The U.S. is in the midst of a severe shortage of prenatal and maternal health-care personnel for women, a new report showed Monday — adding fuel to a movement by several states and possibly Congress to address the crisis.
According to the report by Stateline, U.S. population growth is vastly outpacing the rate of obstetrician/gynecology students entering the field, and an accompanying shortage of nurse midwives means many women are hours away from their nearest doctor or clinic.
The report points out that, according to the American College of Nurse Midwives, nearly half of U.S. counties don’t have an OB/GYN available, and 56 percent don’t have a nurse midwife.
“It has reached the level of being a crisis,” Terry O’Neill, president of the National Organization for Women, told AMI Newswire.
O’Neill said the problem isn’t sudden, but is suddenly obvious. She said U.S. rates of infant mortality have been spiking in recent years as well — worsened, she said, by some physicians’ refusal to accept Medicare or Medicaid, and by the funding battles over women’s health on Capitol Hill.
“I don’t think this is something that just happened overnight,” she said. “I had been vaguely aware of it because you hear things, but until now you don’t realize it’s a crisis ... When the federal government turns the spigot off, and the state does as well, then how are OB/GYNs supposed to behave?”
Even worse, the problem is expected to worsen before it improves, because researchers at women’s health organizations say the pace of expected births in the U.S. is only projected to climb. The American Congress of Obstetricians and Gynecologists (ACOG) estimates that the nationwide shortage of OB/GYN doctors could be as high as 8,800 by 2020. There are currently about 20,000 in the U.S., according to the federal Bureau of Labor Statistics.
ACOG has proposed legislation in Congress that would offer financial incentives to medical school graduates who enter the OB/GYN field. The Improving Access to Maternity Care Act would also designate certain under-served parts of the U.S. as “maternity care shortage areas” under the Public Health Service Act.
Once the federal Department of Health and Human Services does so, National Health Service Corps (NHSC) medical providers would be allowed to serve in medical facilities in such areas.
ACOG's then-President John Jennings said in a statement accompanying the legislation that access to quality maternal care is critical for new mothers.
“Unfortunately, in under-served parts of our country, expecting women face shortages of qualified maternity care providers, including obstetrician-gynecologists,” he said. “This can compromise prenatal and perinatal care that pregnant women receive, leading to poor outcomes for both mother and baby.”
However, the ACOG measure is competing with a raft of others this fall, and Congress is only expected to be in Washington for a few weeks next month before adjourning for the November election.
Without federal help, states are already trying out go-it-alone strategies, such as encouraging more maternal health specialists to set up shop in more rural areas where access is currently poor.
State laws that restrict the practice of nurse midwives are also being looked at. In North Carolina and California, for example, state lawmakers are reconsidering mandates that midwives must be supervised by physicians.
Loosening such restrictions has worked before — the population of nurse midwives has grown by 30 percent since 2012 after several states relaxed their approaches, although the number remains comparatively low at 11,200 nationwide.