How New York Licenses Birth Centers: What Families Should Know

Author: Igel Cudiera

If you are comparing birth centers, words like "licensed," "approved," and "accredited" come up a lot, and they don't all mean the same thing. This guide explains New York birth center licensing in plain language: how a center gets approved, the types of birth centers the state recognizes, what the rules mean for your care, and how to check a center's status using public state tools.

Key Takeaways

• New York regulates birth centers under Article 28 of the Public Health Law, the same law that covers hospitals and clinics.
• Opening a birth center involves separate steps: approval to establish it, approval to build it, and an operating certificate, which a facility must hold before it can operate.
• New York's rules recognize two kinds of birth centers: birth centers run as diagnostic and treatment centers (10 NYCRR Part 754) and midwifery birth centers (10 NYCRR Part 795).
• Licensed birth centers care for low-risk pregnancies only. They don't give epidurals or use medication to start or speed up labor, and they must have plans for transferring care to a hospital.
• A facility's license, a midwife's professional license, and accreditation are three different things, each checked in a different place.
• A license sets minimum standards and oversight. It does not guarantee a particular birth outcome.

What Does It Mean for a Birth Center to Be Licensed in New York?

In New York, a birth center is a regulated health facility. Article 28 of the Public Health Law defines a "hospital" broadly, as a facility providing services under the supervision of a physician or, in the case of a midwifery birth center, a midwife. The definition specifically includes diagnostic centers, treatment centers, maternity hospitals, and midwifery birth centers. The same law defines a midwifery birth center as a facility "engaged principally in providing prenatal and obstetric care, where such services are provided principally by midwives."

The license itself is the operating certificate. Public Health Law section 2805 states that no facility covered by Article 28 may be operated unless it has "a valid operating certificate," which may specify the kinds of services the facility is authorized to provide.

The American Association of Birth Centers (AABC) describes licensure as "a process by which a type of facility is regulated by the state," and explains that licensing "protects the public by monitoring compliance" with codes and regulations.

How New York Approves and Licenses Birth Centers

New York uses a review called Certificate of Need (CON). The Department of Health explains that the CON process "regulates the establishment, construction, renovation, and acquisition of major medical equipment" for health care facilities, including diagnostic and treatment centers. For a birth center, there are three main steps.

Step 1: Approval to Establish

Public Health Law section 2801-a says no facility covered by Article 28 "shall be established except with the written approval of the public health and health planning council," a state council that reviews applications. For midwifery birth centers, the Department of Health says applicants must submit a "Full Review Establishment with Construction" CON application.

Step 2: Approval to Build

Under Public Health Law section 2802, building a facility "shall require the prior approval of the commissioner" of health. Approvals can come with conditions that must be met before a project moves forward. The state's public Certificate of Need dataset tracks each project with statuses such as "Contingent Approval," "Under Construction," and "Project Complete."

Step 3: Pre-Opening Review and the Operating Certificate

The Department of Health conducts pre-opening surveys for projects with physical or clinical components "that need the department's approval prior to opening." Only a facility with a valid operating certificate may operate under section 2805.

The Two Types of Birth Centers New York Recognizes

The Department of Health's Birth Center Classifications guidance describes two regulatory types of Article 28 birth centers:

The guidance also describes a "limited birth center" classification for smaller facilities under either part, with a maximum of six health services rooms and no more than three birthing rooms.

For midwifery birth centers, the regulations add a standards requirement: they must follow evidence-based standards published by a national standards body selected by the Department, the Department may accept accreditation from an approved agency as evidence of compliance, and a center must notify the Department within seven days if it loses accreditation or fails to become accredited.

