About the CABC - Commission for the Accreditation of Birth Centers

The Commission for the Accreditation of Birth Centers is:

The only accrediting organization dedicated exclusively to the quality of the operation and services of all birth centers regardless of ownership, primary care provider, location, or population served.
An independent not-for-profit organization that accredits developing and existing freestanding birth centers and Alongside Midwifery Units in the United States of America, according to established national standards for birth centers.

In 1985, the first national Standards for Birth Centers were published and the Commission for Accreditation of Birth Centers (CABC) was founded by the trade association for birth centers, now called the American Association of Birth Centers (AABC). The Standards for Birth Centers were unanimously adopted by the trade association members. Here is an excerpt from the introduction section of this landmark document:

“Quality assurance is an evaluation function that is both external and internal to the birth center. Licensure and accreditation constitute two arms of external quality assurance. Licensing agencies are officially charged by the federal, state or local governments to protect the public and monitor safety through codes, ordinances and a variety of regulations. This first level of external quality control requires that the birth center meet defined criteria for licensure in order to operate as a business or health care facility. But the level of quality required for licensure may vary from one locality to another. Some states and municipalities are non-specific or uneven in their requirements for regulations while other states may be very specific and uniform in the level of requirements for safe operation.

A second level of external quality assurance is a national program of accreditation. Standards and attributes for accreditation are uniformly applied in all localities, thereby eliminating state and local inconsistency. It is a voluntary program that places the level of quality desired above that which the state may require.

Internal quality assurance begins at the earliest stages of planning of the birth center and comprises a systems approach to evaluation of operation and services. Like all new health care facilities, the birth center has the opportunity to build evaluation mechanisms into all facets of the organization and operation. If attention is given to establishing a strong program of quality assurance in planning the freestanding birth center, application for licensure and accreditation are simply a form of external review--an opportunity to be evaluated or measured by established yardsticks for required and desired levels of excellence.”

The first publication of the Standards for Birth Centers was the culmination of nationwide efforts by birth center founders and stake holders since 1975, including the demonstration Childbearing Center by Maternity Center Association (MCA) of New York. MCA’s demonstration project included:

Identification of criteria for low-risk pregnancy and birth.
Development of policies and procedures for operation of a birth center as a place for the midwifery model of care, and connected to the existing system of health care.
Design of record forms including an extensive informed consent.
A health record that reflects the care provided and the instruction of clients on health relating to pregnancy, birth and early parenting.
Evaluation mechanisms for all aspects of the program offered.

The young trade association compiled all the available data about birth centers and the needs of stakeholders to:

Developing the first national Standards for Birth Centers to reflect the midwifery model of care.
Set up a standing board committee to ensure the currency of these standards, first led by AABC board member, Charles Mahan, MD, FACOG (a proven advocate for midwifery)
Conducting a two-year pilot program to develop and test the optimum mechanism for evaluating:
- the quality of care in birth centers
- the birth centers’ compliance with established standards

CABC was formed under the trade association to:

evaluate the quality of birth center services
promote the development of national guidelines for licensure
review state regulations for birth centers
explore and evaluate the programs of other accrediting agencies
support the expensive process of accreditation with resources from the trade association

The first CABC Board of Commissioners, was led by Eunice Cole RN, immediate past President of the American Nurses Association, and also included nurse-midwives, obstetricians, a pediatrician, and a representative of the public. The recruited Advisory Council to CABC was in place until 1988 and included representatives from a broad group of stakeholders and experts, including birth centers, midwifery, obstetrics, neonatology, nursing, public health, birth center parents, Vice President of the Health Insurance Association of America, President of Pennsylvania Hospital who was also a Commissioner for JCAH, and a Federal policy maker. Designed as a peer review process, birth center midwives and administrators volunteered to train and serve as CABC site visitors and continued to do so up to the end of September 2014, when CABC hired staff to fulfill this role.

The CABC incorporated as a separate 501c3 on January 1, 2002 in Pennsylvania.

