Vulnerable Populations

An Early Feasibility Study of Midwifery Services in a Vulnerable Population

Not all women have equal access to healthcare during their pregnancy. This is especially true for socially vulnerable women, such as those with lower economic resources, lower education levels, and fewer social supports. Midwives take a holistic approach to care, meaning they address women’s emotional, psychological, and social needs; they are trained to manage low-risk pregnancies independently. Our study aimed to understand whether midwives might be a good alternative to traditional physician-led maternity care for vulnerable women.

Given the holistic approach of midwifery-led maternity care, midwives were seen to be appropriate care providers for vulnerable women with low-risk pregnancies. Continuity and accessibility were seen as main benefits of midwifery care. The
potential challenges to implementing successful midwifery services for vulnerable women were lack of awareness and knowledge about midwives and their services, and the need for additional funding to service this population because of increased workload and time required. Having access to a team of health care providers and making sure that maternity care is provided in a flexible and personalized manner were
the most important ways to make midwifery services successful according to our participants.

Next Steps
This feasibility study demonstrated that midwifery services may be an acceptable alternative to physician-assisted births for pregnant women living in socially disadvantaged circumstances. Further research needs to address how midwifery services can be designed, implemented, and evaluated to meet the complex health and social needs of vulnerable women.