History

Since 1918, Childbirth Connection (known as Maternity Center Association until 2005) has worked on behalf of childbearing women, newborns and families to improve the quality of maternity care through research, education, advocacy and demonstration of maternity innovations.

Throughout the 20th century, we helped demonstrate, evaluate and spread many forms of care that have become basic elements of the current maternity care system, including maternity nursing, nurse-midwifery education, parenting and childbirth education, care in freestanding birth centers and collaborative practice. We also pioneered public education about pregnancy and birth.

Since 2000, we have worked with childbearing women, health professionals, policymakers and journalists to promote evidence-based maternity care. We are active in improving maternity care through policy and quality initiatives and through clinical effectiveness activities (e.g., systematic reviews, performance measures, decision aids and clinical practice guidelines). We give voice to the experiences and perspectives of childbearing women through periodic national “Listening to Mothers” surveys.

Below is a timeline highlighting selected accomplishments of Maternity Center Association (MCA) and Childbirth Connection.

1918

• Administered pilot project to provide comprehensive maternity care to underserved women through Maternity Centers in New York City neighborhoods; high-quality maternity care and education led to significant reductions in maternal and infant death.
• Developed first classes for expectant parents as part of comprehensive maternity services.

1920

• Distributed “Maternity Center Handbook” to the public and to voluntary health agencies throughout the United States, describing in detail MCA’s model of maternity care.

1929

• Began Maternity Institutes to educate public health nurses across the country; programs at dozens of local sites reached about half of the estimated 20,000 public health nurses in the country, as well as many nursing students and public health nurses in Canada.

1931

• Established first U.S. school of nurse-midwifery in New York City.
• Launched nationwide educational campaign on Mother's Day to inform the public about the vital importance of maternity care.

1935

• Revised charter to extend scope of operations from New York City to the entire country.

1938

• Began offering a series of well-received classes for fathers; subsequently printed and distributed the syllabus to support classes for fathers across the country.

1939

• Sponsored major exhibit of sculptures of the childbirth process presented by Robert Latou Dickinson and Abram Belskie at the 1939-40 World's Fair. These images illustrated the “Birth Atlas” (first edition 1940), still used today by health educators worldwide.

1942

• Published anatomical teaching charts showing changes in mothers' bodies throughout the childbearing process and fetal development; this series is still in use as the “Growing Uterus” chart set and guide. The images are available here.

1947

• Arranged for Dr. Grantly Dick-Read, author of “Childbirth Without Fear,” to visit the United States and address public and professional audiences on prepared childbirth.

1948

• Supported evaluation of natural childbirth at Yale University under the direction of Dr. Herbert Thoms, with favorable results about the process, outcome and satisfaction with labor among more than 1,000 women.

1949

• Conducted a national survey on the cost of maternity care in collaboration with the American Institute of Public Opinion.

1954

• Supported establishment of American College of Nurse-Midwifery (now the American College of Nurse-Midwives).
• Produced first nationwide television series on childbearing in association with NBC-TV's “Home Show.”

1958

• Maternity Center Association moved its nurse-midwifery school to Kings County Hospital in partnership with the State University of New York, establishing the first Nurse-Midwifery Program at a major municipal hospital.

1959

• Produced “From Generation to Generation,” the first major film on family life and sex education, which was nominated for an Academy Award.

1970

• Developed refresher program to enable nurse-midwives to return to clinical practice as part of a national effort to support hospitals and universities in establishing or expanding nurse-midwifery programs.

1975

• Established The Childbearing Center, a project in New York City to demonstrate out-of-hospital, family-centered maternity care; it was approved by the New York State Department of Health and operated from September 1975 to June 1996.

1979

• Led innovative classes to prepare children for the birth of a sibling.

1983

• Established the National Association of Childbearing Centers, a professional association for out-of-hospital birth centers (now the American Association of Birth Centers).

1985

• Established the Commission for the Accreditation of Freestanding Birth Centers to ensure high standards of operation for out-of-hospital birth centers across the United States.

