Provider Type and Preterm Birth in New York City Births, 2009–2010

This cross-sectional analysis assessed the role of provider type in preterm birth (PTB) using birth certificates (2009–2010) from the New York City Department of Health and Mental Hygiene for singleton births to adult, low-risk women (n=73,887). Provider was categorized as a midwife led model or physician led model; PTB as less than 37 weeks gestation. Thirteen percent (13%) received care from a midwife led model. Preterm birth was significantly lower for women who received care from a midwife led model than for those with a physician led model (2.8% vs. 4.6%, p<.0001). The prevalence of PTB was significantly lower among women who used a midwife led model than among women who used a physician led model. After adjustment, the use of a midwife led model significantly reduced the likelihood of PTB (AOR: 0.56, 95% CI: 0.49, 0.63). These results have implications for clinical care and health care costs.