The Transforming Birth Fund

The Transforming Birth Fund is committed to changing the birth experience for all women and babies in the United States so that birth is experienced as a natural and powerful event and health outcomes of mothers and babies improve.

The Transforming Birth Fund is a donor-advised fund of the New Hampshire Charitable Foundation.

One-third of American women giving birth this year will have a Cesarean section.  Yet just 1% of mothers indicate they want to deliver by C-section without a medical reason.  And medical reasons cannot account for the fact that the C-section rate varies dramatically state by state, hospital by hospital, even within the same community. 1

“Our system is set up as though you have an oral surgeon providing routine teeth cleanings.”  -- Dr. Michael Klein, OB As C-section rates have climbed, neonatal mortality did not go down as expected, while maternal mortality and morbidity has gone up. 2  

Why?  And more importantly, what can be done?

This is the question The Transforming Birth Fund asked when it started making grants in 2005:  Could finding and financially supporting those people and organizations working to make the birth experience more physiologic and less medical catalyze a movement, improve access to physiologic birth, and create momentum toward more widespread acceptance that physiologic birth is the healthiest and most cost-effective option for low-risk mothers?

The answer is yes.

1, 2 Click here for sources
May 16, 2017 

Why this is Important?

The goal of pregnancy is that it ends with a healthy baby and a healthy mother.  

Yet in the United States maternity care trends are worsening.  Maternal morbidity and mortality have been increasing.  The national C-section rate steadily increased from 1965 to 1986, when it held for five years at 23.5%. 1 At that time the CDC established a goal of lowering the C-section rate to 15% .2 Instead, the rate climbed to 32% between 1991 and 2013 with wide variations between states (greater than 36% in Florida and between 20% and 24.5% in New Mexico). 3   C-section rates for low-risk women vary dramatically hospital by hospital, even within the same community. 4

Along with the increase medical intervention comes increase in costs.  A Caesarean birth typically costs 50% more than a vaginal birth.  And since 43% of all births in the United States are paid for by Medicaid, it matter to us all.

Birth is particularly fraught for African American pregnant women.  African American pregnant women in the US are four times more likely to die from pregnancy related complications than are white women. They are two to three times more likely to experience preterm birth, and three times more likely to have a low birthweight baby, even after controlling for risk factors such as medical conditions, low income and education, and alcohol and tobacco use. 5


1, 2 Click here for sources
3   Click here for sources
4   Click here for sources  May, 2017

5 “Racial Disparities in Birth Outcomes and Racial Discrimination as an Independent Risk Factor Affecting Maternal, Infant, and Child Health: An Executive Summary of Existing Research”, Download PDF June, 2015