The growing popularity of midwifery care is partially a response to rising Caesarean rates, says Eugene Declercq, a professor of community health sciences at Boston University who studies American maternity care. Currently, around a third of all births in the U.S. are Cesarean sections, a number far higher than the World Health Organization-recommended target of 10 to 15 percent. The inflated rate is due in part to longstanding misperceptions in the U.S. medical community about how quickly labor should progress and when medical intervention is necessary.

According to Declercq, the high rates of surgery and other unneeded interventions have led to increased interest in the midwifery model, which is lower-tech, less invasive, and less inclined toward intervention without a clear medical need; a 2011 study in the journal Nursing Economics found that births led by midwives in collaboration with physicians are less likely to end in a C-section than births led by obstetricians alone. According to Ginger Breedlove, the president of the American College of Nurse-Midwives, the real reason for this difference is in the approach to care: Midwives typically promote patience with the natural progress of labor and discourage intervention to speed the birth process. “It’s a different model,” she explains.

Popular media is also playing a role in the rising popularity of midwives, Breedlove says. The 2008 film The Business of Being Born and TV shows like the BBC’s Call the Midwife, for example, are helping to subtly reframe the concept of midwifery in the American mind, moving it from a fringe profession to something closer to mainstream.
Though still a relative novelty in the U.S., midwife-led maternity care is the norm in other developed countries, including most of Europe.* In England, for example, midwives are the lead care providers at more than half of all births.