UAMS launches Arkansas' first nurse-midwifery program

• Midwifery is also associated with improved outcomes, like lower cesarean section and preterm birth rates, Samantha Crouch, director of the new UAMS program, told Axios.

Context: Midwifery is holistic and emphasizes birth as a normal process, promoting low-intervention techniques unless interventions like inducing labor or performing a caesarean section become medically necessary.

• Certified nurse midwives can give prenatal and postpartum care for patients and care for their newborn babies for up to 28 days. They can offer some primary care and gynecology services.

What they're saying: "Arkansas is in such a critical state that the dialogue has shifted dramatically, and hospitals are actively seeking midwives, and (obstetrics) physicians are seeing the value in having midwives because it simply can't be done the way we've been doing it for the decades past," Crouch said.

• Recruiting midwives from out of state is difficult, and having an in-state program will likely keep people pursuing midwifery practicing in Arkansas, she said.

How it works: The UAMS program will offer a master's degree that can be obtained in two and a half years to students who are already registered nurses, which is notably faster and cheaper than training doctors.

• The midwives will be trained to identify when a patient needs a higher level of care and can work in teams with ob-gyns and maternal-fetal medicine specialists at hospitals.
• Midwives can safely care for most low- to moderate-risk patients, alleviating doctors' patient load, and can still offer holistic care to patients who want some medical intervention, like an epidural, Crouch said.

Zoom out: The World Health Organization in 2025 called for a global expansion of midwifery care, saying, "While medical interventions such as caesarean sections, inductions, and use of forceps are essential and life-saving when clinically indicated, their routine or excessive use creates short and long-term health risks."

• Experts seeking to improve maternal health in Arkansas have discussed midwifery as a cost-effective way to expand care in the mostly rural state.

By the numbers: About 1.3% of deliveries in 2022 in Arkansas were performed by midwives or health care professionals other than a doctor, according to the Arkansas Center for Health Improvement. The stat includes licensed lay midwives, who differ from certified nurse midwives.

Flashback: Midwifery was the norm until the 20th century, and some of the move away from the practice had to do with white male doctors pursuing childbirth as a profession. Midwifery was largely performed by Black women, in addition to white and Indigenous women, according to Oregon Health and Science University.

• Many doctors launched campaigns against midwifery, and attended about half of births by 1900, despite having little training in obstetrics.
• "… skilled Black midwives represented both real competition for white men who sought to enter the practice of child delivery, and a threat to how obstetricians viewed themselves," according to the ACLU.

What's next: The program starts in the fall with five students and will add five more in the spring. After that, about five to six new students will be added per year. While headquartered in Little Rock, much of the schooling is remote and open to students across the state.

• UAMS is discussing how midwifery services could be added to the state-run county health units, which exist in all counties, Crouch said.