For 29 years, Commission for the Accreditation of Birth Centers conducted accreditation reviews with volunteer board members and site visitors, relying on the good judgement of its most senior birth center experts and the best available evidence for guidance on challenging issues. In 2013, CABC had 55 currently accredited birth centers and hired its first executive director to help the organization grow responsibly and face the challenges of managed growth. Here are highlights of the growth since then:

October 2014 – CABC began conducting site visits with Accreditation Specialists, who are uniquely trained to conduct site visits using the CABC Indicators for Compliance with the Standards for Birth Centers. The first Accreditation Specialists were hired from its former volunteer corps.
February 2015 – CABC is mentioned in and endorsed the American College of Obstetrics & Gynecology and the Society for Maternal & Fetal Medicine Consensus Statement Obstetric Care Consensus on the Levels of Maternal Care.
September 2015 – CABC published its first Reference Edition of the Indicators for Compliance with the Standards for Birth Centers, which revealed CABC’s requirements for accreditation, listed unacceptable practices, and included a glossary of terms, linked index, and reference citations.
January 2016 – CABC reached the milestone of 100 currently accredited birth centers.
May 2018 – CABC initiates pilot program for Alongside Midwifery Unit accreditation.

Today, the process of accreditation is continually reviewed and revised to assure that the program continues to:

evaluate the criteria for accreditation based on the best available evidence for maternity care
provide for the highest level of quality improvement
meet the needs of applicant birth centers

Click to learn about the Relationship between CABC and AABC

COMMISSIONERS

ACCREDITATION SPECIALISTS

ADMINISTRATIVE STAFF

Meet the Board of Commissioners

The Board of Commissioners are professionals in midwifery, obstetrics, nursing, family practice, pediatrics, health care administration, neonatology, and public health.

Maria Petrie, MHIT, BSN, RN Chair

Supporting birthing families as a doula, childbirth educator and a Registered Nurse/Birth Assistant at two CABC-Accredited birth centers
Cybersecurity Account Manager for Commercial Health and Life Sciences at Booz Allen Hamilton
BSN, Medical University of South Carolina; BS in International Affairs and Modern Languages, Georgia Institute of Technology
Master’s in Healthcare Information Technology from University of South Carolina

Emily Hayes, MHA, RNC-OB/EFM Vice Chair

Nurse Manager, Family Beginnings Birth Center, Labor & Delivery, Miami Valley Hospital (Dayton, OH)
EPIC analyst, certified in OpTime and Stork
MHA, University of Cincinnati

Moira Richards, MD Treasurer

Medical Director of Neonatal Specialists (Mednax)
Medical Director of NICU at Tucson Medical Center for Children, Tucson, AZ
Graduate University of Minnesota Medical School; Residency at Phoenix Hospitals Affiliated Pediatric Program

Sandra Lawrence, Secretary

Consumer Representative for CABC Board of Commissioners
Midwifery and Birth Center advocate
Experience as Administrative Staff Member at Geneva Woods Birth Center

Janelle Bandurraga-Rice, LDM, CPM

Clinical Director of Alma Midwifery in Portland, OR
Graduate of Birthingway College of Midwifery

Lauren Braswell, CNM

Staff midwife at Lifestages Centers for Women at Miami Valley Hospital North Campus in Englewood, OH
Master of Science in Midwifery University of Cincinnati
Bachelor of Science in Nursing Georgia State University

Jennifer Fardink, BSM, CPM-TN, LCPM

Co-owner of Clarksville Midwifery, Clarksville, TN
Graduate of Midwives College of Utah with a Bachelor’s of Science in Midwifery
Graduate of Association of Texas Midwives Training Program

Kara Peterson, MSN, CNM, FNP-C

Family Nurse Practitioner-Pittsburgh Mercy Family Health Center in Pittsburgh PA
Midwife-19 years serving families at The Midwife Center for Birth and Women’s Health, a non-profit, independent, free-standing birth center in Pittsburgh, Pennsylvania 2004-2023
MSN/CNM, Frontier School of Midwifery and Family Nursing
FNP, Post Master’s Certificate -University of Cincinnati

