11/17/2025
NYTimes Letter to the Editor ✒️
Many of you may have already seen the NY Times article "The ‘Worst Test in Medicine’ is Driving America’s High C-Section Rate" (https://www.nytimes.com/2025/11/06/health/electronic-fetal-monitoring-c-sections.html?unlocked_article_code=1.108.XT6J.Y2YuWc0Xc01e&smid=url-share ).
AABC sent a Letter to the Editor in response! Since our letter did not get published, we wanted to share it with you all here.
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Dear Editor,
Thank you for highlighting the overreliance on continuous electronic fetal monitoring (EFM) and its role in rising Cesarean rates.
There is a solution to this epidemic. Midwifery-led birth centers use intermittent fetal monitoring instead of continuous EFM. They are an evidence-based model that delivers outcomes comparable to those of the top nations globally by offering holistic, family-centered care that protects and empowers patients, thereby enhancing both physical and mental well-being in our community.
Birth centers are fully integrated into the healthcare system and guided by principles of prevention, safety, appropriate medical intervention, and cost-effectiveness. While midwifery care can occur elsewhere, birth centers are unique in offering this dedicated, physiologic model.
Outcomes speak for themselves:
-Cesarean rates under 6%
-NICU admissions less than half the national average
-Low rates of interventions with superior overall outcomes
These results demonstrate the clinical excellence and fiscal prudence of the birth center model, reducing complications and costs while maintaining world-standard safety, lowering maternal mortality risk, and prioritizing maternal autonomy and satisfaction.
Respectfully,
Kate Bauer
Executive Director
American Association of Birth Centers
Perkiomenville, PA
