The only real issue facing the practice and acceptance of midwifery in the United States is the lack of standardization. Widely varying conceptions of proper midwife practices and expectations exist in the literature and among practitioners and institutions, making licensing and the validation of midwives and bodies of midwifery knowledge very difficult (Kennedy et al. 2003). Without this standardization and the validation capabilities that it leads to, it will be highly difficult for the midwifery professionals to be accepted by the medical community as the truly valuable resources they are. Many other countries have already adopted standardizations for midwifery practice, and if the United States were to follow suit it would be a giant bon to the practice of midwifery both domestically and internationally, raising awareness of midwifery practices and benefits in the general public and establishing higher quality and more stringent...

Insurance carriers often do not provide coverage for midwives, but if the access to such services became easier, more affordable, and more common, the cost-saving benefits of midwife care as preventative and pregnancy-easing might lead to a change in this fact. Standardization of care will also make it easier for insurance companies to determine specifically what services are covered, enabling greater financial access to midwifery care and practice as well. As patients and midwives form more common bonds, midwifery will come more into the mainstream.
References

Kennedy, a., Rousseau, a. & Low, L. (2003). "An exploratory metasynthesis of midwifery practice in the United States." Midwifery 19(3), pp. 203-14.