My colleagues at Emory found a way to estimate the under reporting of midwife attended deliveries. Their study, reported in the Journal of Midwifery & Women’s Health, used midwives records of births attended.1 Yes, this is burdensome record keeping for midwives, but the data suggest vital statistics under reports midwife attended deliveries in this state by 65%. Texas is not unique in this, it is too common for birth certificates to list the head of a practice or one of the physicians rather than a midwife who attended the delivery.
There are other problems with this besides not knowing the total number of deliveries attended by midwives. If the actual attendant is not listed on the birth certificate, we don’t have a complete list of who is attending deliveries. This means that while we know the number of midwives licensed, we don’t know what proportion of those midwives are attending births. This means we cannot accurately assess the adequacy of our maternal health workforce.