Hospital closures and other changes to health care in rural communities mean that families no longer have access to the same maternity care as they once did. Community midwives could help to fill this gap by helping some women through a home birth, but there are concerns about the extra time it would take to get to a hospital in an emergency.

Elizabeth Nethery, a PhD student in the school of population and public health, tackled this dilemma by comparing the outcomes for rural women who have babies at home to those in other, more populated, parts of the U.S. Her study was recently published in the journal Birth. The article is titled, "Rural community birth: Maternal and neonatal outcomes for planned community births among rural women in the United States, 2004-2009."

The findings suggest that rural midwives may be screening clients and referring those who could need more advanced medical care to the hospital based on their access to emergency care.

Midwives serving low-risk women are helping to fill an important gap in the rural health-care system. Increasing access to midwives and home birth could play an important role in expanding much-needed rural maternal health care. The issue of access is not limited to the U.S.; it is also an issue for rural and remote communities in Canada. It becomes difficult to maintain services in small communities when there just isn’t the volume of people to maintain those services.

The role of the community midwife is not just limited to those who plan a home birth. For women who plan a hospital delivery, midwives can deliver prenatal and postpartum care so they don’t need to do as much travelling.