By: Dr. Susan Stone, Frontier Nursing University President
Frontier Nursing University, a leading educator in graduate nursing and midwifery, strives to bring greater awareness to the important role of nurse-midwives and provide resources for others who may be thinking about a career in nurse-midwifery. We advocate for integrating midwifery into the health care system to improve access to care, as nurse-midwives play an integral role in maternity and primary care for women and families.
Maternal Crisis in the U.S.
The United States has experienced increasing maternal mortality rates over the last 25 years. In fact, each year about 700 women die of pregnancy-related causes and more than 50,000 suffer severe complications but do survive.
When we compare the U.S. to other industrialized nations, their maternal mortality rates are decreasing, while the U.S. rate continues to rise.
Racial disparities are evident; the risk of pregnancy related deaths for black women is three to four times higher that those of white women.
Maternal Mortality Preventable Causes
More evidence is needed to understand the actual causes of these deaths; research suggests that more than half of these deaths are preventable. There are some identified factors that contribute to the problem. We know that in the U.S., excellent care is available for some populations, but not all. We have a shortage of providers and facilities, as well as financial, bureaucratic and transportation issues. Language barriers and a lack of consistent, culturally-appropriate care is a contributing factor.
Medical issues such as cardiovascular conditions, pregnancy-related hypertensive disorders, hemorrhage and hypertension are among the highest risk factors for poor birth outcomes.
Nearly half of women are obese prior to becoming pregnant, and half of women gain more than the recommended amount of weight during pregnancy. One in five women smokes within three months of getting pregnant, while one in ten women smokes during the last three months of their pregnancy. About one in nine women has symptoms of major depression or other mental health disorders.
Each of these health factors contributes to the high rate of maternal complications we are seeing in the U.S. Many states, including Kentucky, either have or are creating maternal mortality review committees to analyze every death so that we can better understand the causes and contributing factors. This will allow the creation of programs designed to address the specific problems.
With a rising number of births expected in our country, the shortage of maternity workforce is concerning. Forty percent of U.S. counties do not have a midwife or obstetrician. The problem is exacerbated among rural populations, as we are seeing more hospital closures or the discontinuation of maternity care at hospitals that do remain open.
The Need for a Diversified Maternity Workforce
With the above statistics in mind, it is more important than ever to develop and begin working toward attainable solutions.
Midwifery care has been proven to contribute to improved health outcomes for mothers during pregnancy, birth and postpartum. A diverse, culturally-sensitive, respectful midwifery workforce will increase access to quality care and improve maternal health outcomes around the U.S.
Frontier Nursing University is working to increase the number of certified nurse-midwives who can provide quality maternity care in rural and underserved areas. What’s more, Frontier also aims to increase the racial and cultural diversity among those care providers in order to offer women and families care that makes them the most comfortable and therefore more likely to access services.
Our distance education model offers community-based education for nurse-midwives where they live and work. The American Midwifery Certification Board reported 11,850 certified nurse-midwives in the U.S in 2017.
Despite a growing number of midwives, many rural areas still have women left unserved or underserved. Around 40 percent of counties in the U.S. do not have a practicing midwife or obstetrician. In 2015, the American College of Nurse-Midwives reported 121 practicing nurse-midwives in the state of Kentucky. These midwives only attended 5.95 percent of all births in the state of Kentucky (source).
Because the number of births per year is growing (projected to be more than 4.4 million by 2050), we need to dramatically increase the number of nurse-midwives providing care in the U.S. in order to meet the health care needs of women and families.
As an educational institution with a strong community of educators and graduates who are nursing and midwifery care providers, Frontier focuses strongly on primary and preventative care and collaborative health care environments. We strive to develop graduate nursing and midwifery education programs to address the factors that lead to maternal mortality and poor health outcomes. Finally, we must diversify the health provider workforce so that patients are more likely and willing to participate in care.
We invite you to learn more about nurse-midwifery led care at Frontier.edu/midwiferyweek.
Dr. Susan Stone
President, Frontier Nursing University
View Dr. Stone’s presentation on building a diverse maternity workforce here or watch below:
Frontier Nursing University is the birthplace of nurse-midwifery and family nursing in America. FNU recently held its fourth annual virtual event in recognition of National Midwifery Week, Sept. 30-Oct. 6.
Carrie Belin is an experienced board-certified Family Nurse Practitioner and a graduate of the Johns Hopkins DNP program, Johns Hopkins Bloomberg School of Public Health, Georgetown University School of Nursing, and Johns Hopkins School of Nursing. She has also completed fellowships at Georgetown and the University of California Irvine.
Angie has been a full-scope midwife since 2009. She has experience in various birth settings including home, hospital, and birth centers. She is committed to integrating the midwifery model of care in the US. She completed her master’s degree in nurse-midwifery at Frontier Nursing University (FNU) and her Doctorate at Johns Hopkins University. She currently serves as the midwifery clinical faculty at FNU. Angie is motivated by the desire to improve the quality of healthcare and has led quality improvement projects on skin-to-skin implementation, labor induction, and improving transfer of care practices between hospital and community midwives. In 2017, she created a short film on skin-to-skin called 
Justin C. Daily, BSN, RN, has ten years of experience in nursing. At the start of his nursing career, Justin worked as a floor nurse on the oncology floor at St. Francis. He then spent two years as the Director of Nursing in a small rural Kansas hospital before returning to St. Francis and the oncology unit. He has been in his current position as the Chemo Nurse Educator for the past four years. He earned an Associate in Nurse from Hutchinson Community College and a Bachelor of Science in Nursing from Bethel College.
