Birth Center Availability Declines Nationwide
With 10 states now lacking facilities, families should research birth options early in their pregnancy planning.
Updated on Oct. 27, 2026 in Pregnancy
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A new report from The Commonwealth Fund highlights significant gaps in access to birth centers across the United States. Currently, 10 states have no operating centers, and two dozen facilities have closed nationwide since 2023.
Why it matters
The decline in facilities stems from rising malpractice insurance costs, low Medicaid reimbursement rates, and complex state regulations. For families, these closures limit childbirth options and may increase reliance on hospital-based care for those seeking midwifery-led models.
Nationwide, 10 states have zero birth centers and eight states have only one, while approximately 1% of deliveries occur in these facilities. About 40% of patients pay out of pocket, highlighting the financial hurdles that contribute to recent closures.
The players
The Commonwealth Fund
A private foundation that promotes a high-performing health care system through research and analysis of national health policy.
The details
Birth centers operate under midwifery models and often maintain formal referral relationships with local hospitals to ensure safety. These centers occasionally function under the financial and regulatory umbrella of community health centers to mitigate high overhead. However, many facilities struggle to remain open due to systemic pressures including strict state regulations and high malpractice insurance premiums.
Timeline
Two dozen birth centers closed nationwide between 2023 and 2026.
The Commonwealth Fund released its report on October 27, 2026.
The Home Front
The widespread closure of birth centers marks a departure from trends aimed at diversifying maternal care options as part of broader efforts like the Maternal Mortality Prevention Act. This reduction in accessible facilities forces more families to rely on traditional hospital systems.
If you are planning your birth logistics, contact local hospital midwifery programs early to understand the capacity and availability of care in your state. Review your health insurance policy to confirm whether your preferred facility is in-network and to estimate out-of-pocket costs.
The takeaway
The tightening availability of birth centers makes early research into local care options essential for expecting families. Consider identifying a secondary delivery location if your preferred birth center is in a state with limited access or faces financial uncertainty.
Further reading
For more information on family health options, visit the Pregnancy section.
Source note: This article includes information reported by NC Newsline.
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Should your local community expand access to birth centers for low-risk pregnancies?
