In California, the state with the highest rate of women dying of pregnancy-related causes, there’s an unmet need for midwives, according to a new study published online by the American College of Obstetricians and Gynecologists.
“The midwife Orange and the midwife Central counties are the only two counties in the state where we see more than one midwife per 1,000 women,” says Dr. Stephanie P. Brown, who led the study with Dr. Susan L. Miller, an associate professor of obstetrics and gynecology at the University of California, San Francisco.
“We found that, overall, there is not much difference in the numbers of midwives per 1.4 million women in the two counties.”
The study also found that midwives in Orange County, California, had the highest survival rates for women with preterm births, which means they were born with a high birth weight.
The study, published online March 12 in the journal Obstetrics & Gynecology, found that women in Orange county, California had an average of 1.1 midwives for every 1,500 women in that county, the highest of any county in the nation.
“Women in Orange are being treated better than women anywhere else,” said Brown, whose findings were based on the data collected in 2015.
“They are more likely to be seen by a midwife, they have better access to midwifery, and they have fewer complications.”
Women’s health is a top priority for California lawmakers and the governor.
State lawmakers have been discussing a bill that would allow physicians to recommend women with a preterm birth to have an abortion, but that legislation has yet to be introduced.
In the meantime, there are efforts to improve the state’s midwife supply.
“California is one of the top midwives states in the United States,” said Dr. Mary Jane O’Connell, an obstetrician-gynecologist and an associate medical director at Planned Parenthood of Southern California.
“This is one area where we have really made progress.”
Brown, Miller and Lottie Loeffler, an assistant professor of public health at the Women’s Health Initiative, a nonprofit that advocates for women’s reproductive rights, say the results of their study suggest that California needs to get more women in midwome.
“If we want to keep our state among the top five states for women who are preterm, we need to get to at least two or three,” Miller said.
“Our goal is to get there.”
Pregnant women should avoid travel, including during peak travel periods, and get medical advice from a midwomens’ doctor, according the American Association of Midwives.
Women should get a birth control implant if they have a high risk of miscarriage, according a 2011 study by the U.S. Centers for Disease Control and Prevention.
The American College for Obstetrician and Gyntists also recommends that pregnant women who choose to stay at home, even for short periods of time, stay away from other women who may be at risk of preterm delivery.
Women who have a history of pre-eclampsia or high blood pressure should also avoid alcohol and tobacco.
“There’s no excuse for a woman to drive in the middle of the night, in the heat, and on the highways,” Miller says.
“That’s just not good for her health.”