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Midwifery care increases positive birth outcomes and can be cost-savings
  1. Elena Tarlazzi1,2
  1. 1DIMEC, University of Bologna, Bologna, Italy
  2. 2AUSL della Romagna, Ravenna, Italy
  1. Correspondence to Dr Elena Tarlazzi, DIMEC, University of Bologna, Bologna, Italy; elena.tarlazzi2{at}

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Commentary on: McLean KA, Souter VL, Nethery E. Expanding midwifery care in the United States: Implications for clinical outcomes and cost. Birth. 2023 Dec;50(4):935-945. doi: 10.1111/birt.12748. Epub 2023 Jul 14. PMID: 37449767.

Implications for practice and research

  • Wherever a midwifery model of care is implemented, women experience less caesarean section and other in labour interventions.

  • More research is needed on the cost-effect of the implementation of a midwifery-led model of care.


Since 2016, Miller and colleagues proposed the concept of ‘too much too soon and too little too late’ to describe an imbalance in maternity care in terms of both resources and the translation of evidence.1 The over-medicalisation of births in high-resource nations frequently results in less than ideal outcomes, and this varies greatly between states and regions. When compared with other industrialised nations, giving birth in the USA is …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.