1988

• Opened the Childbearing Center of Morris Heights, a neighborhood-based birth center in the South Bronx serving low-income families.

1989

• Published results of the 84-site National Birth Center Study of outcomes of care in out-of-hospital birth centers in the New England Journal of Medicine; the study concluded that care in birth centers was safe, satisfying and cost effective.

1993

• Held seminar for health professionals on mainstreaming the out-of-hospital birth center in commemoration of our 75th birthday.

1995

• Published seminar proceedings on mainstreaming the out-of-hospital birth center entitled “Prelude to Action II: Reforming Maternity Care.”

1996

• Obtained grant from New York State Department of Health’s Office of Quality Improvement to provide consultation services to institutions interested in implementing and evaluating prenatal education and strengthening postpartum discharge programs.
• Offered national postpartum doula training program for managed care and other health organizations.

1997

• Held national conference titled “Models of Collaborative Practice: Preparing for Maternity Care in the 21st Century” in Washington, D.C., to address challenges, opportunities and barriers to implementing collaborative practice; supported subsequent publication of papers in Women's Health Issues.

1998

• Established and convened Institute for Family-Centered Maternity Care, a national advisory council.
• Held “Having a Baby in America,” an educational forum celebrating MCA's 80th birthday.

1999

• Established long-term national Maternity Wise program to promote evidence-based maternity care.
• Issued first edition of “The Rights of Childbearing Women.”

2000

• Surveyed leaders within U.S. maternal and child health professional organizations about their understanding of and commitment to evidence-based maternity care.

2001

• Launched Maternity Wise website devoted to evidence-based maternity care, with resources for women, health professionals and the media.
• Sponsored multi-disciplinary conference, “The Nature and Management of Labor Pain: An Evidence-Based Symposium,” with the New York Academy of Medicine and a multi-disciplinary national steering committee.
• Received Lamaze International's Research Award in recognition of MCA's national program to promote evidence-based maternity care and to clarify and communicate best evidence about labor pain and labor pain relief.

2002

• Updated mission statement to reflect the evolution of the organization's programs and the changing environment.
• Sponsored publication of systematic and narrative reviews with best evidence on labor pain and labor pain relief methods in a special issue of American Journal of Obstetrics and Gynecology; publicized results via national media campaign.
• Conducted Listening to Mothers, the first national U.S. survey of women's childbearing experiences, in partnership with Harris Interactive; promoted findings via a New York City forum and national media outreach campaign.
• Launched free online version of “A Guide to Effective Care in Pregnancy and Childbirth.”
• Held forum for health care professionals titled, “Trauma, Loss and Communal Grieving: The Experiences of Pregnant Women, New Mothers and Maternity Care Providers after 9/11.”

2003

• Established a National Media Advisory Council comprised of leading journalists to inform media outreach activities.
• Launched quarterly column on "Resources for Evidence-Based Practice" jointly in the Journal of Midwifery & Women's Health and Journal of Obstetric, Gynecologic, and Neonatal Nursing.
• Received the first John Kennell and Marshall Klaus Doula Spirit Award for Research from Doulas of North America in recognition of “Listening to Mothers: The First National U.S. Survey of Women's Childbearing Experiences.”

2004

• Conducted a systematic review to compare harms of cesarean and vaginal birth and created a consumer booklet, “What Every Pregnant Woman Needs to Know About Cesarean Section,” endorsed by more than 25 national non-profit organizations; promoted the booklet via national media outreach.
• Recognized by Medicine on the Net's Web Excellence Award program for the website’s outstanding content.

2005

• Carried out continuing public, professional and media outreach to provide accurate information to women and the public about cesarean issues, including participation in New York City Public Advocate's press conference calling attention to high cesarean rates in local hospitals.
• Changed name to Childbirth Connection to better reflect contemporary focus.

