Trends in Midwife-Attended Births, 1989 to 2007


  • Eugene Declercq PhD

Address correspondence to Eugene Declercq, PhD, Boston University School of Public Health, 801 Massachusetts Ave CT-430, Boston, MA 02118-2526. E-mail:


Introduction: Rates of births attended by certified nurse-midwives (CNMs) rose throughout the 1990s and into the early part of this century, when rates leveled at about 7%.

Methods: The data in this report are based on records gathered as part of the US National Standard Certificate of Live Birth from the public use Web site, VitalStats, that allows users to create and download specialized tables.

Results: For the first time since such data were available in 1989, births attended by CNMs declined from the previous year in absolute terms, as a proportion of all births, and as a proportion of vaginal births. After an all-time high of 317,168 in 2006, CNM-attended births declined marginally to 316,811 in 2007. With total births reaching a US record of 4,316,233 births, the CNM proportion of total births declined for the fifth straight year to 7.3%, the same proportion as in 1999. Births attended by “other midwives” rose substantially to 23,943 although some of that increase may be the result of misclassification of CNM births in some states into the other midwife category.

Discussion: The proportion of CNM births has remained steady at between 7.3% and 7.6% since 1999. However, when the number of births attended by CNMs is combined with the number attended by other midwives, their number reached an all-time high in 2007.