What the Rules Mean for Your Care

New York's birth center regulations translate into practical limits that shape what birth center care looks like:

• Low-risk pregnancies only. Part 754 admits only those whose history, physical exam, and lab screening show the expectation of a normal, uncomplicated pregnancy and labor, and Part 795 defines a low-risk patient in similar terms.
• No epidurals or general anesthesia. Both parts state that "general and regional anesthesia are not administered at the center."
• No medication to start or speed up labor. Under both parts, labor is not induced or augmented with medication "acting directly on the uterus."
• No forceps or vacuum. Both parts say forceps and vacuum extraction are not permitted.
• A dedicated attendant. Under Part 754, a licensed midwife or physician attends you from admission through the immediate postpartum period, and a second staff person is present at each birth.
• A short stay. Both parts describe care for people who need a stay of less than 24 hours after birth. Part 754 requires a postpartum stay of at least four hours and no more than 24.

These limits are why birth centers are built for uncomplicated birth. Our guide to who can give birth at a birth center explains the eligibility side in more detail.

Licensing, Midwife Licensure, and Accreditation Are Not the Same

Three different credentials are often mentioned together. Each answers a different question:

AABC explains that accreditation "is a voluntary process by which birth centers are evaluated by CABC," using indicators based on the AABC Standards for Birth Centers. Having one of these credentials doesn't mean a center or provider has the others, so it's worth checking each one.

How to Check a Birth Center's Status

You can do much of this checking yourself with free public tools:

1. Ask the center directly. Ask for the facility's licensed name, the type of license it holds (Part 754 or Part 795), and whether it has an operating certificate.
2. Search the state's facility listings. Health Data NY, the Department of Health's open data site, publishes a Health Facility General Information dataset that lists facilities by type, including diagnostic and treatment centers and midwifery birth centers. NYS Health Profiles, the Department's tool to "Find and Compare New York Health Care Providers," includes a page on free-standing clinics.
3. Check the status of a new facility. If a center is new, the state's Certificate of Need Applications dataset shows where its project stands, for example "Under Construction" or "Project Complete."
4. Verify your midwife's license. The NYS Education Department says you can verify that someone is currently licensed and registered as a midwife through the Office of the Professions online verification service.
5. Look up accreditation. CABC publishes a directory of accredited birth centers.

If what you find doesn't match what you have been told, ask the center to explain the difference.

Questions to Ask Before Choosing a Birth Center

1. What type of license does the center hold, and does it have a current operating certificate?
2. Who will attend my birth, and are they licensed in New York?
3. Is the center accredited, and by whom?
4. What are your written criteria for who can give birth here?
5. Which hospital do you transfer to, how far away is it, and how does a transfer work?
6. Who stays involved in my care if I transfer?
7. How long will I stay after the birth?
8. What happens if I decide I want an epidural?

What Happens If You Need a Higher Level of Care?

Planning for transfer is built into New York's rules:

• Diagnostic and treatment center birth centers (Part 754) must have a transfer agreement with a hospital within 20 minutes' transport time, written plans for emergency transfers that include ambulance arrangements, and, with the transfer hospital, a list of indicators that call for transfer and a written procedure for automatic acceptance. A copy of your medical record goes with you.
• Midwifery birth centers (Part 795) must be able to evaluate, stabilize, and transfer patients who aren't low risk, including newborns, and must refer or transfer patients for care outside their scope "at any point during the course of care." They must start a transfer when risks are identified, including prolonged labor, fetal distress, a need for spinal or epidural anesthesia, or a possible operative or cesarean birth.

To see what this can look like in practice, read about what a transfer during labor can look like and what happens when going past your due date changes the plan. Some families choose or move to a planned hospital birth with your own midwives.

What Licensing Does and Doesn't Tell You About Safety

A license tells you a facility is subject to the state's rules and oversight. It doesn't promise a particular outcome. The National Academies of Sciences, Engineering, and Medicine (NASEM) found that "there is no risk-free setting for giving birth, whether at home, in a birth center, or in a hospital." For low-risk births, NASEM found that birth centers have lower intervention rates but "a slightly increased risk of poor neonatal outcomes" compared with hospital births.

