The American Congress of Obstetricians and Gynecologists (ACOG) workforce analysis of 2017 projects a shortfall of more than 20,000 qualified maternity care providers by the year 2050. The contributing factors to this shortfall include an increase in the female population and changes in the characteristics of the workforce. Currently, half of U.S. counties have no maternity care providers and this situation will worsen as OB/GYN physician workforce shortages increase in the next decade.

Both ACOG and the American College of Nurse-Midwives (ACNM) believe that a change in the U.S. maternity care system to a team-based model of care will both improve outcomes and address the current and anticipated workforce shortage issues for women’s health services. Research has shown that midwife-led models of maternity care result in fewer preterm births, decreased fetal and neonatal deaths, and fewer intrapartum interventions, reducing cost and increasing patient satisfaction. Midwifery can be a valuable addition to address the workforce issues of our country in the coming decades. However, there are only 39 midwifery education programs accredited by the American Commission of Midwifery Education In the U.S.

Current models of women’s healthcare services are moving toward interdisciplinary practice. The professions of midwifery and obstetrics should be viewed as complementing rather than competing with one another. System redesign must be accompanied by educational reform so that learners are working together in new education models. Educating midwives and physicians together enhances understanding of collaborative practice and improves appreciation of the complementary nature of the two professions: midwifery contributes expertise in physiologic birth, and obstetricians provide expertise in the management of pathology. A midwifery education program within an academic medical center brings learners together in the same institution at the same time, providing robust inter-professional learning opportunities.

Most current models of midwifery education provide education in a university setting while clinical education is provided by midwives in clinical practice. Medical residency programs do not do this: the education, clinical and didactic, is provided by faculty in an academic medical center. This model works for midwifery education as well and has been a successful model at Baystate Medical Center Midwifery Education Program since 1990. Providing midwifery education has increased the profile and visibility of the institution, and promoted interdisciplinary education and teamwork. Our Program has been highlighted in numerous publications as well as at national meetings of ACNM and ACOG. 

At Baystate Medical Center in Springfield, MA, a midwifery education program has existed within an academic medical center since 1990. This model of midwifery education has numerous benefits for an institution. Adding the faculty responsibilities beyond clinical practice expands the midwifery role increasing job satisfaction and retention of midwifery staff. At Baystate Medical Center, 70% of the midwives have remained in their positions for more than 15 years, and many of our graduates are eager to practice here, reducing recruitment costs considerably. Providing a constant flow of new midwives has also helped the area’s workforce issues. The Baystate Medical Center Midwifery Education Program has supplied 25% of the Certified Nurse-Midwives (CNM) currently working in Western Massachusetts.

A midwifery education program within an academic medical center can be self-supporting through a combination of tuition and Medicare allied health education funding, similar to graduate medical education funding for residency programs. These monies cover part of the additional staff required for program administration and midwifery faculty. The remaining funding is available from Medicare funding for Allied Health Education with an academic medical center, similar to graduate medical education funding for residency programs.