OB/GYNs and midwives, working as one team, measurably improve maternal care.
As OB/GYN shortages, burnout and rural maternity care deserts continue across the United States, certified nurse midwives (CNMs) are proving to be a critical part of the solution, not just filling staffing gaps, but improving outcomes.
Maternal care access is under pressure nationwide
OB/GYN shortage
Workforce projections point to a widening gap between OB/GYN supply and patient demand, driven by an aging physician workforce and limited residency capacity.
Clinician burnout
Unpredictable call schedules and acute, high-stakes coverage demands are contributing to attrition among practicing OB/GYNs.
Rural maternity deserts
Hospitals in low-volume and rural markets are closing labor and delivery units, leaving communities with fewer options for maternity care.
CNM-integrated sites outperformed non-CNM sites on 5 of 6 quality metrics
A quality performance analysis across 265 OBHG hospital partner sites compared 57 CNM-integrated sites with non-CNM sites, using data collected from August 2025 through July 2026.
Episiotomy rates differed significantly between CNM sites and non-CNM sites. The rate of 3rd/4th-degree lacerations with instrument-assisted delivery was higher at CNM sites, but still below target and below the national average. Together, the results point to the value of collaborative care between OB/GYNs and CNMs in improving patient safety and reducing unnecessary interventions.
Midwives don't replace OB/GYNs. They complement them.
Midwives are experts in normal, healthy pregnancy and labor and delivery. OB/GYNs bring critical medical and surgical expertise for high-risk and acute cases. Together, the two roles form a complete model of maternity care.
| Care area | Certified Nurse Midwife (CNM) | OB/GYN |
|---|---|---|
| Focus | Physiologic, low-risk pregnancy and birth | High-risk, surgical and acute obstetric care |
| Approach | Education, support and non-intervention when appropriate | Medical and surgical management of complications |
| Where they add value | Reducing unnecessary interventions in uncomplicated deliveries | Managing emergencies and complex cases requiring surgical expertise |
| Role on the care team | Collaborative partner, working alongside OB/GYNs and nursing staff | Available for escalation, consultation and surgical intervention |
More on OB/GYN-CNM collaboration from OBHG
How CNMs and OB/GYNs Collaborate in Labor and Delivery
A podcast conversation on how certified nurse midwives and OB/GYNs work together as part of an OB hospitalist team.
Listen now ›Applauding Our Certified Nurse Midwives
OBHG clinical leaders and CNMs describe how midwifery and physician-led care work together on labor and delivery.
Read more ›New Data Highlights the Impact of CNMs in OB Hospitalist Programs
OBHG's earlier quality performance analysis on CNM-integrated sites, covering an earlier measurement period.
Read more ›Rural Hospitals Struggle to Keep Obstetric Services
How staffing shortages and low birth volumes are driving obstetric unit closures, and what alternative care models can do about it.
Read more ›What Hospital CEOs Are Prioritizing in 2026
How OB hospitalist programs, including midwifery integration, align with the quality and workforce priorities hospital executives are tracking this year.
Read more ›CNM Insights on the OBHG Blog
Ongoing coverage of midwifery, maternal outcomes and OB hospitalist program news from OBHG.
Browse articles ›See how CNM integration could work at your hospital
Tell us about your program and an OBHG team member will follow up with more information, including the full quality performance analysis.
- Full data set from the 265-site quality performance analysis
- Guidance on evaluating CNM integration for your obstetric service line
- Introduction to an OBHG program consultant