Thanks to an extensive study, findings now prove that Birth Centers provide mothers and newborns with a stronger start. As a midwifery-led birth center that offers care for women before, during, and after pregnancy, Breath of Life was honored to be one of the 47 birth centers chosen to participate in the four-year study from 2013 to 2017.


We’ve highlighted the entire case study here, so moms-to-be can make informed decisions about how to best proceed with their prenatal care, labor, and delivery.


A Look at the U.S. Maternity Care


It is becoming increasingly clear, the U.S. maternity care system is failing our mothers and newborns. There are significant disparities associated with race, poverty, and access to quality care.


The U.S. spends more on healthcare than any other developed country, yet our maternal and neonatal outcomes lag behind far behind our counterparts.


  • One in ten births is premature with that rate increasing in recent years.
  • Racial and economic disparities mean that black babies typically have 1.5 times the risk of prematurity.
  • The cost of maternity care is one of our nation’s largest healthcare expenditures
  • Medicaid funds about half of the births in the U.S.; premature birth alone costing over $26 billion per year.


To address these poor outcomes and disparities, the Center for Medicare and Medicaid Innovation (CMMI), a branch of the Centers for Medicare & Medicaid Services (CMS), researched innovative prenatal care models that showed promise of improving outcomes and satisfaction among mothers while reducing costs.


Why Study Birth Centers?


Almost all previous studies of birth center care targeted middle income, educated, low-risk women who could choose to go anywhere for their care. Under that premise, birth center care was considered by many to only be an option for low-risk women and infants only.


When the American Association of Birth Centers (AABC) was awarded a multi-year grant by the federal CMMI, they enrolled women covered by Medicaid in birth center care at 47 participating birth centers. Breath of Life was one of those birth centers involved in the study. The AABC carefully monitored how their study group of mothers fared with birth center care.


What Were the Results?


Outcomes of this new research have been overwhelmingly good, proving reduced rates of preterm birth, lower cesarean rates, higher rates of breastfeeding, and higher rates of satisfaction with the care in particular compared to those in the matched group of standard U.S. maternity care system.

The CMMI report shows that participants who received prenatal care in a birth center experienced a rate of preterm birth that was 26% less than a matched group of women with similar risk profiles who had usual care.


There was a considerable decrease in cesarean rates. The overall primary cesarean rate for women in the birth center portion of the study was 8.7%, compared to a national primary cesarean rate of 21.8%. In addition, the low-risk (NTSV) cesarean rate was 13.9% compared to the national rate of 25.7%.


Significant cost savings were also demonstrated. Using Medicaid claims data for all women in the AABC birth center group, each mother and infant in the birth center care group saved an average of $2,010 to Medicaid during the first year. The birth center model cost includes the cost of all outcomes whether complications occurred or not.


Therefore, the report recommends freestanding birth centers as part of the solution to reduce poor outcomes in the usual maternity healthcare system. In fact, the report demonstrates birth center care has a larger potential impact on the reduction of preterm birth risk than any other recent medical or public health intervention.




Reduction of barriers and policy development/implementation are needed to quickly increase access to birth center model care for more Medicaid beneficiaries nationwide.


The birth center model demonstrates improved population health, patient experience, and value.  According to the report, “Women who participate in… birth centers have more positive birth outcomes and improved care processes relative to women in the comparison group who receive care from typical Medicaid providers.”


Women who receive prenatal care at birth centers like Breath of Life have better birth outcomes and lower costs relative to similar Medicaid* beneficiaries. In particular, rates of preterm birth, low birth weight, and cesarean section are lower among Birth Center participants. In addition, costs are more than $2,000 lower per mother-infant pair during birth and the following year.

*These promising Birth Center results may be useful to state Medicaid programs seeking to improve the health outcomes of their covered populations.


About the American Association of Birth Centers

The American Association of Birth Centers is America’s birth center resource. A non-profit membership organization founded in 1983, AABC is dedicated to developing quality holistic services for childbearing families that promote self-reliance and confidence in birth and parenting. AABC publishes materials on birth centers, sets national standards for birth center operation, and promotes state regulations for licensure and national accreditation by the Commission for the Accreditation of Birth Centers. More information about AABC can be found at Learn more about the AABC Strong Start for Mother and Newborns Initiative at