Who we are

Building a more connected future for care

The Community Birth & Doula Initiative (CBDI) works to improve access to safe, respectful, and community-centered perinatal care across Massachusetts. We bring together families, providers, community organizations, and public health partners to strengthen midwifery-led models of care and break down barriers to optimal collaboration between settings and providers.

A newborn wrapped in a green blanket, held in a parent's arms
A care provider places her hands on a pregnant woman's belly while a partner looks on

Our Mission

  • Right Care

    Families deserve evidence-based, culturally responsive care that meets their clinical, emotional, and social needs.

  • Right Time

    Support that meets families where they are—from pre-conception through pregnancy, birth, and the full first year of postpartum life.

  • Right Place

    Care that is accessible in the communities where people live and work, including home, birth center, and hospital settings.

Why community birth?

The United States is facing a health crisis

The United States experiences higher rates of maternal and infant health complications than many peer nations, while access to community-based maternity care remains limited.

In Massachusetts, where CBDI is home, important progress has been made, yet many families still face barriers to accessing doulas, midwives, and community birth options close to home.

  • >50%

    of birthing people report difficulty finding or accessing skilled support and care close to where they live and work

  • 2.5x

    Black women and women of color are 2.5x more likely to die of pregnancy-related causes than their white peers

  • >40%

    of pregnancy-associated deaths are linked to untreated mental health issues

  • 2x

    Caring for a birthing person and child through year one costs more than double other high-income countries

Our approach

Four pillars of true systems transformation

  1. Workforce & Trust

    Support a diverse workforce of doulas, midwives, clinicians, and community leaders who build trusted relationships with families.

  2. Expanded Networks of Care

    Strengthen collaboration between midwives, EMS provider, birth centers, public health systems, and hospitals

  3. Financing Innovation

    Develop sustainable funding and reimbursement models that make community birth services more accessible.

  4. Transparent Data & Documentation

    Use data, research, and shared learning to improve care quality and track progress over time.

Evidence & approach

Midwifery-Led Models of Care

Midwifery models of care place educated, licensed, and regulated midwives as the primary providers for birthing people and newborns—from pre-pregnancy through the postnatal period. Grounded in a philosophy that promotes person-centered care, optimizes physiological and social wellbeing, and uses clinical interventions only when indicated, these models have a strong global evidence base.

  • Reduces unnecessary interventions

    Midwifery-led care is associated with fewer unnecessary hospitalizations and medical interventions, reducing system-driven harm and lowering financial burdens on health systems and families.

  • Advances health equity

    Demonstrated to reduce health inequities across social and economic contexts, midwifery-led care reaches communities that have historically been underserved by conventional maternity systems.

  • Centers autonomy and decision-making

    Midwifery models prioritize the client–midwife relationship and partnership, supporting informed, autonomous decision-making for birthing people throughout the perinatal journey.

  • Maximizes the value of public investment

    By ensuring public funds are directed toward effective, evidence-based maternal and newborn care, midwifery-led models make health systems more efficient and equitable.

A large group of training participants sits on the floor of a conference room
Go to World Health Organization Networks of Care for Maternal and Newborn Health Implementation Guidance (opens in a new tab)

Our Team

The Massachusetts Center of Excellence and Learning Lab

We acknowledge the Massachusetts Department of Public Health—and in particular the Bureau of Family Health and Nutrition—for their ongoing commitment to birth equity and capacity building across the Commonwealth. Their leadership, funding, and partnership have been essential in strengthening the systems, workforce, and community support that help families access community birth care.

For further information about all of MA DPH’s perinatal and maternal health initiatives visit their website or contact Cristina Alonso.

Learn More (opens in a new tab)

Our DPH Team

Massachusetts Community Birth Integration and Doula Initiatives are led by the MA Department of Public Health.

Massachusetts Department of Public Health
Pregnancy, Infancy and Early Childhood Division
250 Washington Street, Boston, MA 02108

For more information contact:
Cristina Alonso, DrPH, MPH, CPM
Email Pregnancy, Infancy and Early Childhood Division at Cristina.E.Alonsolord@mass.gov

Our Partners

CBDI works in close collaboration with more than two dozen local, regional, and national partners across clinical, community, and public health systems.

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