Unraveling the Tapestry: Variations in Midwifery and Community Birth Utilization Among Asian Subgroups

Background: This article examines the utilization patterns of community birth (CB) and midwife-attended birth (MAB) among Asian/Pacific Islander (API) populations in the United States. It highlights the presence of significant racial-ethnic disparities and discusses cultural variations that influence these birth choices. Objectives: To describe variation in the probability of CB and MAB in low-risk pregnancies across API communities and to explore contributors to these variations, including traditional birth practices and cultural beliefs. Methods: The study employs logistic regression analysis of 2010–2020 birth certificate data to examine the probability of CB and MAB across pan-ethnic groups and API subgroups. The data include information on place of birth, birth attendant, maternal demographics, and race-ethnicity, providing a comprehensive view of perinatal care utilization among diverse populations. Results: The findings reveal that CB and MAB rates are significantly lower among API groups compared to other pan-ethnic groups. Among API subgroups, there is substantial heterogeneity in the uptake of CB and MAB, with lower rates in Asian Indian and Chinese populations and higher rates in Hawaiian, Japanese, and Guamanian populations. Conclusion: The study underscores the importance of addressing racial-ethnic disparities in perinatal care and promoting culturally sensitive approaches. Factors such as traditional birth customs, cultural beliefs, and conditions of immigration may influence the choice of perinatal care among API communities. Efforts to promote CB and MAB should consider how cultural differences and values across different API subgroups may promote or inhibit the adoption of evidence-based low-intervention perinatal care models.