Thinking outside of the Hospital and Nurse-Midwife Paradigms: A Qualitative Examination of Midwifery in Times of Natural Disasters

Scientists predict that natural disasters will occur with increasing frequency and severity. Although hospitals provide the backbone for medical response during a disaster event, disasters increase demand for medical care and simultaneously reduce medical systems’ abilities to provide that care. This study considers the role that out-of-hospital midwives (birth-center and home-birth midwives) could play as disaster responders for the vulnerable population of pregnant women, new mothers, and infants who have time-sensitive, specialized medical needs. Drawing on qualitative data, we examine midwives’ commitment to respond, their preparedness measures, and the barriers to disaster response that they perceive. Many midwives believed that their model of care prepared them for natural disaster response, and they expressed a deep commitment to assist their own clients, other mothers, and infants. However, all midwives in the sample identified two barriers to their potential disaster response: limited social networks and low occupational status.