Rural Texan Mothers Need Midwives: A Literature Review of Midwife-led Care and Inequities of Women’s Healthcare at the State-level

Purpose: To analyze research studies comparing midwife-led care to physician-led care and to compare state-regulatory frameworks and policies for midwives and women’s healthcare. Sample: Fifteen articles published between 2017 and 2022 presenting data on births in the United States. Method: A keyword search of EBSCOhost, Google Scholar, Wiley Online Library, and PubMed databases. Papers were analyzed if published between 2016-2023, written in English, and studied U.S. populations. A quality appraisal using the John Hopkins Nursing Evidence-Based Practice tool and a synthesis approach similar to Perriman et al. (2018) were used to develop objectives for qualifying articles. Findings: Midwife-led care has lower rates of birthing interventions and increased rates of patient satisfaction than physicians. Conclusions: Midwives are a crucial resource with adequate research displaying their innate ability to care for women and infants in an empowering and respectful birthing environment. The state of Texas must act to scale-up and utilize this resource to increase access to health care and improve women’s health. Research should be continued to identify stakeholder involvement in advocacy for expanding the midwifery scope of practice and to determine reasoning for the lack of data collection and reporting mechanisms within this field. The need to draft and ratify legislation to either equally regulate midwives of all occupations or to remove collaborative/supervisory frameworks is evident.