2006

• Joined National Quality Forum to address maternity care in national health care quality improvement initiatives.
• Launched ChildbirthConnection.org website, a redesign and expansion of MCA’s highly regarded website; received WebAwards for Health Care Standard of Excellence and Non-Profit Standard of Excellence and World Wide Web Health Award.
• Convened Listening to Mothers National Advisory Council (2005) and carried out the second national “Listening to Mothers” survey with Harris Interactive and in partnership with Lamaze International; published survey results and conducted national media outreach campaign to publicize results.

2007

• Held Capitol Hill briefing titled, “Health Care for Pregnancy and Childbirth: Closing Gaps Between Best Evidence and Common Practice,” sponsored by the Congressional Women's Caucus, to raise awareness about needed improvements in maternity care quality, access and value.
• Received DONA International Research Award for “Listening to Mothers II” survey.

2008

• Published “New Mothers Speak Out: National Survey Results Highlight Women’s Postpartum Experiences,” report of a follow-up survey directed to “Listening to Mothers II” participants.
• Collaborated with the Milbank Memorial Fund and Reforming States Group to author and issue “Evidence-Based Maternity Care: What It Is and What It Can Achieve”; the Fund printed and fulfilled thousands of copies, which were instrumental in getting maternity care on the national health care reform agenda.
• Launched Childbirth Connection Facebook and Twitter (@childbirth) accounts.
• Issued “Health Care Reform Priorities for High Quality, High Value Maternity Care.”

2009

• In celebration of 90th anniversary, convened a national multi-stakeholder, multi-disciplinary policy symposium, “Transforming Maternity Care: A High-Value Proposition.”

2010

• Published direction-setting consensus reports resulting from engagement with more than 100 national leaders in special issue of Women’s Health Issues: “2020 Vision for a High-Quality, High-Value Maternity Care System” and “Blueprint for Action: Steps Toward a High-Quality, High-Value Maternity Care System.”
• Established Transforming Maternity Care Partnership to foster implementation of priority “Blueprint for Action” recommendations.
• Partnering to Improve Maternity Care Quality Act of 2010 filed in House of Representatives following collaboration with Reps. Eliot Engel and Sue Myrick.

2011

• In collaboration with Informed Medical Decisions Foundation, began PregnantMe initiative to develop state-of-the-art decision aids for childbearing women.
• Quality Care for Moms and Babies Act introduced in House and Senate following collaboration with Congressional offices and core partners.
• Launched Transform.ChildbirthConnection.org website to foster maternity care quality improvement.

2012

• Updated and published review of evidence comparing harms of cesarean and vaginal birth – “Vaginal or Cesarean Birth: What Is at Stake for Women & Babies? A Best-Evidence Review,” and updated consumer booklet, “What Every Pregnant Woman Needs to Know About Cesarean Section.”

2013

• Co-authored and published major report titled “Maternity Care and Liability: Pressing Problems, Substantive Solutions,” fact sheets and three companion articles published in Women’s Health Issues.
• With Catalyst for Payment Reform and Center for Healthcare Quality and Payment Reform, commissioned Truven Health Analytics to prepare and publish “The Cost of Having a Baby in the United States.”
• Carried out initial and follow-up national “Listening to Mothers III” survey and published “Listening to Mothers III: Pregnancy and Birth” and “Listening to Mothers III: New Mothers Speak Out.”
• Quality Care for Moms and Babies Act introduced in House and Senate following collaboration with Congressional offices and core partners.

2014

• Joined forces with and became a core program of the National Partnership for Women & Families.

2015

• Published major report, “Hormonal Physiology of Childbearing: Evidence and Implications for Women, Babies, and Maternity Care,” and related resources for childbearing women, health professionals and policymakers.
• Quality Care for Moms and Babies Act introduced in Senate with bipartisan support.

2016

• In collaboration with Choices in Childbirth, published Overdue: Medicaid and Private Insurance Coverage of Doula Care calling from reimbursement of this high-value service, together with related resources.
• Quality Care for Moms and Babies Act introduced in House with bipartisan support
• Redesigned, updated and launched new ChildbirthConnection.org website.