Kaleen Richards, CNM, ARNP, FACNM

Founder/Owner and Director of CABC-accredited Tree of Life Birth & Gynecology
Master of Science in Nursing from Frontier School of Midwifery & Family Nursing
President Florida Alliance of Birth Centers, member of the AABC Government Affairs Committee, and ACNM Florida Legislative Delegate

Erin Stein, MSN, CNM, WHNP-BC

Staff midwife at Novant Health Presbyterian Medical Center in Charlotte, NC
Former Director of Clinical Services at CABC-accredited Charleston Birth Place and full-time CNM there since 2014
Master of Science in Nursing from Case Western Reserve University – Frances Payne Bolton School of Nursing

Mark B. Woodland, MS, MD, FACOG

Previous Chair, Department of OBGYN, Reading Hospital/Tower Health (Reading, PA);
Clinical Professor of Obstetrics and Gynecology, Drexel University College of Medicine (Philadelphia, PA)
Board certified in Obstetrics and Gynecology
Graduate of George Washington University School of Medicine (Washington, DC)

Site Visits conducted by Accreditation Specialists are an integral part of the accreditation process. CABC Accreditation Specialists all have (or have had) involvement with substantial administrative and clinical duties in CABC-accredited birth centers and extensive clinical training in healthcare. The role of the Accreditation Specialist is to collect data, verify the Self-Evaluation Reports submitted by birth centers, and submit their findings to the Review Panel. Accreditation Specialists work as a team to ensure consistency and breadth of perspective in applying the Standards.

Meet the CABC Accreditation Specialists

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Deb Alessandro

Who doesn’t want a job that feels like family? That’s exactly what Deb found once she began working in a birth center. Witnessing the strength and empowerment of the birth experience, especially among women who had trauma or feelings of self-doubt, has been an ongoing source of inspiration to her. Deb enjoys sewing and quilting, and her hidden talents include dancing (alone – so no one will have to experience that vision) and singing (with grandchildren, at the top of their lungs, always).

Pam Bartlett

The homelike environment and focus on mom and baby are what first drew Pam to work at a birth center where she could support women and their families in the natural birth process. Pam loves making plans and policy (where both her creative and engineering sides show) and will try anything once. She is the mother of five athletes and the wife of a coach. You won’t find this self-described klutz on any court or field, though. She would much rather be traveling or listening to Rock music.

Kristi Cunningham

Kristi is a Licensed Midwife with over 25 years of out of hospital birth experience, and nine years as a Free-Standing birth center owner. The combination of learning from a traditional home birth midwife and an apprenticeship in 1999, helped curate her balanced approach to supporting birthing families. She moved to Jamaica shortly after becoming a CPM in 2001, where she had a home birth practice and attended births at the waterbirth center in Oracabessa. Her work in Jamaica led to a collaboration with midwives in the Casamance region of Senegal, and the support of the French translation of “A Book For Midwives” which was donated and dispersed across Western Africa. She Co-founded a birth center in Mendocino County, California, in 2015 where she was the Director for nine years.

Marcia Ensminger

A passion for shared decision making is what led Marcia to become a midwife and open a birth center, where she could offer alternative birthing options to her community. In her spare time, she enjoys traveling. Tropical locations are at the top of her list. When she is not able to travel, reading fiction or binge watching the latest Netflix series occupies her free time. She has two grown children who are slightly jealous of the attention her hairless dog, Gaby, receives.

Elizabeth Fontenot

Elizabeth was drawn to midwifery and birth center care by the emphasis on natural, physiologic, undisturbed birth and all that is born out of that process. She appreciates the birth center setting and the emphasis on education and shared decision making. A native of the deep South, she lives with her husband, four children, and one crazy dog. None of her four births went the way she expected, from an unplanned c-section to an unplanned home birth! When she’s not carting her children around town or recovering from a busy call shift, she may be found propagating plants, redecorating her house, or enjoying the outdoors.

