The Problems Everyone Sees...
And Has Been Trying To Fix For Decades
Birth Centers should be expanding rapidly. Instead, they're struggling with the same broken systems year after year.
Workforce Crisis
We can't find midwives to staff centers, but we're offering low pay, high stress, and crushing debt for the privilege.
Equity Failures
"Accessible" care that's only accessible to communities that already have options.
Insurance Madness
Better outcomes + lower costs = higher premiums. Because that makes perfect sense.
Liability Costs
Lower risk providers paying higher insurance premiums. The math doesn't compute.
Systemic Dysfunction
All these problems are connected - and they're all at the systems level.
Make This Make Sense Series
This series is a valuable education tool for those unfamiliar with the ongoing struggles birth centers face. Help by being a part of the solution.
Episode 5: Solutions Edition
Every problem has a solution. Here's how we fix the system.
The Solutions
The "Make This Make Sense" series exposed the broken systems plaguing birth centers—but every problem has a solution. While we're past Birth Center Week, these episodes remain crucial educational tools for understanding the challenges we face and the path forward.
Real Solutions to Real Problems
Workforce Crisis → Federal loan forgiveness programs + expanded regional education access
Insurance Problems → Coverage parity mandates + risk-based pricing reform
Equity Failures → Mobile birth center programs + community health worker integration
Liability Costs → Industry risk pools + federal backup coverage programs
The Missing Piece: Your Voice
This community of birth centers and midwives have already driven significant policy wins in 2025 alone—the BABIES Act reintroduction, the Midwives for MOMS Act funding, and expanded TRICARE coverage through the MIDWIVES for Service Members Act, and continued momentum behind the Momnibus legislation package. But policy reform needs public awareness to succeed.
The solution isn't accepting the status quo—it's getting more people to understand why the status quo is unacceptable.
Take Action This Week
If you’re new to these issues, start small but take action:
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Write to Congress (use ACNM’s Action Center for ready-to-send scripts)
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Volunteer with a community-based organization
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Support a local Birth Center with your time
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Seek prenatal and well-woman care at a birth center
The more insurance commissioners and legislators hear from the public, the more momentum we build for change.
If you are a birth center: choose one barrier that impacts you most. Don’t just work around it—identify who has the power to fix it, then reach out.
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Insurance denying coverage? Call your state insurance commissioner + legislators.
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Workforce shortages? Contact midwifery education programs + congressional reps.
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Equity gaps? Partner with community health centers + transportation services.
Ready to Implement Change?
Running a birth center is exhausting enough without fighting broken systems alone. If you have ideas for your birth center and want help implementing actual solutions—not workarounds—let's strategize together.
Schedule a consultation to find a path forward that makes sense for you, your team, and your birth center.
About
I'm Lauren McCullough - a labor and delivery nurse, operations expert, and birth center consultant who's spent over a decade in the maternal health system. As someone who helped a New York birth center achieve CABC accreditation and navigate complex regulatory landscapes, I've seen brilliant birth centers fail not because of their care, but because of systemic barriers. From insurance companies that penalize better outcomes to "community" care that's only available in affluent neighborhoods, I'm ready to see the change so many have worked for.
Birth Centers have great outcome statistics and relatively low costs compared to hospitals and they could be the answer to many of our nation's maternal health problems - so why are they struggling to expand and serve the communities that need them most?
This series calls out every absurd contradiction in our industry and provides real solutions that work while pushing for the changes we desperately need.
Because celebrating birth centers is nice. But fixing the systems around them... That's better.
