The American Association of Birth Centers: History, Membership, and Current Initiatives

Abstract

The American Association of Birth Centers (AABC) is a multidisciplinary membership organization dedicated to the birth center model of care. This article reviews the history, membership, and current policy initiatives of the AABC. The history of AABC includes the promotion of research, education, and national and state policies that are supportive of birth center care. Current AABC priorities address three main pressures to birth center sustainability: high malpractice insurance rates, the lack of a federally mandated birth center facility fee, and low rates of certified nurse-midwife/certified midwife reimbursement. The AABC is addressing these concerns through lobbying, collaborating with other national organizations, and the promotion of birth research.

Maternal Outcomes in Birth Centers: An Integrative Review of the Literature

“…3,4 Birth centers are a fairly recent location for birth, with the first studies on this model published in the 1980s. 5,6 However, there is a growing body of useful literature on this model of care. The purpose of this integrative review is to assess and summarize the current literature on maternal outcomes in birth centers to provide clear information for clinicians, administrators, and policy makers.…”

Midwives and Liability: Results from the 2009 Nationwide Survey of Certified Nurse‐Midwives and Certified Midwives in the United States

“…Since the Midwifery Litigation Survey of 2005, the litigious environment surrounding obstetrics and midwifery has remained both pervasive and hostile 3‐5 . No new data‐based research on the state of liability and midwifery in the United States has been reported since 2005.…”

“…As early as 1991, the Harvard Medical Practice studies identified strategies to decrease the risk of litigation 3 . With minimal variation, these same risk management strategies are encouraged today 4 : provide evidence‐based care, design and implement safe systems, improve supervision of employees, listen to patients, educate and involve patients in their care, improve charting, work as a team, and be professional in commenting on the care given by others. With nominal change in suggested strategies to decrease lawsuits, have the rates of litigation against midwives changed?…”

“…Birth centers, staffed almost exclusively by midwives, saw a 189% rise in the cost of their malpractice insurance premiums between 2006 and 2007, largely related to insurance company investment losses on the stock market. 4 The rise in malpractice premiums, coupled with a plateau in health care insurance reimbursements, has contributed to the closure of birth centers and maternity services nationally. 4 The current litigious environment has led to a tendency toward fear-based practice, wherein the traditional clinical practice or "standard of care" is maintained, regardless of whether or not it is evidence based.…”

“…4 The rise in malpractice premiums, coupled with a plateau in health care insurance reimbursements, has contributed to the closure of birth centers and maternity services nationally. 4 The current litigious environment has led to a tendency toward fear-based practice, wherein the traditional clinical practice or "standard of care" is maintained, regardless of whether or not it is evidence based. It has been suggested that the unnecessary use of technology and intervention is characteristic of defensive clinical practice and thrives in a professional environment influenced by risk management and fear of litigation.…”