Interprofessional Collaboration Between Certified Nurse‐Midwives/Certified Midwives and Obstetrician‐Gynecologist Physicians: A State of the Science Review

Abstract

Interprofessional collaboration (IPC) occurs when autonomous professionals work together to achieve shared system‐level or patient‐centered goals and is a promising strategy to improve perinatal care. Prior research suggests that when midwives and physicians collaborate, there is increased access to perinatal services, improved care outcomes, and more efficient use of limited health care resources. However, it is not always clear how IPC is defined, operationalized, demonstrated, or hindered. This state of the science review examines how IPC between certified nurse‐midwives or certified midwives and obstetrician‐gynecologist physicians is described in current US literature and highlights gaps to guide future practice, policy, and research. Smith's conceptual model of midwife‐physician collaboration guided the synthesis and organization of findings from 14 publications. The publications were organized into 5 areas: (1) professional roles and expectations, (2) relational and communication processes that build collaboration, (3) structural and relational barriers to IPC, (4) interprofessional education and IPC, and (5) the impact and evaluation of IPC. IPC was associated with practice environments that included clear clinical roles, shared goals, and structured guidelines supported by organizational leadership. Other relational dynamics such as mutual respect, trust, and clear, consistent communication were found to strengthen IPC. Institutional hierarchies and regulatory restrictions on midwives’ autonomy were identified as barriers to IPC. Very few studies used objective measures of IPC, linked IPC to outcomes, or examined rural settings. These findings highlight the need for policy reform, improved measurement strategies, and intentional efforts to strengthen clinician relationships to advance IPC and support a sustainable perinatal care workforce.