{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T18:23:45Z","timestamp":1788805425940,"version":"build-2803163510"},"reference-count":49,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,1,30]],"date-time":"2013-01-30T00:00:00Z","timestamp":1359504000000},"content-version":"vor","delay-in-days":29,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Midwife Womens Health"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> The safety and effectiveness of birth center care have been demonstrated in previous studies, including the National Birth Center Study and the San Diego Birth Center Study. This study examines outcomes of birth center care in the present maternity care environment.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> This was a prospective cohort study of women receiving care in 79 midwifery\u2010led birth centers in 33 US states from 2007 to 2010. Data were entered into the American Association of Birth Centers Uniform Data Set after obtaining informed consent. Analysis was by intention to treat, with descriptive statistics calculated for maternal and neonatal outcomes for all women presenting to birth centers in labor including those requiring transfer to hospital care.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Of 15,574 women who planned and were eligible for birth center birth at the onset of labor, 84% gave birth at the birth center. Four percent were transferred to a hospital prior to birth center admission, and 12% were transferred in labor after admission. Regardless of where they gave birth, 93% of women had a spontaneous vaginal birth, 1% an assisted vaginal birth, and 6% a cesarean birth. Of women giving birth in the birth center, 2.4% required transfer postpartum, whereas 2.6% of newborns were transferred after birth. Most transfers were nonemergent, with 1.9% of mothers or newborns requiring emergent transfer during labor or after birth. There were no maternal deaths. The intrapartum fetal mortality rate for women admitted to the birth center in labor was 0.47\/1000. The neonatal mortality rate was 0.40\/1000 excluding anomalies.<\/jats:p><jats:p><jats:bold>Discussion:<\/jats:bold> This study demonstrates the safety of the midwifery\u2010led birth center model of collaborative care as well as continued low obstetric intervention rates, similar to previous studies of birth center care. These findings are particularly remarkable in an era characterized by increases in obstetric intervention and cesarean birth nationwide.<\/jats:p>","DOI":"10.1111\/jmwh.12003","type":"journal-article","created":{"date-parts":[[2013,1,30]],"date-time":"2013-01-30T22:54:55Z","timestamp":1359586495000},"page":"3-14","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":174,"title":["Outcomes of Care in Birth Centers: Demonstration of a Durable Model"],"prefix":"10.1111","volume":"58","author":[{"given":"Susan Rutledge","family":"Stapleton","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara","family":"Osborne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Illuzzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,1,30]]},"reference":[{"key":"e_1_2_9_2_2","volume-title":"National Health Expenditure Data","author":"Centers for Medicare and Medicaid Services","year":"2012"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2011.0662"},{"key":"e_1_2_9_4_2","volume-title":"Hospitalizations Related to Childbirth, 2008","author":"Podulka J.","year":"2011"},{"key":"e_1_2_9_5_2","volume-title":"HCUP Facts and Figures: Statistics on Hospital\u2010Based Care in the United States, 2009","author":"Wier LM","year":"2011"},{"key":"e_1_2_9_6_2","volume-title":"The National Hospital Bill: The Most Expensive Conditions by Payer, 2008","author":"Wier LM","year":"2011"},{"key":"e_1_2_9_7_2","volume-title":"2010 Comparative Price Report: Medical and Hospital Fees by Country","author":"International Federation of Health Plans","year":"2012"},{"key":"e_1_2_9_8_2","volume-title":"World Health Statistics 2010","author":"World Health Organization","year":"2011"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.31478\/201206e"},{"key":"e_1_2_9_10_2","unstructured":"Patient Protection and Affordable Care Act. 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