Prof. Mimi Niles Awarded Grant to Study Midwifery in Public Hospitals

August 12, 2021

P. Mimi Niles, PhD, MPH, CNM, assistant professor at NYU Meyers, has received a grant from the Commonwealth Fund to study midwifery care in New York City’s public health care system as a means to improve the healthcare experiences of childbearing people.

The U.S. has the highest maternal mortality rate among developed countries, with stark racial disparities in maternal health outcomes: Black women are three times as likely to die than white women from pregnancy-related complications.

Midwifery care is known to improve outcomes, reduce health care costs and improve patient satisfaction—yet it only represents 10 to 12 percent of the maternity care workforce.

“The clarion call for equity-oriented strategies to eliminate these long-standing maternal health disparities rooted in racism is resounding,” said Niles. “Exploring how midwifery care serves communities seeking care in public health networks may guide us and provide actionable strategies in building birth equity throughout the country.”

The New York City public health care system—the nation’s largest—has long integrated midwives in maternal care for New Yorkers, including those who qualify for Medicaid. The one-year, $157,000 grant from the Commonwealth Fund will support Niles’ research to analyze how midwifery care is organized, implemented, and integrated into existing maternity care services in hospitals that predominantly take care of Black and other historically marginalized people.

The research team will conduct interviews within the eight maternity care services in New York City public hospitals utilizing midwives, including meeting with key gatekeepers—leadership of midwifery, obstetrics, and nursing—to produce a comprehensive report on the strengths, challenges, and potential impact of midwifery integration into the public healthcare system.

“Midwifery care presents a pathway to actualizing the goals of patient-centeredness and respectful maternity care—both pillars of the midwifery model of care and both needed to meet the needs of marginalized childbearing people,” said Niles. “A deeper understanding of how midwifery functions in these settings and communities offers a possible strategy to transform the U.S. maternity care system.”

The partnership with the Commonwealth Fund is in alignment with a shared mission to promote a high-performing health care system that advances health equity, achieves better access, improved quality, and greater efficiency, particularly for society’s most marginalized, including low-income people, the uninsured, and people of color.