State-Level Associations Between Poverty, Rurality, Midwifery Care, and Birth Outcomes: A Secondary Data Analysis

This session will present findings from a state-level secondary data analysis examining associations among poverty, rurality, midwifery care, and adverse birth outcomes across the United States. The presentation will situate the study within current maternal and infant mortality trends and persistent rural and socioeconomic disparities in maternity care access. Participants will review the study design, analytic approach, regression findings, and exploratory interaction effects suggesting that the relationship between midwifery care and birth outcomes may differ by rurality. The session will also consider the implications of these findings for maternity care systems, workforce planning, and public health policy. Discussion will emphasize the potential role of midwifery care in strengthening maternal and infant health, particularly in rural communities.

Learning Objectives

At the conclusion of this session, participants will be able to:

1. Describe current U.S. and global trends in maternal and infant mortality
2. Identify key disparities related to poverty and rurality in the U.S.
3. Explain how poverty, rurality, and midwifery care function as a system-level determinants of birth outcomes within a state-level maternal health framework
4. Interpret findings from multiple linear regression and interaction models examining the association between midwifery care and adverse birth outcomes.
5. Discuss the evolving role of midwifery care as a public health strategy to improve birth outcomes, particularly in rural communities.

Speakers

Myra DeLuca, MSN, CNM, FACNM

Speaker Bio(s)
Myra DeLuca, MSN, CNM, FACNM is a Certified Nurse-Midwife with clinical experience providing care across diverse clinical settings. She has practiced in home birth and birth center settings serving the Amish population in Lancaster County, Pennsylvania, as well as in a large teaching hospital where she supported resident physician education. She now works in a small, community hospital setting while pursuing her PhD in Nursing at The Pennsylvania State University Ross and Carol Nese College of Nursing. Her research examines the evolving role of the midwifery workforce, including examining collaborative practice environments, and broader health system factors such as regulatory and system level factors. Overall, her focus in on how these shape access to maternity care and maternal–infant outcomes across geographic contexts, with the goal of strengthening the midwifery workforce and maternity care systems, improving interprofessional collaboration, and reducing disparities for childbearing families. Myra is active in maternal health advocacy and professional service at both the state and national levels and is committed to advancing equitable, high-quality, patient-centered maternity care and strengthening the role of midwifery within the U.S. health care system.

CEs Offered: 1 CE

Course expiration: September 23, 2028