Conclusions: States that have rules that support independent midwifery practices have more nurses and midwives and a higher proportion of births supported by the knA. Correlations between autonomous practice laws and improved birth outcomes indicate that future policy efforts to improve access to midwifery services could be beneficial to pregnancy outcomes and infant health. Results: States with autonomous practice laws have an average of 4.85 CNMs per 1,000 births, compared to 2.17 in countries where the practice of the NJC is subject to a collaboration agreement. In countries where the NJC is self-sufficient, women were more likely to give birth (Adjusted Quota Ratio [AOR], 1.59; p – 0.004) than women in countries where midwifery conventions are regulated. In addition, in states where self-contained practice is practised, women were less likely to perform caesarean section (AOR, 0.87; p – 0.016), premature birth (AOR, 0.87; p Background: Despite examinations that show that the health, cost and quality of maternity care provided by the midwife are comparable to those of patients receiving medical care , midwifery plays a more important role in some U.S. states than in some U.S. states. However, this variability is not well understood. Objectives: This study assesses the link between state practice laws related to midwifery autonomy with certified nurse and midwifery (CNM) staff, access to midwifery, and birth-related procedures and outcomes. Methods: Using multivariate regression models, we analyzed Natality Detail File birth data from 2009 to 2011. Each state was ranked on the basis of Lexis law research with respect to the autonomous practice of midwives (without control or contractual arrangement).

Copyright © 2016 Jacobs Institute of Women`s Health. Posted by Elsevier Inc. All rights reserved.