created a system called MISS (Midwifery Integration Scoring System). A higher score indicated better integration based on on regulations, limitations and restrictions, prescription writing authority, etc. States with higher MISS scores had substantially increased rates of vaginal delivery, VBAC, breastfeeding, and lower rates of cesarean sections, preterm birth, low birth weight, and neonatal death, implying that states with better integration of midwives have better outcomes.

Vedam S, Stoll K, MacDorman M, Declercq E, Cramer R, Cheyney M, Fisher T, Butt E, Yang YT, Powell Kennedy H. Mapping integration of midwives across the United States: Impact on access, equity, and outcomes. PLoS One. 2018 Feb 21;13(2):e0192523. doi: 10.1371/journal.pone.0192523. PMID: 29466389; PMCID: PMC5821332.

"The risk of perinatal or neonatal mortality was not different when birth was intended at home or in hospital."

(Hutton et. al, 2019)