For millennia and across cultures, midwives provided care to women in labor and throughout their reproductive years with a universal emphasis on providing compassionate treatment.
Today, however, maternal health in the United States is in crisis.
According to the Department of Health and Human Services, the U.S. has the highest maternal mortality rate among high-income countries. Even in Massachusetts, a state known for top-notch health care, maternal mortality nearly doubled from 2011 to 2020, according to the Massachusetts Department of Public Health.
To address this problem, Boston College’s Connell School of Nursing (CSON) launched a two-year, in-person graduate nurse-midwifery program in May 2025, the only program of its kind in eastern Massachusetts. Building on CSON’s tradition of academic excellence, the program educates students to provide the full scope of care for their patients, from adolescence throughout the lifespan, and care for newborns in the first month.
A time-honored tradition at a tipping point
Katharine Hutchinson, program director, M.S. in Nurse-Midwifery
“Midwifery is an ancient profession. You’ll find midwives in the Bible and throughout history. These are women who were trained on the job, attending other women in their community or in their families. There’s a long history of midwifery in the United States, including among enslaved Black women in the South,” says Katharine Hutchinson, Dr.P.H., CNM, director for both the nurse-midwifery and women’s health programs at CSON.
In the country’s early years, new midwives traditionally apprenticed under experienced ones, traveling together to women’s homes to care for mothers and babies in need. They combined clinical acumen during delivery with straightforward nutritional advice, psychological support, and mentorship that respected the emotional nature of labor and the intense postpartum period.
Hutchinson, a full-time faculty member at CSON and a staff midwife at Boston Medical Center, will lead the new midwifery program in the spirit of this tradition. She says the program marks a turning point for women’s health care.
“The United States faces a crisis,” she explains. “Over the past decades, we’ve seen more U.S. counties with zero obstetric care providers: no obstetrician, no midwife, no family medicine doctor trained in delivery, or no hospital available. Even in Massachusetts, there are many areas where people have to drive more than an hour to access reproductive health care.”
Midwifery care is associated with lower morbidity and mortality among mothers and newborns, fewer preterm births and low birthweight infants, and reduced interventions in labor. And, in other industrialized nations with better maternal health, midwives are commonplace: they provide uncomplicated, non-emergency obstetric and gynecological services for women across the reproductive years and play a crucial role in preserving women’s health during labor.
Thamarah Crevecoeur, associate professor of the practice
“The data points to midwifery as a really sustainable, cost-effective solution,” adds Thamarah Crevecoeur ’06, Dr.P.H., CNM, an associate professor of the practice and a certified nurse-midwife at Boston Medical Center. “In other developed countries in Europe, midwives are basic to the maternal health care system. Beneficial midwifery outcomes are very clear.”
However, with the rise in U.S. obstetric medicine in the 1800s, the holistic role of midwives became less commonplace. Currently, they tend to just 12 percent of U.S. births. But this might change soon. Massachusetts Governor Maura Healy signed an August 2024 maternal health care bill, expanding access to midwifery, among other health care options, for pregnant patients. In October 2024, Massachusetts awarded $1 million to increase community birth centers.
Community outreach through an equitable lens
The new CSON curriculum will offer 16 courses centered on whole-person care across the lifespan. Hutchinson emphasizes the new program’s important focus on providing uniformly excellent care for all, which means addressing perinatal inequities: Black and Indigenous women have an estimated three to four times the risk of dying in pregnancy, childbirth, or the first year postpartum compared with their white peers—and compared with other modern countries.
“So many areas of U.S. medicine have a long history of racism,” she explains. “Midwifery is no different, and midwifery as a profession needs to be aware of and work toward a more just future within our field. We know that there are troubling, distressing differences in outcomes for our patients. How are we working to overcome those and moving to a future where all patients receive equitable, safe, evidence-based, loving care? Our courses ensure that students have the scientific underpinnings and academic preparation to serve as nurse-midwives while also ensuring that they are knowledgeable about disparities in care and outcomes.”
Additionally, CSON received a grant from the Massachusetts Department of Public Health for the Birthworker Equity in Education (BEE) Collaborative. This interdisciplinary effort with BC’s School of Social Work and Mattapan Community Health Center supports health care workers who specialize in perinatal and neonatal care to improve pregnancy and birth outcomes.
“Midwifery care is really the vanguard and leader of the patient-centered movement. We partner with our patients so they feel cared for and loved during some of their most vulnerable moments, which leads to better outcomes.”
—Katharine Hutchinson
Program Director, M.S. in Nurse-Midwifery
Caring for the whole woman
One reason for improved outcomes lies in midwifery’s holistic, preventive approach. Consider anemia: pregnant women are often iron-deficient. Instead of looking for a purely medical solution, midwives will focus on optimizing diet and educating women on ways to improve iron absorption through proper nutrition. This way, a woman ultimately might avoid the need for a blood transfusion or risk running low on breastmilk.
“We focus on ways to prevent the problems that can occur later, in a health system that doesn’t always make that easy,” Hutchinson explains.
Midwives also play a stabilizing role in women’s overall well-being. This is especially important when caring for patients who face systemic disadvantages or barriers to accessing health care, or feel unseen by their providers, and thus are less likely to seek proper care or follow-up appointments.
“It’s of course important that you survive childbirth,” Hutchinson says. “But midwives see a bigger picture than that. We want to ensure that you’re taken care of by people who deeply respect you, your autonomy, and your choices, and who will make sure that you don’t feel traumatized by the experience. Midwifery care is really the vanguard and leader of the patient-centered movement. We partner with our patients so they feel cared for and loved during some of their most vulnerable moments, which leads to better outcomes.”
Midwives frequently also offer group prenatal care, which unites women with common symptoms and gestational ages in larger sessions, fueling camaraderie and allowing midwives to have a wider reach while building community.
“Rather than having the same 10-minute conversation 15 times with different people, group prenatal care brings together pregnant patients around the same gestational age who create a sense of community,” Hutchinson explains. “The midwife attends to help answer questions, but a lot of the value of the group comes from the participants really getting to know each other and helping each other. That part feels really rewarding as a health care provider: getting to know your patients and seeing them in their community.”
Facilitating this, Crevecoeur, who works at Mattapan Community Health Center, will oversee internships with students to fulfill clinical hours. She also has high praise for CSON’s history of placing students in service trips for hands-on learning—one of her nursing students recently traveled to Jamaica—and job placement.
“I’m excited to have more midwives on the ground, simply so that more people have access. And, as a former BC student myself, I’m proud that the CSON and BEE Collaborative is the space where all kinds of birth workers can come together,” she says.
Ultimately, Hutchinson and Crevecoeur believe the new program marries moment with mission: an essential initiative delivered from the right place, at the right time, with a community focus.
“The Jesuit mission fits so nicely with what midwives do: caring for the whole person. It’s not just looking at the pathology of pregnant patients, but really trying to optimize the outcomes for them, their families, and their communities,” Hutchinson adds. “The power of midwifery is life-changing. Midwives are what our world needs today. As we say: peace on earth begins with birth.”