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Access to Maternity Providers: Midwives and Birth Centers

Medicaid finances a significant portion of births, particularly for women who are more likely to have disparities in maternal health outcomes. This issue brief highlights evidence that midwives and the midwifery-led model of care provided in birth centers can improve maternal and child health outcomes at a lower overall cost to Medicaid. Certified nurse-midwife services and coverage for care at licensed birth centers are mandatory Medicaid benefits under federal law.

However, there are barriers to expanding access. These include variation in payment policies, challenges contracting with managed care organizations, requirements related to licensure, certification, and accreditation, scope of practice for midwives, and the limited supply of these providers, especially in rural and traditionally marginalized communities.