Why Collaborative Maternity Care Makes Birth Safer for Everyone

Collaboration in birth work is a critical strategy for families and for those of us called to serve them.

When the room reflects the community

Last week I had the privilege of sitting in a Bronx sanctuary watching “You Are Not Alone,” a short film that lays bare what it means to give birth in the Bronx. In the same room were OBs, midwives, doulas, clients, community members and advocates, all gathered under the banner “And Still We Birth” for a film screening, panel discussion and book signings with Dr. Janet A. Williams (a retired midwife) and Dr. Jennifer Lincoln (An OB/GYN). I was there representing March for Midwives and cheering on Birth Center Equity’s Beloved Birth 50 by 50 campaign, which dares to imagine a future where half of all U.S. births happen with midwifery care by 2050.

What struck me wasn’t just the film; it was the mix of people. We were side by side, listening to stories of loss, resilience and systemic failure, and then talking honestly about what needs to change.

A radical model of hospital humility

During the panel, Dr. Jennifer Lincoln shared something I had never heard before. At the hospital where she practices on the West Coast, they routinely invite OBs, midwives, doulas and community members into one room to have structured, respectful conversations about births that happen in their hospital and how care can be improved. It is not a performative listening session; it is ongoing quality improvement that treats community voices as essential data.

I found myself wondering: where else is this happening, especially on the East Coast? If you have seen models like this—regular, facilitated debriefs that include hospital staff, community providers and families—I want to know about them! Because this is what humility in healthcare looks like: opening doors and asking, “How can we do better together?”

What Collaborative Maternity Care Could Look Like in Real Life

Too often, the relationships between birth stakeholders are defined by tension: OBs versus midwives, hospitals versus doulas, EMS versus homebirth midwives. Those fault lines are real, and they are reinforced by policy, liability concerns and culture. But they are not inevitable.

Here are some ways we can intentionally build a culture of collaboration instead of combativeness:

• Shared education in physiologic birth. Imagine if OBs and midwives trained together in evidence-based, physiologic birth, led by experienced community midwives as well as hospital clinicians. When providers learn in the same rooms, using the same language and data, trust has a chance to grow. Joint trainings also surface the different constraints each provider faces—staffing, liability, reimbursement—which can shift conversations from blame to problem-solving.

• Required exposure to out-of-hospital birth. I believe OBs, PAs, EMS, and L&D nurses should all have meaningful exposure to community birth settings—birth centers and planned home births with qualified midwives. There is a persistent myth that hospital equals safe and anything outside is reckless, a myth often held most tightly by those who have never witnessed high-quality community birth. Things can go beautifully or go sideways in any setting; our collective job is to get people to the right level of care at the right time, with their understanding and consent.

• Bidirectional relationships, not one-way transfers. Transfers from home or birth centers to hospitals should not be treated as failures or betrayals. They should be seen as part of a continuum of care that honors client choice and clinical realities. That requires formal relationships, clear protocols and mutual respect between community midwives and hospital teams, ideally co-created at tables where everyone has a voice.

I say this as someone who has worked in all three environments—hospital, home birth, and birth centers—and who has birthed both in hospital and at home with midwives. My colleagues who only see the worst few percent of cases in a busy hospital understandably carry fear; it colors how they view birth outside the hospital. Exposure and relationship-building are the antidotes to that fear.

Example collaboration steps

Practice change	Who’s involved	What it can look like
Joint physiologic birth workshops	OBs, CNMs/CPMs, nurses	Quarterly in-person trainings with shared case reviews and simulation.
Community birth observation days	OB residents, EMS, PAs, nurses	Shadow shifts at birth centers or with homebirth midwives.
Structured community-hospital debriefs	Hospital leadership, midwives, doulas, community members	Monthly meetings reviewing births and transfers with psychological safety agreements.
Shared transfer protocols	Hospitals and community midwives	Co-written guidelines covering communication, documentation and client handoffs.

Collaboration is a strategy for safer birth

At the end of the day, every one of us—whether we wear scrubs, a birth center T‑shirt, or carry a doula bag—shares the same goal: safer births, not only physically but psychologically. The U.S. maternal health crisis demands that we stop spending our energy fighting each other and start beating the system that harms families and burns out providers.

Events like “And Still We Birth” show what’s possible when we intentionally bring everyone into the same room, anchor in real stories, and ask hard questions together. We need more of them: in hospitals, in birth centers, in community spaces and online. If you are in a position to host or support this kind of gathering, consider this your nudge.

People and projects to know

One of my favorite parts of the evening was meeting people whose work embodies this collaborative maternity care spirit. Bronx Bound Books came to sell Dr. Jennifer Lincoln’s “The Birth Book,” which breaks down labor and delivery in accessible language and is designed to demystify birth for families and clinicians alike. I was lucky enough to win a copy and cannot wait to dig in. Bronx Bound Books has a gorgeous mobile library—a full bookstore on wheels—and travels to schools and all sorts of events. Please check them out!

I also briefly met Ashley Spivey, who shared her powerful story and her advocacy with PUSH for Empowered Pregnancy, which works to secure paid leave for families who experience stillbirth and to prevent preventable stillbirths through education and policy. I connected in person with Flor and her daughter after first meeting them on Zoom, and I was excited to see Chelsea White, a doula featured in the documentary whose presence and energy clearly make a difference for the families she serves.

All of these visions require policy change, financing, workforce development and culture change. It also requires addressing barriers here in New York, like the lack of a pathway for CPMs to practice, which directly affects staffing for birth centers and homebirth practices.

If you have a story about why midwifery matters, why CPM licensure in New York, midwives not requiring an MD to practice in NJ (or another change in your state) would impact your family or your work, I invite you to share it on the March for Midwives platform. When we collect stories at scale, they become data and leverage—tools we can bring to legislators and the public to move from individual frustration to collective action.

Because collaboration isn’t just about sitting on panels together. It’s about aligning our voices, our stories and our strategies so that the families we serve can birth in safety, dignity and love—wherever they choose to bring their babies earthside.