“It is estimated that if the U.S. switched to a midwife-based system for childbirth, the country would save $8.5 billion a year.” ~ Marsden Wagner, M.D.

Texas Birth Facts

  • Childbirth is the most common reason for hospitalization of women in the United States and places a significant financial burden on both private and tax-funded payers
  • Texas’ percentage of uninsured and underinsured  residents continues to rank as one of the highest in the country
  • Over half of births in Texas are paid for by Medicaid; in 2004, that accounted for 203,000 of 384,000 deliveries
  • Cesarean rates across the state continue to increase even among low-risk women, with some counties reaching 40%. This is more than double the federal health objective of <15.5% set by the CDC in Healthy People 2010.  

Midwives as Part of the Solution

  • Midwives are licensed primary providers who consistently prove their ability to achieve excellent outcomes, including lower prematurity and infant mortality rates, by providing comprehensive care without the routine use of expensive medical interventions.
  • Midwifery-led care results in higher rates of uncomplicated vaginal deliveries, breastfeeding success, and overall patient satisfaction.
  • Care with a Midwife for an out-of-hospital birth costs on average 60 – 70% less than an uncomplicated vaginal birth in the hospital.
  • Independent systematic reviews continue to lead public policy experts such as the American Public Health Association and the World Health Organization to recommend increasing access to both in- and out-of-hospital maternity care with Midwives.


Texas Health and Human Services Commission. Texas Medicaid in Perspective Sixth Edition, Jan. 2007. http://www.hhsc.state.tx.us/medicaid/reports/PB6/PinkBookTOC.html


 Johnson KC, Daviss BA. Abstract: Outcomes of planned home births with certified professional midwives: large perspective study in North America. British Medical Journal, June 2005; 330:1416-19. http://www.bmj.com/cgi/content/full/330/7505/1416


 Anderson RD, Anderson DA. The cost-effectiveness of home birth. Journal of Nurse Midwifery 1999;44:33-5.


U.S. Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health. 2nd ed. Washington, DC: U.S. Government Printing Office, November 2000. http://www.health.gov/healthypeople


Sakala C., Corry M.P. Evidence-Based Maternity Care: What It Is and What It Can Achieve. Milbank Memorial Fund, 2008. http://www.childbirthconnection.org/pdf.asp?PDFDownload=evidence-based-maternity-care