Birth Center vs. Home Birth in Pennsylvania: What’s the Difference?

If you’re exploring out-of-hospital birth, you may be deciding between a state-licensed birth center and a home birth supported by a traditional birth attendant. While both options exist outside the hospital system, they differ significantly in terms of regulation, autonomy, and legal protection.

This page offers a clear comparison to help you make an informed decision aligned with your values, needs, and vision for birth.

Birth Centers in Pennsylvania

There are currently only two state-licensed birth centers operating in Pennsylvania. These centers are regulated medical facilities, designed to provide a more relaxed atmosphere than a hospital, while maintaining full compliance with state oversight.

By law, birth centers must be run by or affiliated with Certified Nurse Midwives (CNMs)—licensed healthcare providers who follow clinical protocols under the supervision of a physician or health system.

Pros of Birth Center Birth:

  • Out-of-hospital setting with a home-like environment

  • Care led by state-licensed CNMs

  • Some facilities accept private insurance or Medicaid

  • Proximity to hospitals for emergency transfers

  • May offer reassurance to family members who are hesitant about home birth

Cons of Birth Center Birth:

  • Extremely limited access due to high demand and few locations

  • CNMs must follow state-mandated risk screening and intervention protocols

  • Lower flexibility for families seeking full autonomy or spiritual alignment

  • Transfers late in pregnancy are common if “risk” criteria are no longer met

  • While more personal than hospitals, care is still structured around institutional liability

Home Birth in Pennsylvania

Home birth offers the most private, autonomous setting for those who want to give birth on their own terms. Some families choose to invite direct entry midwives—including Certified Professional Midwives (CPMs), traditional attendants, or spiritual and community birth attendants—into this space for relational, faith-based support.

However, Pennsylvania does not license or recognize any midwives except CNMs. This means that home births attended by direct entry midwives are not protected under state law, and those offering support may be at legal risk—even if their role is spiritual or educational in nature.

Pros of Home Birth:

  • Total privacy and freedom to labor, birth, and bond in your own home

  • Greater opportunity for faith-based or culturally aligned support

  • Deeper relationships built over time with your chosen support person

  • Ability to include siblings, family members, or prayer into your birth space

  • Personalized postpartum rhythm without institutional discharge timelines

Cons of Home Birth:

  • No licensure protection unless attended by a CNM

  • No formal transfer agreements or emergency coordination

  • Hospital systems may misunderstand or stigmatize unassisted or traditionally attended births

  • Direct entry midwives may face civil or criminal liability under current law or proposed legislation

  • Families must assume full responsibility for decision-making, outcomes, and continuity

SB507 and the Future of Home Birth

Under current Pennsylvania law, providing any form of clinical care—without a license—can be interpreted as practicing medicine or nursing without authorization. That includes common midwifery skills such as monitoring fetal heart tones, assessing vitals, or offering emergency support.

Senate Bill 507 would formalize and expand these restrictions, making it easier for the state to prosecute traditional or faith-based midwives. If passed, SB507 would effectively criminalize most forms of direct entry midwifery in Pennsylvania, regardless of training, certification, or community consent.

Our Position at Cardinal Birth

At Cardinal Birth, we serve in a non-medical, faith-based capacity only. We are not licensed healthcare providers. We do not offer exams, medications, diagnostics, or emergency interventions. We walk with families who are fully informed, prayerful, and intentionally choosing traditional, private support over clinical oversight.

We are watching SB507 closely and consulting with legal counsel to remain transparent about what we do and do not provide. Our work is grounded in relationship, conscience, and the belief that families have the right to birth in alignment with their values—even when the law grows more hostile to that belief.

Making Your Decision

Birth centers and home birth represent two very different models of maternity support. One is legally protected but bound by state protocols. The other offers greater personal freedom—but comes with legal ambiguity and risk.

There is no one right answer. Only what is right for you.

If you are seeking traditional support from a faith-rooted, experienced guide—and understand the current legal climate—we welcome you to reach out. We do not make promises we can’t keep. But we do offer what we can: presence, prayer, respect, and truth.