Beyond the pandemic, American women face two problems that licensed midwives can help with. First, America is one of only 13 countries where the maternal mortality rate increased between 2000 and 2017, putting it in the august company of Venezuela and Syria. The risk of dying during childbirth can be exacerbated by a lack of trust between patients and health workers. In America that is especially true for black women, who die from pregnancy-related complications at more than three times the rate that white women do. Midwives cannot perform complex surgery or deliver babies for women with certain chronic health problems. But they can support low-risk women through labour. That frees doctors to do the harder stuff.
Second, because midwives’ callingcard is not intervening in labour, collaboration between midwives and obstetricians has been shown to lower the number of Caesarean sections. Nearly a third of babies born in America each year are delivered by c-section. But the WHO reckons that the necessary rate hovers between 10% and 15%. Caesarian deliveries can be life-saving for new-born babies and mothers, but they are major surgeries. They increase the risk of infection, haemorrhages and blood clots. George Washington University Hospital introduced midwifery services a decade ago, and has since seen its c-section rate drop by nearly 6%.
Will the interest in midwifery outlast the pandemic? It seems likely. The practice was growing even before the virus started to spread. And collaboration between doctors and midwives can prove effective. “Our doctors were willing to learn from our midwife colleagues,” says Dr Gaba. “If other places could do something like that, I think women would really benefit.”