ABSTRACT
This chapter demonstrates a public policy that can be embraced without facing trade-offs: a proposal to increase access to professional midwifery care at home or in birth centers in the United States. Successful implementation of a national policy in the United States to increase rates of homebirth would be facilitated by at least tacit support from the national obstetric and public health communities. The chapter discusses the statements of the American Public Health Association and the American College of Obstetricians and Gynecologists (ACOG) on community birth since the 1970s. Most of the international studies that ACOG condones have been carried out in countries where midwifery is an autonomous profession distinct from medicine and nursing, and there is public compensation for attendance at community births through the health care system. The time seems ripe both to recognize the weight of literature on community birth in the United States and to better integrate American midwives who can offer options for birth settings.
