Analysis of hospital policies on midwifery

Pennsylvania, Philadelphia in particular, has been noted in recent years to be experiencing a growing shortage of obstetrical health care providers. Much research and attention has been focused on Obstetricians and the issues they are facing; however, hardly any of this attention has been about midwives and the care that they offer. This study was designed and implemented by a Master's level student in conjunction with the Maternity Care Coalition, a local non-profit maternal and child healthcare organization, with a primary goal of elucidating the reasons underlying hospital utilization of Certified Nurse Midwife on Labor and Delivery floors. It is hypothesized that hospital's have a very wide range of staffing models ranging from not employing any midwives to having them attend the majority of births. In the literature, this wide range has been attributed to both financial and marketing motivations. This project will also try to understand the degree to which academic partnerships drive staffing models. Coupled with the analysis of hospital policies, reimbursement strategies and legislative guidelines and rules will also be examined to flesh out the full range of obstacles preventing an increase in the usage of midwives as birth providers in Philadelphia. Given the questionable future of maternity services in the area, this study was determined to be of utmost significance for maternal and child healthcare organizations in the area, especially those that advocate for the poor and uninsured.