Feature ArticlesProgesterone and Preterm Birth Using Empirical Research to Explore Structural Racism Within Midwifery-Led CareStandard, Venus MSN, CNM, APRN, FACNM, LCCE, CD(DONA); Jones-Beatty, Kimberly DNP, MSN, CNM; Joseph-Lemon, Lodz MSN, MPH, CNM; Marcelle, Ebony DNP, CNM, FACNM; Morris, Charlotte E. DNP, CNM, FACNM; Williams, Trinisha MPH, CM, LM, LCCE, FACCE; Brown, Tracie MSN, CNM; Oura, Haley Shizuka BS, MPH; Stapleton, Susan DNP, CNM; Jolles, Diana R. PhD, CNM Author Information Department of Family Medicine, UNC School of Medicine, Chapel Hill, North Carolina (Ms Standard); Integrated Research Center for Fetal Medicine, GYN/OB Department, School of Medicine, Johns Hopkins University, Baltimore, Maryland (Dr Jones-Beatty); El Rio Health, Tucson, Arizona (Ms Joseph-Lemon); Midwifery Melanated, LLC, Washington, District of Columbia (Dr Marcelle); Midwifery and Women's Health, Frontier Nursing University, Versailles, Kentucky (Drs Morris and Jolles); Midwifery Collective, Brooklyn, New York (Ms Williams); Community of Hope, Washington, District of Columbia (Ms Brown); Mel and Enid Zuckerman College of Public Health at the University of Arizona, Tucson (Ms Oura); and American Association of Birth Centers Perinatal Data Registry, Perkiomenville, Pennsylvania (Dr Stapleton). Corresponding Author: Venus Standard, MSN, CNM, APRN, FACNM, LCCE, CD(DONA), Department of Family Medicine, UNC School of Medicine, 590 Manning Dr, Chapel Hill, NC 27599 ([email protected]). The authors acknowledge Carla Townsend, MLIS, Jennifer Wright, BA, and Lauren Hoehn-Velasco, PhD. Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Each author has indicated that he or she has met the journal's requirements for Authorship. Submitted for publication: February 27, 2022; accepted for publication: April 25, 2022. The Journal of Perinatal & Neonatal Nursing 36(3):p 256-263, July/September 2022. | DOI: 10.1097/JPN.0000000000000664 Buy Metrics Abstract Background: Progesterone has been the standard of practice for the prevention of preterm birth for decades. The drug received expedited Food and Drug Administration approval, prior to the robust demonstration of scientific efficacy. Methods: Prospective research from the American Association of Birth Centers Perinatal Data Registry, 2007-2020. Two-tailed t tests, logistic regression, and propensity score matching were used. Results: Midwifery-led care was underutilized by groups most at risk for preterm birth and was shown to be effective at maintaining low preterm birth rates. The model did not demonstrate reliable access to progesterone. People of color are most at risk of preterm birth, yet were least likely to receiving progesterone treatment. Progesterone was not demonstrated to be effective at decreasing preterm birth when comparing the childbearing people with a history of preterm birth who used the medication and those who did not within this sample. Conclusions: This study adds to the body of research that demonstrates midwifery-led care and low preterm birth rates. The ineffectiveness of progesterone in the prevention of preterm birth among people at risk was demonstrated. © 2022 Wolters Kluwer Health, Inc. All rights reserved.