Cheryl “Sherry” Hartenbower

Sherry was introduced to birth center care as a student when she spent her last semester at a birth center in Georgia. “From the moment I walked in the doors of the Birth Center and was greeted, I knew I was home.” She is certified as a Parent Educator and Aware Practitioner, has studied Spinning Babies and the Body Ready Method, and has used those skills to “help pregnant people have more comfortable pregnancies, easier labors, and better postpartum recoveries.” “I love to quilt, hike, flower, and spend time with my grandchildren. My husband and I look forward to new adventures traveling in our RV.”

Gazelle Lange

Gazelle became a midwife almost before she knew it was happening. Part of the Ina May generation, her beautiful home birth inspired her to help other women searching for that same experience. Throughout her 40 years as a midwife, she has loved helping women through pregnancy and childbirth. Gazelle is an avid gardener and enjoys making pickles and fermented products, and putting up produce. She appreciates good ice cream and enjoys drinking craft beer while playing cribbage with her husband.

Susan Melnikow

Susan has devoted forty years to being a maternal-child change agent, spanning a variety of roles including doula, RN, midwife, teacher and administrator in a variety of settings in four states. She is committed to facilitating undisturbed, physiologic birth, after the experience of birthing her own daughter at home, and approaches pregnancy and birth as a sacred event. Susan is a true “child of the 60’s,” having grown up in Oakland/Berkeley during that era, and derives great pleasure from the study of indigenous, earth-based ways of life, loves to spend time in nature, and enjoys cooking a good meal.

Julie Moon

Julie knew as soon as she was exposed to the birth center model that it was what she had been searching for to help serve and empower families through the birthing process. As she has expanded that to traveling and teaching at birth centers she has found that we all have so much to share with each other to be stronger and better, and that has become her passion. Julie lives in rural Alaska with her husband and three children, where they grow/raise/fish and hunt most of their food, and enjoy traveling and exploring the glorious world they live in. Julie is happiest on the water, in the kitchen with her children, and anywhere new and exciting things are happening.

Elizabeth Smith

Elizabeth has served Sonoma County families for more than 25 years and advocates for all types of families to receive equitable, midwifery-led care both in and out of the hospital. She is mom to four amazing children. Elizabeth loves to eat, but hates to cook and thinks dessert is the best part of a meal! In her free time, she likes to knit and crochet.

Additional Accreditation Specialists may be added as needed.

Meet the CABC Administrative Staff

Michele DeAngelo, Executive Director

Michele began her career at a birth center where she wore lots of different hats. This paved the way for her work at CABC, first as the Operations Manager, before being promoted to Executive Director. Michele lives with her husband, two exuberant dogs, and three daughters who were brought into the world with the help of midwives. When she’s not overseeing the daily activities of CABC, Michele enjoys spending time outdoors with her family.

Cassandra Turoczi, Operations Manager

Cassandra brings over 20 years of managerial expertise across diverse sectors, including SAAS, Healthcare, and Automotive. Her passion for impacting lives led her to CABC, driven by its mission to empower families with informed healthcare choices. Outside of work, Cassandra cherishes moments with her daughter, indulges in family activities, savors the outdoors, and explores new destinations through travel.

Susan Stapleton, CNM, DNP, FACNM, Communications Coordinator

After a long career providing full-scope midwifery care in multiple locations, Susan is now focusing on her two professional loves for which there was little time before – research and writing. Susan has a long history with CABC and is glad to be serving the organization in a new way. Her other time is filled with family – especially grandchildren, travel to parts of the world that broaden her view of the world, and spending time outdoors in her adopted state of Maine.

Abbie Synan, Administrative Assistant

Early on, Abbie was a birth center volunteer before evolving to Administrative Director of a freestanding birth center in Pennsylvania for over seven years. Additionally, she has worked as a billing consultant, assisting birth centers and solo practitioners, since 2012. Before joining the CABC administrative team, Abbie’s involvement with the CABC began as a Board member. She also participates on the Board of the American Association of Birth Centers Foundation. Aside from her work within the birth center world, Abbie is also a freelance writer and avid traveler.

The Commission for the Accreditation of Birth Centers is:

History & Purpose

Our Dedicated Leadership & Staff

Meet the Board of Commissioners

Meet the CABC Accreditation Specialists

Meet the CABC Administrative Staff