The Level of Importance and Level of Confidence that Midwives in the United States Attach to Using Genetics in Practice


  • Marilyn J. Crane CNM, DNP,

  • Mary T. Quinn Griffin PhD, RN,

  • Claire M. Andrews CNM, PhD,

  • Joyce J. Fitzpatrick PhD, MBA, RN

Marilyn Crane, CNM, DNP, College of Nursing and Health Sciences, University of Massachusetts Boston, 100 Morrissey Blvd, Boston, MA, 02125-3393. E-mail:


Introduction: The clinical application of genetic advances has the potential to transform preconception and pregnancy care and improve pregnancy outcomes. The study aim was to evaluate the level of importance and level of confidence that midwives in the United States attach to using genetics in practice.

Methods: The study was a descriptive, cross-sectional, online survey with a convenience sample of certified nurse-midwives who were active members of the American College of Nurse-Midwives (ACNM) and provided midwifery care in the United States. The survey contained genetic case studies and questions related to genetic activities that occur in clinical practice. Participants were asked to rate how important each genetic activity is to midwifery practice generally and their personal level of confidence in carrying out the stated activity at the present time; questions were rated on a Likert-type scale of 1 (not at all important, not at all confident) to 4 (essential, confident to teach).

Results: There were 612 survey responses from among the 4244 active members of ACNM (14.42%). Most midwives believed that genetics-related activities were very important or essential to their clinical practices, but they were only moderately confident in their abilities to perform these activities. The average importance survey score was 88%, and the average confidence survey score was 70%. Some midwives (17.5%) thought that taking a 3-generation family history was essential, and some midwives (20.9%) were extremely confident in their abilities to perform this activity. Almost all midwives (98.5%) indicated that they wanted to learn more about genetics and genomics.

Discussion: Genetics education programs need to be developed and made available to midwives to increase their confidence levels in using genetics in clinical practice.