Maternal and Child Health Trends

While the United States has the highest per capita spending on health care in the world, this has not led to optimal outcomes. The maternity care sector, in particular, has many trends that are heading in the wrong direction.

  • U.S. infant mortality rate is worse than over thirty other industrial nations
  • U.S. maternal mortality rate has not improved since 1982 and is steadily creeping upward
  • Rates of premature and low birth weight infants are exceedingly high
  • Declining rates of normal physiologic childbirth are alarmingly common
  • Cesarean section is the number one surgery performed in the United States, 1 in every 3 pregnant women will undergo surgical birth 
  • Health status and perinatal outcomes for women and infants of color are far worse than for their White counterparts
  • Hospital costs are without a doubt the largest sector of health care costs
  • Hospital costs for mother-baby care are considerable and are the highest of all hospital “profit centers”

Midwives As a Key Solution to Alarming Trends

The evidence is mounting that because midwives focus on normal physiologic childbirth and safe, personalized, cost-effective care, they offer a key solution to what ails our broken maternity care system.

Opportunities to support and promote maternal and child health care policies that:

  • Position exemplary maternity care models squarely within the U.S. health care system
  • Showcase evidenced-based choices in childbirth
  • Affect better outcomes for mothers and babies
  • Address disparities in health care status
  • Create greater access to midwives so they can play an integral part in a diverse, high quality, multidisciplinary maternity care workforce.

MANA and our partners are influencing and shaping maternal and child health policy by:

  • Working with congressional offices to ensure that midwives figure prominently in new legislation for maternal and child health care
  • Collaborating with other professional organization in global and national alliances
  • Organizing grassroots support for legislation that includes midwives, citizens and other health care professionals 

The Advocacy section of this website will introcuce you to MANA's social justice, legislative, and midwifery platform and projects; and provide inspiration and practical tools necessary to achieve policy goals in reforming the maternity care system in the United States. Contact us at if you would like to be part of the solutions!

Division of Access & Equity

 "Access" and "equity" are both words that capture the essence of this work: access = the right or opportunity to use or benefit from something; equity = the quality of being fair and impartial. As a midwife, you know that the right or opportunity to use or benefit from midwifery has not been fair or impartial. This is true for many, layered reasons

Social Justice

Why do more women and infants of color in the U.S. die than their white counterparts? Six different midwives address the critical issue of health disparities in the US and describe how midwifery care improves birth outcomes for women and babies in vulnerable communities by providing safe, supportive and culturally sensitive care.

Health Policy

MANA seeks to raise awareness and improve the quality, safety, equity, effectiveness and outcomes of maternal and child health care through the promotion of the Midwives Model of Care. Therefore, the Midwives Alliance devotes considerable resources to advocacy and activism to achieve these goals.

Tools for Advocacy

Key fact sheets, policy statements, and documents that advocates find useful in promoting and talking about midwifery.