A growing focus on maternal health disparities prompts lawmakers to remove barriers for nurse-midwives

A growing focus on maternal health disparities prompts lawmakers to remove barriers for nurse-midwives
As maternal health disparities come under increasing scrutiny in Virginia and across the country, there’s been a political push to address the problem. (Source: Pexels)

A few months into the COVID-19 pandemic, Nichole Wardlaw opened her own midwifery practice in Chesapeake.

A certified nurse-midwife, or CNM, Wardlaw was taking advantage of an emergency order signed by Gov. Ralph Northam, which allowed certified-nurse midwives and nurse practitioners to treat patients without an agreement with a licensed physician — something that’s typically required in Virginia.

But she was also trying to fill a need in her community. Wardlaw said she’s now the only Black certified nurse-midwife in the Hampton Roads region to open an independent practice, spurred by concerns she heard from expecting mothers throughout the early months of the pandemic.

Even before then, Wardlaw said she was keenly aware of the maternal health disparities faced by many in her community. In Virginia, Black women are more than twice as likely to die in childbirth than White women, according to the most recently available data from the state Department of Health. A 2013 survey of mothers across the country found that Black women were more than three times as likely as White women to report that they were “always or usually” treated poorly in hospitals due to race, ethnicity, cultural background or language.

“My concern is that Black women are dying in childbirth and from childbirth-related issues,” said Wardlaw, who also serves as the legislative chair for the Virginia Affiliate of the American College of Nurse-Midwives. “And since I opened my practice, I’m getting calls from far north of here because women want someone who looks like them.”

As maternal health disparities come under increasing scrutiny in Virginia and across the country, there’s been a political push to address the problem. During this session, the General Assembly unanimously passed legislation creating a task force to collect more maternal health data and narrowly endorsed a bill to remove some restrictions on midwives.

Some providers and legislators see midwifery as an important tool, arguing it could increase the number of obstetric providers in underserved communities and reduce inequities in birth outcomes. In 2014, The Lancet, an international medical journal, found that midwife-led care by licensed and educated providers led to better maternal health outcomes. Another 2018 study examined the regulation of midwives in 50 states and found C-sections, premature births and infant fatalities all declined when midwives were integrated across health care settings.

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