Brandy Jackson serves as the Director of Undergraduate Nursing Programs and Assistant Educator at Wichita State University and Co-Director of Access in Nursing. Brandy is a seasoned educator with over 15 years of experience. Before entering academia, Brandy served in Hospital-based leadership and Critical Care Staff nurse roles. Brandy is passionate about equity in nursing education with a focus on individuals with disabilities. Her current research interests include accommodations of nursing students with disabilities in clinical learning environments and breaking down barriers for historically unrepresented individuals to enter the nursing profession. Brandy is also actively engaged in Interprofessional Education development, creating IPE opportunities for faculty and students at Wichita State. Brandy is an active member of Wichita Women for Good and Soroptimist, with the goal to empower women and girls. Brandy is a TeamSTEPPS master trainer. She received the DASIY Award for Extraordinary Nursing Faculty in 2019 at Wichita State University. 
Dr. Sabrina Ali Jamal-Eddine is an Arab-disabled queer woman of color with a PhD in Nursing and an interdisciplinary certificate in Disability Ethics from the University of Illinois Chicago (UIC). Dr. Jamal-Eddine’s doctoral research explored spoken word poetry as a form of critical narrative pedagogy to educate nursing students about disability, ableism, and disability justice. Dr. Jamal-Eddine now serves as a Postdoctoral Research Associate in UIC’s Department of Disability and Human Development and serves on the Board of Directors of the National Organization of Nurses with Disabilities (NOND). During her doctoral program, Sabrina served as a Summer Fellow at a residential National Endowment of the Humanities (NEH) Summer Institute at Arizona State University (2023), a summer fellow at Andrew W. Mellon’s National Humanities Without Walls program at University of Michigan (2022), a Summer Research Fellow at UC Berkeley’s Othering & Belonging Institute (2021), and an Illinois Leadership Education in Neurodevelopmental and related Disabilities (LEND) trainee (2019-2020).
Vanessa Cameron works for Vanderbilt University Medical Center in Nursing Education & Professional Development. She is also attending George Washington University and progressing towards a PhD in Nursing with an emphasis on ableism in nursing. After becoming disabled in April 2021, Vanessa’s worldview and perspective changed, and a recognition of the ableism present within healthcare and within the culture of nursing was apparent. She has been working since that time to provide educational foundations for nurses about disability and ableism, provide support for fellow disabled nursing colleagues, and advocate for the disabled community within healthcare settings to reduce disparities.
Dr. Lucinda Canty is a certified nurse-midwife, Associate Professor of Nursing, and Director of the Seedworks Health Equity in Nursing Program at the University of Massachusetts Amherst. She earned a bachelor’s degree in nursing from Columbia University, a master’s degree from Yale University, specializing in nurse-midwifery, and a PhD from the University of Connecticut. Dr. Canty has provided reproductive health care for over 29 years. Her research interests include the prevention of maternal mortality and severe maternal morbidity, reducing racial and ethnic health disparities in reproductive health, promoting diversity in nursing, and eliminating racism in nursing and midwifery.
Dr. Lisa Meeks is a distinguished scholar and leader whose unwavering commitment to inclusivity and excellence has significantly influenced the landscape of health professions education and accessibility. She is the founder and executive director of the DocsWithDisabilities Initiative and holds appointments as an Associate Professor in the Departments of Learning Health Sciences and Family Medicine at the University of Michigan.
Dr. Nikia Grayson, DNP, MSN, MPH, MA, CNM, FNP-C, FACNM (she/her) is a trailblazing force in reproductive justice, blending her expertise as a public health activist, anthropologist, and family nurse-midwife to champion the rights and health of underserved communities. Graduating with distinction from Howard University, Nikia holds a bachelor’s degree in communications and a master’s degree in public health. Her academic journey also led her to the University of Memphis, where she earned a master’s in medical anthropology, and the University of Tennessee, where she achieved both a master’s in nursing and a doctorate in nursing practice. Complementing her extensive education, she completed a post-master’s certificate in midwifery at Frontier Nursing University.
Dr. Tia Brown McNair is the Vice President in the Office of Diversity, Equity, and Student Success and Executive Director for the Truth, Racial Healing, and Transformation (TRHT) Campus Centers at the American Association of Colleges and Universities (AAC&U) in Washington, DC. She oversees both funded projects and AAC&U’s continuing programs on equity, inclusive excellence, high-impact practices, and student success. McNair directs AAC&U’s Summer Institutes on High-Impact Practices and Student Success, and TRHT Campus Centers and serves as the project director for several AAC&U initiatives, including the development of a TRHT-focused campus climate toolkit. She is the lead author of From Equity Talk to Equity Walk: Expanding Practitioner Knowledge for Racial Justice in Higher Education (January 2020) and Becoming a Student-Ready College: A New Culture of Leadership for Student Success (July 2016 and August 2022 Second edition).