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American Association of Birth Centers

May 2, 2017

Dear AABC Member,

As a membership organization, AABC Board of Directors works hard to ensure our members' concerns are heard and addressed in strategic discussions and decisions. Since the AABC Birth Institute last fall we have been working on the issue of in-hospital birth centers, seeking input from all members, gathering research, and analyzing the data. We are writing today to continue our dialogue with members and review the overall findings of the survey and actions taken by the Board.

The survey showed:

  • Members support AABC being more inclusive and taking a leadership role in transforming maternity care.
  • Individually they are feeling threatened by in-hospital birth centers and/or hospitals calling their OB units “birth centers.”
  • There may be confusion regarding what AABC is able to control. For example, we cannot change the US health system but we can continue our work to support inclusion of CPMs/LMs in payer networks.
  • We need to decide as an organization how best we can support our members and continue to be at the forefront of this movement.

We also identified central themes in the survey results and comments:

  • It is essential that AABC continue to collaborate with other organizations and maintain our “seat at the table” by actively defining birth centers.
  • CPMs/LMs feel disenfranchised and excluded, the inclusion of CPMs/LMs in birth centers and AABC is important.
  • Consumers need choices and access to care. However, hospitals calling their obstetrical units birth centers creates consumer confusion.
  • The definition of a birth center needs to be clarified. Specify that it is “not a hospital.”
  • In-hospital birth centers need to be defined and named something else.

The Board of Directors met on April 23rd where we discussed the Open Forum Follow-Up Survey Report. Based on the findings of the survey of AABC members, the Board made several decisions:

1) Revised definition of birth center.

The birth center is a health care facility for childbirth where care is provided in the midwifery and wellness model. The birth center is freestanding and not a hospital.

Birth centers are an integrated part of the health care system and are guided by principles of prevention, sensitivity, safety, appropriate medical intervention and cost-effectiveness. While the practice of midwifery and the support of physiologic birth and newborn transition may occur in other settings, this is the exclusive model of care in a birth center.

The birth center respects and facilitates a woman’s right to make informed choices about her health care and her baby’s health care based on her values and beliefs. The woman’s family, as she defines it, is welcome to participate in the pregnancy, birth, and the postpartum period.

The board directed the Standards Committee to include an attribute in the Standards regarding a birth center being an ambulatory outpatient health care facility. You can expect proposed revisions to be put forth to the membership for a vote in the coming months.  For more information, please see our attached FAQs.

2)  New membership type - Other Birthing Unit

Other Birthing Unit membership is for organizations or groups that provide birth services based in the midwifery model of care but do not meet the AABC definition of a birth center. For example this may include institutions, professional practices or corporations. Creating a community for Other Birthing Units to network and learn will help improve care for all moms and babies. For more information, please see our attached FAQs.

3) Position statement in support of CPM providers and US MERA

The inclusion of CPMs/LMs in birth centers and AABC is important. To show this, AABC will be issuing a position statement in support of CPM providers and the US MERA. Additionally, we are developing a toolkit for birth centers to help CPMs achieve the bridge certification. Working together we can make the midwifery profession stronger in the United States.

4) Position statement regarding hospitals calling their OB units birth centers

Members have identified a concern with hospitals calling their obstetrical units “birth centers.” This practice creates confusion among consumers, policymakers and payers. While this is not a new practice, AABC has not tackled it before. AABC will be issuing a position statement against the use of the term “birth center” when the facility does not meet the AABC definition. Our goal is that this document could be used to educate hospitals and payers.

We appreciate your participation and patience as we have engaged in this transformational process. It is our desire that AABC emerges a stronger association that will carry birth centers into the future.
As always, we welcome your constructive feedback and we look forward to continuing to work with you.



Lesley Rathbun, MSN, CNM, FNP - AABC President
Amy Johnson-Grass, ND, LN, LM, CPM - AABC President-Elect
Kate Bauer, MBA - AABC Executive Director

American Association of Birth Centers
3123 Gottschall Road | Perkiomenville PA 18074
Tel: 215.234.8068 | Fax: 215.234.8829

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