FAQ

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What does the DOR do?

The Midwives Alliance Division of Research enables high-impact research and offers credible resources that can be used to evaluate and improve the care that midwives provide. The Division’s MANA Statistics Project facilitates relevant research by collecting data on maternal and infant health outcomes in midwife-assisted births, and provides midwives who contribute data with their own practice statistics. The DOR works to increase knowledge about midwifery research and helps midwives become more fluent in conducting research, evaluating studies, and incorporating research findings into their practice.

Doesn’t the Division of Research conduct research?

Our primary mission is to collect high-quality data for other researchers to use. We collect the data so qualified researchers, inside and outside the Midwives Alliance, can access it to conduct studies. The credibility of research done on our data will be improved if independent researchers from multiple backgrounds and affiliations conduct and publish studies. We welcome researchers to apply for access to the MANA Stats data!

The DOR is working towards being able to report some general statistics from the MANA Stats database on an annual basis, similar to the birth statistics that the National Center for Health Statistics releases every year (like the number of babies born at home or in birth centers, preterm birth rates, low birth weight, cesarean rates, etc.). This is not research, but rather what's called "benchmarking statistics." Midwives can then compare their own practice statistics with what's in the whole dataset and be able to see where they line up.

It seems to take a long time to publish any research using this data. Why?

There are many elements involved in getting research from the idea stage to a published paper. Before MANA Stats data can be used for research, the DOR must have “closed” the relevant portion of the dataset, which means that for the time period in question the midwives have caught up with entering all of their births, and the Data Review Team has completed all of the reviews so that the data is as error-free as possible. Because midwives are extremely busy people and the DOR is a volunteer organization, this process probably takes longer than it would if this were everyone’s only job.

On the researcher side of things, when someone has an idea for a research project that involves human subjects (as our database does), one of the first steps is to present the idea to an Institutional Review Board for approval. This can be a very lengthy and detailed process in itself. The researcher also goes through many steps to get the data they need, fix the errors in the data (although we do most of this for the researchers who use MANA Stats data), analyze it, write it up into a paper, have the paper reviewed (perhaps several times) and make revisions, then begin the process of submitting it to journals for publication. It is not uncommon for this whole process to take a number of years from start to finish, depending upon how motivated and/or busy the researcher is with other things.

Where do I find information on the safety of homebirth?

Many peer-reviewed research studies from around the world have confirmed the safety of home birth for women with uncomplicated pregnancies. This body of research includes a landmark study published in the British Medical Journal that followed over 5400 women in the U.S. and Canada who planned to give birth at home with a Certified Professional Midwife (Johnson & Daviss, 2005). The study found much lower rates of interventions such as induction and augmentation of labor, episiotomy and cesarean delivery with no greater risk to mother or baby.

The Senior Advisor for the DOR, Saraswathi Vedam, has co-authored an incredible annotated bibliography of the existing research on homebirth, available on the "Homebirth Studies" section of our Research Resources page. Each study is described in a short paragraph and categorized according to its quality. Additional resources for understanding research are also available there.

Can I see the MANA Stats data?

The MANA Stats database is proprietary and is owned by the Midwives Alliance of North America, who is responsible for the reliability, integrity, privacy and security of the data contained within it. This database contains information about women, newborns, pregnancy and birth experiences, their health care, and practices of the midwife contributors. It is made available through a written informed consent process with each client and includes a process of enrollment, data collection and data entry by midwives.

Researchers with a study proposal are welcome to apply for access to the data; please click here for the application materials. Midwives can see their own practice data at any time from inside their MANA Stats account. State midwifery organizations that have an account can see overall data for all of their members together, but not data for each individual midwife in the organization.

I want to do some research on X. How can I get access to the MANA Stats data?

We can help! Click here for the Handbook for Researchers and application materials. We look forward to your application!

I’d like to do a special project on X, but there are no questions about X on the current data form. How can I get my questions added to the form?

Great question, and one that excites us! The DOR can help researchers to put together special modules for prospective data collection using the MANA Stats system. Contact us if you have a prospective study proposal!

Do I need to have a CPM or other credential to contribute data to MANA Stats?

No, you do not. The MANA Statistics Project is open to midwives of all types, practicing in all settings (though we primarily collect data on home and birth center births). MANA asks that you tell us when you enroll which credentials and licensure you currently have (if any), and that you update this information if it changes. Credentials are validated with credentialing organizations to prepare the data for research.

Can student midwives enroll as contributors to MANA Stats?

Yes, we encourage all student midwives/apprentices to enroll in the Statistics Project if possible. The student/apprentice can be listed as the second or third midwife on the birth form, if appropriate (that’s up to the preceptor). This way new midwives can track the outcomes and numbers of births they have been involved in from the beginning of their careers!

Why is the data form so long?

The Midwives Model of Care(TM) is unique in the way that maternity care is delivered, from the first prenatal visit to the last postpartum contact. The MANA Stats database is the only database that collects information on the distinctive ways in which North American midwives provide care. The Full dataform is very comprehensive in order to capture the unique aspects of midwifery care that result in better outcomes for mothers and babies. Balanced with this desire to collect deep practice data however, is the need to make participation possible for a broad, and therefore representative, number of North American midwives. Therefore, in 2011, the DOR launched a much shorter Minimal data form, which we expect will allow many more midwives to integrate MANA Stats participation into their practice over the long term.

What’s in it for me as a midwife?

Besides contributing to research on midwifery outcomes and the midwifery model of care, midwives reap two main benefits from contributing their data:

Information about your practice’s outcomes, volume, and demographics is available to you via the MANA Stats statistics reports in your website account. You can use this to market your services, explain your practice to related health professionals, and answer questions from potential clients, as well as improve your practice through review of your statistics and comparison to national, regional, and local statistics.
Certified Professional Midwives can earn CEUs towards recertification by contributing to MANA Stats. See NARM’s CPM recertification bulletin (PDF) for details.

What if I don’t include all this information in my charting?

The Minimal form is designed to ask only information you would likely be charting already. We do have some charting aids that may be helpful to you, which you will find on the manastats.org web site (sign in to your MANA Stats account and click on "Stats Project help and instructions" in the box at the lower right of your screen). The more data that midwives contribute to the database, the stronger it will be for research, so we want to make this as easy for midwives as possible!

I really believe in the MANA Stats project, but I don’t have time to keep up. What can I do?

Integrate your data entry into your workflow throughout your prenatal care, as soon as possible after each birth, and at the close of your postpartum care so that it’s not such a big job at the end
Streamline your data collection, modernize your charting
Enlist a student, office manager, volunteer
Use the Minimal form
Remember that contributing birth data earns you CEUs toward CPM recertification