The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) describe birth centers as providing care for low-risk women with uncomplicated, single-baby, head-down term pregnancies. That is why careful screening and a clear transfer plan matter as much as the license on the wall. You can also compare how a birth center differs from a planned home birth.

Frequently Asked Questions

What is an Article 28 facility?

It is a health facility regulated under Article 28 of New York's Public Health Law. The law's definition of "hospital" covers a wide range of facilities, including general hospitals, diagnostic and treatment centers, maternity hospitals, and midwifery birth centers. An Article 28 facility needs a valid operating certificate to operate.

Can you get an epidural at a birth center in New York?

No. New York's birth center regulations state that general and regional anesthesia are not given at the center. Under the midwifery birth center rules, a need for spinal or epidural anesthesia is one of the reasons a center must start a transfer to a hospital.

Is an accredited birth center automatically licensed?

No. AABC describes licensure as regulation by the state and accreditation as a voluntary evaluation by CABC. They are separate, so check both.

Does "approved by the Department of Health" mean a birth center is open?

Not necessarily. Approval to establish and approval to build are earlier steps. Under Public Health Law section 2805, a facility needs a valid operating certificate to operate.

Can a midwife be licensed if the facility isn't?

Yes. They are separate licenses. The NYS Education Department licenses midwives under Education Law Article 140, and the Department of Health issues operating certificates to facilities under Public Health Law Article 28.

Does insurance or Medicaid cover care at a licensed birth center?

Medicaid.gov lists "freestanding birth center services when licensed or otherwise recognized by the state" among the benefits state Medicaid programs must cover. New York's Department of Financial Services states that maternity coverage includes the services of a licensed midwife practicing in conjunction with a facility licensed under Article 28. Coverage still depends on your plan, so read more about how insurance and Medicaid cover birth center care.

Taking the Next Step

Licensing is one piece of the picture. When you are choosing a birth center, check its operating status, your midwife's license, and its accreditation, then ask about eligibility and transfer plans. A center that is glad to answer those questions clearly is giving you the information you need to decide.

Sources and References

• Public Health Law section 2801, section 2801-a, section 2802, and section 2805. New York State Senate.
• 10 NYCRR Part 754, Birth Center Services: 754.1, 754.2, 754.3, 754.4, 754.6, and 754.7. New York State Department of Health regulations.
• 10 NYCRR Part 795, Midwifery Birth Centers: 795.1, 795.2, 795.3, 795.4, and 795.11. New York State Department of Health regulations.
• Birth Center Classifications, Certificate of Need, Midwifery Birth Centers, and Pre-Opening Survey. New York State Department of Health.
• Health Facility General Information and Certificate of Need Applications. Health Data NY, New York State Department of Health.
• Diagnostic and Treatment Centers (Clinics). NYS Health Profiles, New York State Department of Health.
• Midwifery: Questions and Answers. New York State Education Department, Office of the Professions.
• Frequently Asked Questions About Birth Centers. American Association of Birth Centers.
• Find Accredited Birth Centers. Commission for the Accreditation of Birth Centers.
• No Hospital, Birth Center, or Home Birth Is Risk-Free (2020). National Academies of Sciences, Engineering, and Medicine.
• Levels of Maternal Care, Obstetric Care Consensus No. 9. American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine.
• Mandatory and Optional Medicaid Benefits. Medicaid.gov, Centers for Medicare & Medicaid Services.
• Insurance Circular Letter No. 1 (2021). New York State Department of Financial Services.

About the Author

Igel Cudiera

Igel Cudiera wrote this article for Birthing Center NYC. It draws on New York's Public Health Law and Department of Health regulations and guidance, along with information from the American Association of Birth Centers, the Commission for the Accreditation of Birth Centers, and the other sources listed above.

This content is intended for general educational purposes only and is not legal or medical advice. Regulations and a facility's status can change, so check current information with the New York State Department of Health and talk with your health care provider about the setting that is right for you.