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What does Accreditation mean?

The Mark of Quality

The Commission for the Accreditation of Birth Centers (CABC) provides support, education, and accreditation to developing and existing freestanding birth centers and Alongside Midwifery Units.

The AABC Standards for Birth Center

CABC uses the standards of the American Association of Birth Centers (AABC) for freestanding birth center accreditation.

The standards used for freestanding birth center accreditation are reviewed and revised on a regular basis. A complete and current copy of the standards is available for purchase from the American Association Birth Centers (AABC).

Select one of the seven standards, to see some examples of what the CABC reviews during accreditation.

1. Philosophy and Scope of Service
  • The birth center respects the health care rights of all clients, including privacy and follows standard HIPAA practices.
  • The birth center providers practice midwifery and support the normal birth process, including:
    • careful screening for potential complications,
    • honoring the mother’s needs and desires throughout labor,
    • assisting the mother in managing pain,
    • paying close attention to the mother and baby’s status in labor.
  • Because they are not appropriate for use in normal labor, the birth center does not use certain interventions, such as:
    • vacuum extraction
    • medication to speed up labor
    • continuous electronic monitoring
    • epidural
  • The birth center has a specific plan for transferring to a hospital if complications arise before, during labor, or after birth, and interventions are required.
2. Planning, Governance and Administration
  • The birth center builds and maintains community ties, ensuring that it adapts to meet the changing needs of the community it serves.
  • A birth center that is part of a larger health system has adequate representation in the health system.
  • As an independent birth center, it has a governing body that meets regularly.
  • The birth center actively seeks feedback from birth center consumers.
  • The birth center follows generally accepted accounting principles.
  • The birth center takes measures to make sure it is fiscally responsible, including a plan to cover shortfalls.
  • The management of the birth center ensures continuity of leadership and quality of care.
3. Human Resources
  • Clinicians are licensed, as required by state and federal laws.
  • At least two staff members attending every birth are trained and certified in CPR and newborn resuscitation.
  • Staff members are trained according to the policies and procedures of the birth center.
  • The birth center keeps a schedule for clinical staff on call, to make sure that all shifts are covered, day and night, seven days a week.
  • The birth center conducts regular emergency drills, to make sure staff members are prepared to manage unexpected situations with laboring moms and newborns.
4. Facility, Equipment and Supplies
  • The birth center facility is inspected by state and local officials for building code requirements.
  • Medical equipment is inspected regularly by the birth center staff.
  • There are sufficient supplies on hand for the number of childbearing families served at the birth center.
  • If the state requires a birth center license, the birth center is licensed.
  • The birth center provides a safe and welcoming environment for all family members, including: small children, disabled partners, laboring women.
  • There are basic emergency medical supplies on hand for both mothers and babies.
  • The birth center has an emergency plan in the event of fire and natural disasters, and practices this plan on a regular basis.
5. The Health Record
  • The patient chart includes forms appropriate for use in a birth center, and clinicians use the chart to document patient care accordingly.
  • Use of the chart supports a full prenatal exam to ensure that all clients are low risk, and the birth center has a plan for transferring care as needed.
  • The birth center educates clients on self-care in pregnancy, including nutritional counseling, informed decision-making about pain relief in labor, and newborn care.
  • The birth center maintains a plan for transferring the patient chart to another facility if the mother or newborn needs to be transferred.
6. Research
  • If the birth center is involved in research, appropriate protocols are followed, including obtaining informed consent from participants.
7. Quality Evaluation and Improvement
  • The birth center reviews its practices and clinical outcomes on a regular basis to ensure that it follows its own policies.
  • The birth center actively seeks client feedback, and then evaluates and works to improve client satisfaction on a regular basis.
  • Birth center staff are evaluated on a regular basis to ensure competency and alignment with birth center policies.

CABC Alongside Midwifery Unit Standards and the Mother-Friendly Childbirth Initiative Criteria

The standards used for Alongside Midwifery Unit accreditation are reviewed and revised on a regular basis. A complete and current copy of the standards can be requested here.

Select one of the six standards, to see some examples of what the CABC reviews during accreditation.

1. Organization and Community
  • Midwives are integrated into the organization, including in leadership roles within the Alongside Midwifery Unit (AMU)
  • There is support for the facility and the principles of evidence-based, physiologic birth within the larger organization.
  • The rights and responsibilities of the mother and her family as she defines it are clearly delineated in the facility’s documents and are communicated to the childbearing family.
  • Care provided is culturally competent care that is sensitive and responsive to the specific beliefs, values, and customs of the laboring woman’s ethnicity and religion.
2. Model of Care
  • Care for normal labor, birth, and continuous risk screening is consistent with the best-available evidence for normal physiologic labor and birth, and with national standards for midwifery and birth center care.
  • An Alongside Midwifery Unit is a facility for normal, physiologic labor, birth, and immediate postpartum & neonatal course. Any condition or intervention that falls outside of this parameter requires transfer to an acute care obstetrical or neonatal unit.
3. Facility
  • Fire safety instruction and drills are provided for all personnel.
  • Birth rooms are homelike and non-institutional in appearance.
4. Equipment and Supplies
  • Facility has properly maintained equipment for the routine care of mothers and neonates in the physiologic model of care.
  • Equipment is available for routine care.
  • AMU has readily accessible equipment, supplies & medications to manage common maternal & newborn emergencies.
5. Health Record
  • Health records include all CABC required data elements
6. Continuous Quality Improvement
  • There is a formal, established program for evaluating the quality of care for childbearing families and the facility in which that care is provided.
  • The AMU has a system in place for the collection and analysis of both utilization and outcome data
  • There is a formal system in place for soliciting feedback from patients receiving care in the AMU
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