BACKGROUND:
The alarming rise in U.S. maternal mortality and disparities in perinatal, sexual, and reproductive health outcomes underscores the urgent need for effective, equitable, evidence-based models of care. Care by certified nurse-midwives (CNMs) and certified midwives (CMs) care has played a critical role in addressing these disparities.

OBJECTIVES:
We sought to conduct a comprehensive synthesis of the impact of CNM/CM care across healthcare quality domains.

METHODS:
A scoping review methodology following PRISMA-ScR guidelines was used to assess the association of CNM/CM care and perinatal, sexual, and reproductive health outcomes through the lens of the Institute of Medicine’s six domains of healthcare quality: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity.

RESULTS:
This review included United States-based studies published since 2012 identified via PubMed and CINAHL. Studies were screened for relevance to the six domains and CNM/CM care. Data were extracted into a spreadsheet, grouped by domains, and analyzed using narrative synthesis. A total of 66 studies met inclusion criteria. Within the domains of safety, effectiveness, and patient-centeredness, CNM/CM care was associated with similar or improved perinatal, sexual, and reproductive health outcomes compared to care by physicians, including lower rates of cesarean birth, fewer interventions, improved neonatal outcomes, greater patient satisfaction, and reduced healthcare costs. CNM/CM care also demonstrated potential in mitigating racial and geographic maternal health disparities, though scope of practice restrictions and institutional policies limited their integration.

CONCLUSIONS:
Despite this evidence, gaps remain in understanding the influence of CNM/CM care on healthcare quality as it relates to efficiency, timeliness, and equity. Future studies should incorporate standardized outcome measures and explore the role of CNM/CM care within collaborative models to enhance perinatal care quality and accessibility.

KEY MESSAGE:
Our findings highlight the importance of expanding CNM/CM integration within the United States’ healthcare system to improve care delivery and associated health outcomes, reduce health disparities, and advance health equity. Poster session 1 (Group A)