Midwifery linked to lower odds of birth complications for low-income women

Research from UBC and the University of Saskatchewan adds to the evidence in support of midwives as a safe option for prenatal care, especially for women who have low socioeconomic status.

The study, “Reduced prevalence of small-for-gestational-age and preterm birth for women of low socioeconomic position: A population-based cohort study comparing antenatal midwifery and physician models of care,” published in the British Medical Journal Open, found that low-income pregnant women who receive care from a midwife compared to a physician are less likely to go into early labor, to have a baby with a low birth weight, or to have a small-for-gestational age birth.

Midwives, general practitioners, and obstetricians each offer a different style of prenatal care that matches different women’s preferences and needs. Midwives tend to spend more time with their patients with a focus on the overall physical, emotional, and psychological well-being of mothers and their newborns, which benefits women who are more vulnerable.

For the study, researchers followed 57 872 women in BC who carried a single baby, had low- to moderate-risk pregnancies, and received medical insurance premium assistance sometime between 2005 and 2012. They used maternity, medical billing, and demographic data to investigate the odds of small-for-gestational age birth, preterm birth, and low birth weight for low-income women receiving care from a midwife, GP, or OB.

After controlling for differences such as age, previous pregnancies, where they lived, and pre-existing medical conditions, researchers found that low-income women who received prenatal care from a midwife had 29% lower odds of a small-for-gestational age birth compared to women who received care from a GP, and a 41% reduction compared to those who received care from an OB.

Authors of the study suggest the findings could help develop policies that make the service more accessible to low-income women, who might not be as aware of this option.

The study was coauthored by Daphne N. McRae, Patricia Janssen, Saraswathi Vedam, and Maureen Mayhew at the University of British Columbia, and Deborah Mpofu, Ulrich Teucher, and Nazeem Muhajarine at the University of Saskatchewan. It is available at https://bmjopen.bmj.com/content/8/10/e022220.