Midwifery care represents an untapped opportunity for benefits leaders

Having a baby in the US is significantly riskier than in other comparable countries. As of 2022 the US had a higher maternal death rate than any other high-income country, according to the Centers for Disease Control and Prevention, at 22 deaths for every 100,000 live births.

In recent years midwifery care has emerged as one potential way to address this crisis. Gaps in education and access, however, prevent many patients from working with midwives. A new report from Morgan Health, a business arm of JPMorgan Chase focused on healthcare benefits, sheds light on how these trends play out in populations with employer-sponsored insurance.

Barriers to access. Just one in five patients on employer-sponsored insurance had a midwife as part of their care team during their last pregnancy, according to the survey held in March. A higher share of respondents (66%), though, said they would be interested in midwifery care for a future pregnancy.

“Lack of knowledge” and “insurance coverage” were cited as the main barriers to midwifery care among those who were interested in it, but didn’t use it.

“People want access to midwifery care,” said Bea Capistrant, VP of healthcare innovation at Morgan Health. “But there are some gaps that we can fill there.” Patients may struggle to understand the scope of a midwife’s practice, how they work with other providers, and how they manage existing health conditions, for example, she said.

A certified nurse midwife is a type of registered nurse that provides a range of reproductive health services, including prenatal care, childbirth, and postpartum care. They can work in hospitals and private practices, as well as birthing centers. Research indicates midwifery is generally associated with more positive clinical outcomes for pregnant people, including fewer cesarean sections and lower preterm birth rates, but a dearth of providers makes it difficult to secure such care in the US.

Closing education gaps. Available data shows insurance coverage for certified nurse midwives isn’t currently widespread, with just 25% of employers with 500 or more workers covering it, according to Mercer’s 2025 health and benefit strategies survey.

Should employers want to help their employees access midwifery care through a medical plan, they wouldn’t necessarily need to invest in a separate point solution, as some companies have done for doula or fertility services in recent years. Oftentimes employees can work with midwives just as they would any other provider, such as an OBGYN, on their health plan. Employers may work with their insurance carriers, then, to help connect workers with midwife “providers that are already in-network, on existing health plans,” Capistrant said.

When working with carrier partners, employers can focus on the delta between “educating patients” and “clarifying access,” Capistrant added.

The access piece may be trickier to address, particularly if employees are based in states where midwives aren’t sufficiently integrated into the maternal healthcare system. Midwives are less prevalent than OBGYNs in the US for a variety of reasons, including regulatory requirements that make it difficult to work in certain states, and lower reimbursement rates that translate to lower wages compared to other physicians.

If these broader systemic issues are addressed, though, Capistrant and others expressed optimism that employers would see a positive return-on-investment from directing their workers to midwifery care when it makes sense. One reason is that deliveries that incorporate midwifery care tend to see lower rates of costly procedures like C-sections and NICU visits.

“What our employers want from us is the best possible outcomes, and also they want to be able to manage costs across the board,” said Neel Shah, chief medical officer with Maven Clinic, a reproductive healthcare benefits firm that includes midwives in its network. “They can get more efficiency out of their spending, and they can produce better health by having solutions that incorporate midwives.”