Abstract
Policy Points: r Certified nurse-midwife (CNM)/certified midwife (CM) care is associated with outcomes that are comparable or improved compared to physician care across multiple domains of health care quality, especially safety and effectiveness. CNM/CM care is consistently associated with lower rates of intrapartum interventions and improved birth outcomes and patient satisfaction. r Integration of CNM/CM care remains limited across many US health systems due to scope of practice restrictions and institutional policies. r Growing, diversifying, and integrating CNM/CM care offers a critical pathway to advancing health care quality, equity, and efficiency in the United States and addressing the alarming rise in adverse perinatal and sexual and reproductive health outcomes. Context: The alarming rise in US maternal mortality and disparities in perinatal, sexual , and reproductive health outcomes underscores the urgent need for effective, equitable, and evidence-based models of care. Care provided by certified nurse-midwives (CNMs) and ## These authors contributed equally to this work