More women are opting out of hospital deliveries and choosing birth centers instead, with the number of birth center deliveries tripling over the past two decades, according to a report published Tuesday by the Commonwealth Fund and covered by Wyoming Public Radio. The midwife-run centers, which serve low-risk patients, are especially popular in rural Western states.
The shift reflects growing demand for a more personal, lower-intervention birth experience. Research consistently finds that midwife-led birth centers improve outcomes for mothers and infants, with lower rates of cesarean sections and preterm birth compared with similar low-risk hospital deliveries — a key reason public health experts have pushed to expand access.
The United States has the highest maternal mortality rate among wealthy nations, and the crisis is worst in states with the fewest maternity care options. Birth centers, which handle low-risk pregnancies with midwife-led teams and transfer patients to hospitals when complications arise, have posted strong safety records in peer-reviewed studies — with cesarean rates far below the national average of roughly one in three births.
But access remains wildly uneven. Mississippi remains one of just 10 states with no birth centers at all, Mississippi Today reports, and it ranks among the states with the fewest midwives per birth in the nation — a troubling gap in a state with some of the country's worst maternal and infant mortality rates.
Policy experts say expanding the model will require states to modernize licensing, raise Medicaid payment rates for midwifery care, and remove barriers that let hospital systems block new facilities. Without those changes, they warn, birth centers will remain a boutique option for the well-insured rather than the mainstream alternative the data suggest they could be. The Commonwealth Fund's findings, advocates say, are a signal to policymakers: the demand is there, and the model works.
Photo: State Library and Archives of Florida, Public domain, via Wikimedia Commons