Birthing Centers

Birth centers are places where women and their families can experience the joys of childbirth. They provide intensive care to the childbearing family through extensive education and offering choices throughout pregnancy, labor, birth, and the postpartum period. The philosophy is family centered, and all birth centers provide a home-like environment that offers a nurturing and protected milieu for the mother. The woman is in control at a birth center, much like being in her own home.

The modern birth center was developed in 1975 as a pilot project by the Maternity Center Association (MCA) in New York City. The MCA has a long history of meeting its goal to improve the health of mothers  and  its  infants.  Established  in  1925,  the MCA has initiated such innovations as developing prenatal care, establishing the first school for nurse midwives in the United States, and promoting childbirth education.

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The birth  center  was  an  innovation  for  women who were dissatisfied with typical hospital births that consisted of many routine interventions like shave preps, enemas, and isolation of the mother from her family. It offered safe birth care, including the ability to transfer mothers to an acute-care hospital when that type of care was necessary. For the majority of women then and now, birth is an uncomplicated physiological event that can safely take place in a birth center with a qualified attendant usually a midwife. Midwives are skilled in attending normal birth, while the hospital and physicians are reserved for the complicated cases.

Birth centers provide safe, sensitive, and personalized care. This means that time is spent with the woman and her family during the pregnancy, questions are answered, and women become partners in their care. They weigh themselves and write in their own chart. They decide who will be with them in labor.

During labor, pain relief measures used in birth centers include position changes, massage, hydrotherapy, visualization, hypnosis, and the continuous presence of the birth attendant. Continuous presence of the birth attendant has been shown to decrease the length of labor and the number of operative births. The natural process of labor is enhanced by having mothers  walking,  drinking,  and  eating  lightly. The attendant midwife carefully monitors the condition of the mother and baby using intermittent auscultation of the fetal heart rate and feeling the contractions with a hand rather than relying on machines to do this very sensitive surveillance. Women birth in the position that is most comfortable for them and in the place they choose, such as the tub.

Family members are very involved with the woman in labor. They encourage her, hold her, and offer cool compresses and drinks. Siblings are often present to see the birth of the newest family member.

Extensive  research  has  demonstrated  the  safety of birth centers. In 1989, the results of a prospective study of more than 11,000 women who went to birth centers for care was published in the New England Journal of Medicine. In addition to validating the safety of the birth center model of care, the study documented the tremendous consumer satisfaction. There are now 90 birth centers throughout the country with more in the development stages.

The National Association of Childbearing Centers (NACC) is the national organization for birth centers and has midwives, physicians, nurses, administrators, and consumers as members. NACC has developed national standards for birth centers, and the Commission for the Accreditation of Birth Centers accredits centers that meet these standards.

Birth is a joyous event, and birth centers celebrate it by providing women and their families with time-intensive, personalized care that results in a healthy baby and a new nurtured and happy family.


  1. Department of (1993). Changing childbirth: Parts I and II. London: HMSO Publications.
  2. Jackson, J., Lang, J. M., Swartz, W. H., Ganiats, T. G., Fulleron, J., Eckers, F., et al. (2003). Outcomes, safety, and resource utilization in a collaborative care birth center program compared with traditional physician-based prenatal care. American Journal of Public Health, 93(6), 999–1006. National Association  of  Childbearing  Centers,
  3. Pew Health Professions Commission. (1995). State Health Personnel Handbook. San Francisco: UCSF Center for the Health
  4. Rooks,  P.  (1997).  Midwifery  &  childbirth  in  America. Philadelphia: Temple University Press.
  5. Rooks, P., Weatherby, N. L., Ernst, E. K., Stapleton, S., Rosen, D., & Rosenfield, A. (1998). Outcomes of care in birth centers: The national birth center study. New England Journal of Medicine, 321(26), 1804–1811.