With the passage of the ACA, the US Government mandated birth control choices to be made available to women. However, we are still far behind other civilized Western nations when it comes to birth choices. Mothers who wish to use midwives in birthing centers or at home instead of going to a hospital with an OB are often denied coverage and must choose between an out of pocket birth where they feel safe, or an insured birth where they may be subjected to unnecessary procedures such as cesarean sections or episiotomies that can lead to infection. The UK's regulator of the NHS in late 2014 changed the standards to suggest midwife birth for all healthy mothers with uncomplicated pregnancies, but American doctors will fight it - not for women's health, but to avoid losing patients and money.



