Katy B. Kozhimannil, PhD, MPA

Births in freestanding birth centers are increasing, and the number of birth centers is increasing, as well, but capacity is not keeping up with demand. Freestanding birth centers provide many of the same services that are provided for low-risk pregnancies in hospitals, and there is evidence of equivalent or better outcomes of care both here in the United States and in abroad. Yet, freestanding birth centers are paid less than hospitals for doing the same work.

In the United States, too many of our mothers are dying during and after childbirth. Costs of childbirth care are high for everyone—for health plans, for taxpayers, and for families. We are moving in the wrong direction, and it is well past time to change course.

Truly improving equity in childbirth care requires a bold new path forward.

Racial bias happens everywhere; it happens, often implicitly, as decisions are made about access to childbirth care in rural America.

This post is part of a series of blogs illuminating aspects of racial equity in childbirth and highlighting promising practices to ensure access to a safe, empowering, healthy, and positive birth for all people.

This post is part of a series of blogs illuminating aspects of racial equity in childbirth and highlighting promising practices to ensure access to a safe, empowering, healthy, and positive birth for all people.

This series of blogs will illuminate aspects of racial equity in childbirth and highlight promising practices to ensure access to a safe, empowering, healthy, and positive birth for all people.

The rising costs of healthcare generally, and the high costs of childbirth in the United States, are forcing innovation in payment models for maternity care alongside the ongoing efforts in other clinical areas.

Systems failures frustrate women who seek access to evidence-based, cost-effective contraceptive care.

A recently-published paper in the New England Journal of Medicine sheds light on an urgent question: is it safer for moms and their babies to give birth at a hospital or in a setting outside a hospital?

A recent report in JAMA has identified a tipping point that reverses the advantage of cesarean delivery on reducing maternal and infant mortality.

Pregnant women need clear, transparent information on the costs associated with childbirth so they can derive the most value form the healthcare they receive.

There is a quiet revolution happening among health plans. Mothers and fathers who work for health insurance companies-and who had the support of a doula at the time of childbirth-are beginning to inquire about expanding benefits to include coverage for this evidence-based service.

How can the US increase value for the money we spend in maternity care? This is an important question that must be considered more broadly than individual patient choices or clinician decisions.

Increasing access to continuous labor support from a birth doula may facilitate decreases in non-indicated cesarean rates among women who desire doula care.