Prenatal care in US birth centers: Midwives' perceptions of contributors to birthing People's confidence in physiologic birth

Carrie E. Neerland, Stephanie L. Delkoski, Arielle E. Skalisky, Melissa D. Avery

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objective: The purpose of this study was to describe US freestanding birth center models of prenatal care and to examine how the components of this care contribute to birthing people's confidence in their ability to have a physiologic birth. Design: This was a qualitative descriptive study utilizing semi-structured interviews with birth center midwives. Data were analyzed using thematic analysis, constant comparative method and consensus coding to ensure rigor. Setting and Participants: Midwives from six urban and rural freestanding birth centers in a Midwestern US state were interviewed. Twelve birth center midwives participated. Findings: Six themes emerged: the birth center physical space and organization of care, dimensions of midwifery care within the birth center, continuity of care and seamless service, the empowered birthing person, physiologic birth as normative, and the hospital paradigm and US cultures of birth. Key Conclusions: We identified significant components of birth center models of prenatal care that midwives believe enhance birthing people's confidence for physiologic childbirth. These components may be considered for application to other settings and may improve perinatal care and outcomes.

Original languageEnglish (US)
Pages (from-to)535-545
Number of pages11
Issue number3
StatePublished - Sep 2023

Bibliographical note

Funding Information:
Research reported in this manuscript was supported by the American Association of Birth Centers Foundation.

Publisher Copyright:
© 2022 The Authors. Birth published by Wiley Periodicals LLC.


  • birth center
  • continuity of care
  • culturally congruent care
  • medicalization
  • midwifery
  • physiologic birth
  • prenatal care

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't


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