United States Birth Center Regulations

United States Birth Center Regulations

Birth center regulations can be overwhelming for some midwives. 

 There are 50 states with their own way of looking at free-standing birth centers. Presently, 80% of the states have some sort of regulation for birthing centers.  As of today, the states with no birth center regulations are Michigan, North Carolina, Virginia, Wisconsin, North Dakota, Delaware, Idaho, Maine, Vermont, Alabama, and Louisiana.

For the states with regulations, it is essential that you review those before opening your own birth center. Find out if there are any barriers that might complicate putting the birth center where you think you want to put it. Additionally, the regulations will cover things such as definitions, staffing, the facility, fire and building codes, and the services you can and cannot provide. For example, no state allows cesarean sections to be done in birthing centers. These regulations will also give you information about the services that you must provide, policies, procedures, organization, quality assurance, and evaluation. These state regulations will serve as a guide and help you as you proceed with planning your birth center services.

Licensing protects the public by monitoring compliance with codes, ordinances, and a variety of regulations. Some states and municipalities are very specific and uniform in the level of requirements for safe operation, but others are nonspecific or vary in their requirements, which may or may not be relevant to birth centers. The standards and attributes for national accreditation are uniformly applied in all localities, thereby eliminating state and local inconsistency.

Meeting the standards of accreditation indicates to clients, states, health and liability insurance agencies, consulting providers, and hospitals that a birth center has met a high standard of evidence-based and widely recognized benchmarks for maternity care, neonatal care, business operations, and safety. A strong internal quality improvement program, in accordance with the standards, promotes success with external measurements of quality. Continuing accreditation demonstrates to consumers and other entities that best practices are being met and maintained by a birth center.

The standards address the following:

  • Philosophy and Scope of Service
    Planning, Governance, and Administration
    Human Resources
    Facility, Equipment, and Supplies
    The Health Record
    Quality Evaluation and Improvement

AABC has developed a toolkit, “Best Practices in Birth Center Regulations,” to help birth centers advocate for removing structural barriers and addressing inequitable access to the birth center model of care by modernizing their birth center licensing regulations or by introducing appropriate regulations where none exist. This toolkit provides draft regulatory language, fact sheets, and other implementation support.

Midwifery Business Consultation has excellent resources to help with the details of implementing customized business planning for birth centers across the US.  AABC and CABC are great with high-level standard recommendations, but no direct support for your unique business needs.  We love helping with that aspect of the planning process.  If you want help with getting your birth center going well in a day-to-day business operational sense, take our “How to Start a Successful Birth Center” course today!

How to Run a Successful Birth Center | Empowering Midwifery Education (teachable.com)

How to Run a Successful Birth Center