Each year in the U.S., hundreds of individuals die from complications related to pregnancy or childbirth, and tens of thousands experience unexpected outcomes such as heart failure. In 2022, the US Government Accountability Office (GAO) reported that research showed more than half of rural counties lacked hospital-based services for pregnant people. GAO also reported on persistent racial and ethnic disparities in maternal death and severe maternal morbidity. Maternal health care providers, such as midwives, can play a critical role in improving maternal health outcomes. GAO was asked to examine midwifery education and access to midwifery care. This report describes information on midwife-attended births, the midwifery workforce, and any challenges to obtaining midwifery care; information on students of midwifery education programs, any midwifery educational challenges, and available federal financial support; and any challenges to measuring the quality of maternal health care, including midwifery care. GAO analyzed data from federal agencies and midwifery education and provider organizations, and reviewed research on midwifery care and education. GAO also interviewed a non-generalizable selection of 15 stakeholders knowledgeable about midwifery care and education, and eight researchers and officials from federal agencies about maternal care quality measures.