The 1970s were a decade of social upheaval and community redevelopment, making space for important shifts in how health care systems could better care for patients. At Zuckerberg San Francisco General Hospital, the city’s only public hospital was busy investing in what would later be known as health equity.

Dr. Richard Fine created one of the first outpatient clinics at a public hospital with a mission to serve the underserved. The Emergency Department became one of the first Federal Trauma Centers in the country. And just one year after midwifery became legal in California, the Labor and Delivery Ward at ZSFG began relying on Certified Nurse Midwives to better care for birthing parents in San Francisco.

This year, the Family Birth Center is celebrating 50 years of hospital-based midwifery and the immense impact it has had on generations of San Franciscans. Innovation has always been at the forefront of this work, adapting programs and services to better meet the needs of birth parents in our community.

In 1976, the Alternative Birth Center opened at ZSFG, bringing the comforts of home births into the hospital setting.  In the 1990s, volunteer doulas began collaborating with ZSFG staff to offer support for birthing families throughout the labor and delivery process.

And in 1999, ZSFG became a pioneer in the Centering Pregnancy model of care, creating group education and prenatal care for expecting parents. This was quickly followed by groups for Black/African American and Spanish-speaking families in partnership with local organizations such as Homeless Prenatal Program and Mission Neighborhood Health Center.

These innovations in obstetric care are part of the fabric of the Family Birth Center today, which hosts a team of 17 midwives available 24/7 as well as a team of volunteer doulas. As a teaching hospital, midwives also play an important role in educating UCSF trainees, modeling patient-centered care for interns and residents rotating through the Family Birth Center, as well as hosting future midwives during their own training.

The impact of midwifery care is clear: the hospital’s C-section rate averages 16%—half the national average—and recent data shows Black/African American patients who received comprehensive prenatal care through Black Centering delivered fewer preterm and low birth weight babies than those receiving traditional prenatal care.