Pregnancy and birth are such an important and personal experience for women, and they deserve to have the best level of care and support available. It is important that women have the ability to choose what works best for them, and birth centers are one incredible option. Birth centers are stand-alone facilities that operate separately from a hospital and use a midwifery model of care to provide services during pregnancy, delivery, and postpartum for women with low-risk pregnancies. They emphasize education and support of the informed decisions made by the mother and family for the care wanted during birth. They also provide a relaxing and home-like environment, offering amenities like private suites and birthing tubs.
Worsening Maternal Health Outcomes
About 98% of women choose to give birth in a hospital, and for good reasons. Modern medicine has made birth a much safer experience for women and infants through the development of antibiotics and safe cesarean sections, which have caused maternal mortality rates to decline by 99% since the year 1900. However, progress has taken a small step back in recent decades as the U.S. maternal mortality rate has increased from 7.2 to 18.7 per 100,000 births between 1987 and 2023. This is still remarkably low, but the slight uptick is a cause for concern.
There are many factors contributing to this rising issue, all of which birth centers help address, and they have incredible health outcomes because of it. For example, while a cesarean section is a life-saving procedure, it is an invasive surgery with risks like infection and blood clots that should be a last resort. However, the U.S. has a very high rate of C-section deliveries. One in three births in the U.S. is by C-section, and in 2025, 25.3% of first-time mothers carrying a single, full-term baby in a head-down position, who are the least likely to need one, delivered by C-section. This may cause more issues postpartum than would have otherwise been experienced had the mother been allowed to deliver naturally.
Better Birth Center Outcomes
Women who participate in birth center care, even if it is only prenatal care, have much better outcomes. Between 2013 and 2017, only 12.3% of women participating in birth center care gave birth by C-section, compared to 31.2% of women nationally. Birth centers have also been found to reduce preterm birth by 26%, and are associated with higher rates of breastfeeding. Part of the great success of birthing centers is their greater utilization of certified nurse midwives (CNMs) and doulas. CNMs are associated with higher rates of vaginal delivery and lower rates of infant mortality. Access to CNMs is increasingly important as we face a maternal care shortage. There was a net loss of 399 obstetric wards around the country between 2010 and 2022, and the Department of Health and Human Services projects a shortage of over 5,000 OB/GYNs by 2030.
This shortage puts a strain on remaining providers, which makes it more difficult for women to feel like they are being supported and receiving quality care. In a 2023 CDC survey, 45% of mothers reported holding back their questions because they were told that what they were feeling was normal, were embarrassed or unsure of their experiences, felt their doctor was rushed, or didn’t want to be seen as difficult. In 2025, 56% of women skipped postpartum check-up appointments, which are critical for catching any possible complications. Birth centers are able to offer more personalized care and education before, during, and after childbirth, leading to improved outcomes. Birth centers have higher overall patient satisfaction with 98.8% of participants saying they would recommend it to others or return for a future birth, and doulas specifically have been found to increase the likelihood of women attending their postpartum visits.
Reducing Pressure on the System
Birth centers can better support women, but they are also a great opportunity to relieve the growing pressure of maternity care on our hospital systems. Only about 0.65% of births take place in a birth center now, and most women would still choose to give birth in a hospital. However, if just 10% of births took place at home or in a birth center, that would result in yearly cost savings of $2 billion. This is because hospitals could operate more like risk-appropriate centers—as is recommended by the Alliance for Innovation on Maternal Health—allowing labor and delivery units to focus on complications, surgeries, and emergencies for high-risk pregnancies. Not only is this much more cost-effective, but it would prevent the closing of maternity wards due to underfunding and allow hospital staff to better care for the patients they have.
Despite the many benefits for women and the system overall, birth centers face regulatory hurdles such as Certificate of Need (CON) laws that require approval for health facilities to open or expand. CON laws are a major obstacle to open birth centers, especially because existing hospital systems, which may see them as competition, can oppose applications. There are 14 states where CON laws require approval for birthing centers. Repealing these CON laws would go a long way in allowing birth centers to provide necessary maternal care and improve outcomes.
Women deserve safe, affordable, and supportive maternal care options no matter where they decide to receive care, and birth centers are a necessary part of making that care accessible.