I'm not going to share this post as one of Midwifery vs Medical Model. That has been done multiple times.
What I will share are the positions of ACOG, The American College of Obstetrics and Gynecology, essentially the guiding protocol creator that directs how the Medical Model is presented to healthcare consumers.
Here are some ACOG position papers or committee opinions that relate to pregnancy and childbirth:
1. Universal Access to Midwifery Care
ACOG Recommendation: Midwives play a critical role in providing care for low-risk pregnancies and reducing cesarean rates through collaborative care models.
Status in Mississippi: Midwifery care is limited and not fully integrated into hospital systems. Medicaid does not cover home births or midwifery services, creating access barriers. Certified Nurse Midwives or CNM's, do not have autonomy here.
Reference: ACOG Policy Priorities: Midwifery
2. Delayed Umbilical Cord Clamping
ACOG Recommendation: Delay cord clamping for at least 30–60 seconds to improve neonatal outcomes, including better iron stores and reduced anemia. Stated in 2017, and reaffirmed in 2023.
Status in Mississippi: This practice is not consistently applied, especially during cesarean or high-risk deliveries.
Reference: Delayed Umbilical Cord Clamping After Birth
3. VBAC (Vaginal Birth After Cesarean) Accessibility
ACOG Recommendation: VBAC is a safe option for most women with prior cesareans when emergency care is available.
Status in Mississippi: VBAC access is limited due to restrictive hospital policies, lack of provider support, and inadequate emergency resources. By closing 51% of the available hospitals, Mississippi has created multi-county maternal healthcare deserts that have created an environment where a near 39% cesarean rate is somehow acceptable to the medical establishment here.
Reference: Vaginal Birth After Cesarean Delivery
VBACFacts Biggest Concerns with the VBAC Guidelines
4. Reducing Interventions in Low-Risk Births
ACOG Recommendation: Avoid unnecessary interventions like early inductions and continuous electronic fetal monitoring for low-risk pregnancies.
Status in Mississippi: High rates of routine interventions persist, increasing the likelihood of medical complications and cesarean deliveries. True informed choice is skewed to reflect hospital policy and Doctor preference in most every case.
Reference: Approaches to Limit Intervention During Labor and Birth
5. Support for Birth Plans and Shared Decision-Making
ACOG Recommendation: Encourage shared decision-making and respect for birth plans to foster patient satisfaction and autonomy.
Status in Mississippi: Birth plans are not consistently supported in hospitals, and many facilities are reluctant to accommodate non-traditional options such as water births.
Reference: Shared Decision Making and Ethics
ACOG Committee Opinion: Informed COnsent and Shared Decision Making in Obstetrics and Gynecology
6. Addressing Racial Disparities in Maternal Care
ACOG Recommendation: Implement systemic changes to address racial disparities, including bias training for providers and equitable access to care.
Status in Mississippi: Racial disparities in maternal and infant outcomes are significant, but efforts to address implicit bias and systemic inequities are minimal. Maternal Mortality increased 14% between the 2014-2018 and 2018-2022. These increases included obesity (8%) depression (11%), drug-related deaths (38%), and we carry 66.4:100,000 for deaths related to/aggravated by pregnancy occurring within 42 days of delivery among non-hispanic Black women.
Reference: Changing the Culture of Medicine and Eliminating the Racial Disparities in Women's Health Outcomes
7. Screening for Social Determinants of Health
ACOG Recommendation: Screen for social determinants of health (e.g., transportation, housing, food insecurity) to enhance care.
Status in Mississippi: Social determinants of health are rarely assessed, leaving underserved populations without the necessary support. Midwifery Care can help this!
Call to Action
Mississippi has the opportunity to significantly improve maternal and neonatal outcomes by adopting ACOG-recommended practices, expanding access to midwifery care, reducing unnecessary interventions, and addressing systemic inequities, which are critical steps toward healthier births for families across the state.
The Association of Mississippi Midwives, and all of here at Hands and Hearts Birth & Wellness stand behind and fully support 2025 House Bill #927 sponsored by Representative Dana McLean. This bill, drafted on the bones of previous attempted legislation, has been amended after thoughtful collaboration and multiple meetings among our groups and supporting families, to reflect the voices of not only AMM and Better Birth MS, but also those of our supporting families and community.
Join us in showing your support of HB 927 by contacting your legislators today and letting them know you stand with this Bill as presented and will not support any other proposals. Stand with every birthing family and let your voice be heard!
Stay up to date with Midwifery Legislation efforts by joining AMM and Better Birth MS on Facebook at
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