Report: barriers affecting alternative birthing providers
A growing shortage of maternity care in the United States—driven in part by the closure of more than 500 hospital obstetric units since 2010—has reduced access to prenatal and delivery services, particularly in rural areas, increasing travel distances and risks for expectant mothers. As demand shifts toward alternative providers such as midwives and freestanding birth centers, state regulatory frameworks are identified as a significant constraint on expanding access, including scope-of-practice restrictions, physician supervision requirements, and inconsistent licensure pathways that limit the ability of certified nurse-midwives and certified professional midwives to practice. Additional barriers, such as certificate-of-need laws, further restrict the establishment of new birthing facilities, even as these models gain popularity and may offer lower-cost, lower-intervention care for low-risk pregnancies. The analysis frames these regulatory limitations as contributing to “maternity care deserts” and suggests that addressing workforce and access challenges will require reconsideration of existing licensure, supervision, and facility approval policies that may inhibit the availability of qualified providers and alternative care settings.