Birth Center Access Declines Across United States

Ten states now lack birth centers as financial challenges drive closures for facilities serving expectant families.

Updated on Oct. 27, 2026 in Pregnancy

Birth Center Access Declines Across United States

Live Poll

Should your local community expand access to birth centers for low-risk pregnancies?

A new report from The Commonwealth Fund highlights significant gaps in birth center availability, noting that 10 states currently have no operating facilities. While birth centers provide care for about 1% of U.S. births, two dozen centers closed nationwide between 2023 and 2026.

Why it matters

Financial hurdles, including low Medicaid reimbursement rates and rising malpractice insurance costs, have led to numerous closures. This limits access for expectant parents who may prefer midwifery-led care as an alternative to traditional hospital-based delivery settings.

The Commonwealth Fund report reveals that two dozen birth centers closed from 2023 to 2026, leaving 10 states without any facilities. Nationally, only 1% of births occur in these settings, with current patient demographics skewed toward non-Hispanic white individuals.

The players

The Commonwealth Fund

A private foundation that supports independent research on health care issues and promotes a high-performing health care system.

The details

Birth centers generally provide prenatal and delivery care using a midwifery model, which often includes referral relationships with hospitals for emergencies. Some centers operate under the regulatory or financial structure of community health centers to help manage high overhead. However, restrictive state regulations and the high cost of malpractice insurance continue to create significant operational challenges for many facilities.

Two dozen birth centers closed nationwide between 2023 and 2026.
The Commonwealth Fund released its report on October 27, 2026.

Health Landscape

The availability of birth centers is increasingly dictated by public policy and reimbursement frameworks, such as Medicaid, which often fail to cover the full costs of this specialized care model. This trend marks a shift away from diverse delivery options, narrowing the landscape of available prenatal and birth resources.

If you are considering a birth center for your care, verify the facility's standing and relationship with nearby hospitals during your early consultations. Since 40% of patients currently pay out of pocket, it is important to confirm insurance coverage details early in your pregnancy.

The takeaway

Birth centers offer a specific midwifery-based model, but their presence remains geographically limited due to ongoing financial and regulatory pressures. Discuss your birth preferences with an OB-GYN or midwife to understand the safest, most accessible options available in your specific community.