A startup midwifery clinic in Berkeley, California, recently received $12 million in funding from venture capitalists and announced plans to open two more clinics this year. This is an incredibly positive move — but some may ask, “Aren’t the method of birth (vaginal delivery vs. Cesarean section, aka C-section, delivery) and the type of healthcare provider (midwife vs. OB/GYN) unimportant as long as the baby is born?”
Arguably, the method of birth and the type of healthcare provider who assists with it matter very much, especially to pro-lifers. Here’s why.
1. C-section rates are at an all-time high, and most first-time moms who have one go on to have another.
In 2022, according to the Centers for Disease Control and Prevention (CDC), 1 in 3 births (32.1%) were done via Cesarean section. Of note, this number is fully three times higher than the World Health Organization’s recommendation that C-sections comprise no more than 1 in 10 births.
C-sections among first-time mothers were at an all-time high that year, constituting 22.4% of all first births. As the Bump summarized succinctly, “Because 4 out of 5 women who have a first-time c-section will go on to have another, the increase in this first-time rate means c-section rates overall are likely to increase in the future.”
Certainly, vaginal birth after Cesarean (VBAC) is on the rise in the United States, but is not yet the norm. At present, many women who have one Cesarean will go on to have another, and each one is a major abdominal surgery with short and long-term risks for mother and baby.
Dr. Timothy J. Rafael, MD, commented to Romper, “A Cesarean is a major abdominal operation. Most women can have two to three C-sections uneventfully; however, even after the first C-section I’ve seen patients have complications in a second pregnancy.” OB/GYN Dr. Barbara McLaren, MD, explained to Romper that with each C-section comes additional scar tissue, and “The surgery is also technically difficult to perform the more scar tissue that is present.”
2. C-sections can become an indirect, unintended form of birth control.
C-section births, especially to first-time mothers, can de facto become an unintended form of birth control, as doctors will caution women about the risks of conceiving again after several C-sections. Dr. Rafael summed up, “The best practice is to try and avoid the first C-section.”
Another factor to consider regarding C-sections and family size is related to postpartum mood and anxiety disorders (PMADs). PMADs include postpartum depression, anxiety, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and psychosis. Many factors can contribute to the development of one or more PMADs, but a particular one is an unplanned or emergency C-section.
Postpartum anxiety and depression brought on by PTSD from an emergency C-section understandably lead many mothers to think, “Why would I ever risk going through that again?” or “I can’t do that again.”
READ: Pro-life doula creates clinic to improve birth outcomes for Black mothers
3. Midwives can drive down C-section rates.
But how do we drive down C-section rates so that that first domino to limit family size doesn’t fall? Midwives.
Midwifery care is proven to drive down C-section rates, particularly for low-risk and moderate-risk women, and to improve women’s experiences of labor and birth. This is a known fact in other countries, where integration of midwives within and outside of hospital systems is long standing practice.
Anu Sharma, founder and CEO of the Millie, the California midwifery-led maternity clinic startup that’s already fundraised $19 million total, cited the discrepancy between maternal care in the United States vs. elsewhere, saying, “When you look at Canada, the U.K., France, Germany, the Nordic countries, front-line care from the community is provided by midwives and OB-GYNs really get involved when more care is needed. We’ve sort of done it backwards here in the U.S.”
She continued, “For low- to moderate-risk pregnancies, and even for higher-risk pregnancies, a big portion of maternity care can be provided by midwives and, hands down, it creates better outcomes with lower rates of C-sections. They are the right care provider—that’s their training and they’re very skilled at promoting natural vaginal birth.”
She summed up, “[Midwives] practice medicine very differently. They’re not proceduralists, they’re basically designed to care for people going through this journey, which can require a level of clinical care, but doesn’t always require a level of medicalization that OB-GYNs bring to the problem.”
Millie’s flagship clinic, which opened in 2022, reported 30% lower C-section rates and 67% lower preterm birth rates than the national average.
4. Pregnancy is not a disease, and midwifery care recognizes this.
The implication behind dehumanizing pro-abortion terminology that calls preborn babies “parasites” and “leeches” is the idea that pregnancy is pathological. On the contrary, pregnancy is not a disease but a natural biological process (and even has some surprising health benefits for the woman) necessary for the continuation of the human race.
Undeniably, pregnancy leads to marked changes in the woman’s body, including increased blood volume, changes in her heart rate and breathing pattern, and many more. And yet, the female body was beautifully designed to accommodate these changes.
Midwifery care grasps that pregnancy is a normal and natural part of being a woman, not a disease to be feared, and supports that reality.
5. Midwifery care helps counteract the rise in maternity care deserts.
There’s another reason midwifery care should matter to every pro-lifer. Contrary to popular pro-abortion slogans, pro-lifers care about both mother and baby, and that care doesn’t end after a woman rules out abortion. The sad reality is that many women who choose to continue their pregnancies don’t have access to the prenatal care they need and deserve.
Midwives can help solve the maternity care crisis in America, which has led to the classification of 35% of American counties as maternity care deserts (an area without birthing facilities or obstetric providers), according to a 2024 March of Dimes report. In addition to an ongoing shortage of OB/GYNs, in just two years, 100 obstetrics units closed across the United States. Women in maternity care deserts receive poorer prenatal care and experience more gestational hypertension (high blood pressure during pregnancy) and preterm birth.
Overall, demand for midwifery care is high, and 2023 changes to the Centers for Medicare and Medicaid Services’ payment model prioritize increased access to doulas and midwives. This is good news — because less red tape allows for exciting opportunities to transform the maternal care landscape through midwifery care.
