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Home Birth: Resources for Payers and Policymakers

The following resource outlines the research on home birth. This can be used by payers, policymakers, and others to support reimbursement and legislation supporting home birth.

ACNM supports a woman's right to choose home birth. Clinical practice must be guided by research. The scientific evidence strongly demonstrates that planned home birth under established selection criteria is a safe alternative to hospital birth. In the links below, we summarize this evidence, explore the drivers behind the home birth choice and recommend specific strategies to improve the continuity of care for the small proportion of women and families choosing home birth.

The Case for Expanded Access to Midwifery Care
Cost Effectiveness
Evidence-Based Practice
The National Business Group on Health's Investing in Maternal and Child Health names certified nurse-midwives and certified midwives first on the list of providers women should consider and recommends health plans develop CNM-friendly benefit design strategies that reduce the risks and costs of unnecessary medical interventions at birth.

"Employers incur the high costs of pregnancy-related healthcare. Pregnancy and neonatal services are often employers' highest claims. Increased utilization of high-cost diagnostics, increases in preterm birth and multifetal pregnancies, and high rates of cesarean delivery are making employers aware of the need to focus on pregnancy-related costs." - NGBH, Investing in Maternal and Child Health toolkit

The Home Birth Debate

In August 2008, former ACNM President Kitty Ernst responded to the American Medical Association and emphasized ACNM's strong support for a woman's right to choose her site of birth and voices strong opposition to AMA's call for greater physician oversight in midwifery.

Transforming Birth Fund Awards Grant to Convene Home Birth Summit in 2011

Letter to AMA on Resolutions 204 and 205

ACNM Urges Reversal of Aetna Anti-Home Birth Policy

Resources for Payers and Policymakers
About ACNM
Qualifications for Professional Midwifery Practice
Home Birth as a Rational, Personal Choice
Planned Home Birth Using Established Selection Criteria is a Safe Alternative to Hospital Birth
Disaster Preparedness Planning Must Include Provisions for Birthing in Place
Home Birth in the Context of Current Challenges facing the US Maternity Care System
Midwifery is an Autonomous Profession
ACNM's Policy Agenda to Expand Access to Midwifery Care

Additional ACNM Resources
Home Birth Position Statement
Clinical Bulletin: Criteria for Provision of Home Birth Services
Home Birth Handbook
Sample Letter to Insurance Companies for Home Birth Services
Division of Standards and Practice
(maintains a home birth section)

Other Resources
Home Birth - An Annotated Guide to the Literature (Updated 2013)

For further information, please contact the Department of Professional Practice & Health Policy.

American College of Nurse-Midwives
8403 Colesville Rd. Ste. 1550 Silver Spring, MD 20910
Phone: 240.485.1800 Fax: 240.485.1818
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