Rachel Buchman's Feb. 5 article, "A push to stop midwives," reviewed the benefits of, and concerns about, lay midwives. A crucial issue remains unacknowledged: Provider shortages are one of the critical barriers to accessing health care in Pennsylvania. A positive step is the governor's "Prescription for Pennsylvania" proposal, which would extend prescriptive authority to nurse practitioners.

The Maternity Care Coalition's research report, "Childbirth at a Crossroads," underscores the dearth of timely, quality, low-cost maternity care in Southeastern Pennsylvania. The number of graduating medical students in the United States who are choosing obstetrics and gynecology as a specialty has dropped by almost 50 percent since 1980. There are 118 practicing certified nurse midwives in the five-county area, and only 4.5 percent of local births are attended by midwives, compared to 9 percent nationally. It is clear that we are in desperate need of more childbirth practitioners.

Licensing, certification or registration for direct-entry midwifery is available in 23 states, including New Jersey. Pennsylvania should explore these options, seeking ways to incorporate the experience and commitment of trained midwives.

JoAnne Fischer

Executive Director
Maternity Care Coalition
Philadelphia

Learn about the childbirth crisis through our Maternity Care in Southeastern PA pages, or visit our Maternity Services Advocacy pages to find out how communities are advocating and how you can take action!

MCC's full Childbirth at a Crossroads report can be viewed here.