Expanded use of nurse-midwives would help improve access

Regarding the article “Rural women must often travel great distances for care” (ModernHealthcare.com, Sept. 5), it’s interesting that the federal government puts billions of dollars into graduate medical education to train physicians, including approximately $100,000 a year for an OB-GYN resident, and yet puts almost nothing into training certified nurse-midwives when their training is significantly less costly, and they can be trained more rapidly than the docs.

If we had more midwives, it would free physicians to focus on what they are most capable of doing, which is to care for women with higher risk profiles. It’s the model followed by many other developed countries that have a high number of midwives relative to OB-GYNs. In this country, we have that situation reversed, with a high number of OB-GYNs versus midwives.

Interestingly, OB-GYNs who work in partnership with certified nurse-midwives also make more money, because they can focus on the higher-acuity cases, where their skills are needed and thus generate more revenue with their time. Such partnerships are a win-win for the docs and the midwives.

There’s a lot of data that demonstrates conclusively that care provided by midwives is excellent for low-risk women. They’re a good solution to this issue of the maternal care workforce shortage, and there are some simple things that could be done to help foster the number of them trained in the U.S. each year. Jesse Bushman Alexandria, Va.