Feature ArticlesImproving the Experience of Care Results of the American Association of Birth Centers Strong Start Client Experience of Care Registry Pilot Program, 2015-2016Stapleton, Susan DNP, CNM; Wright, Jennifer MA; Jolles, Diana R. PhD, CNMAuthor Information American Association of Birth Centers, Perkiomenville, Pennsylvania (Drs Stapleton and Jolles); Commission for the Accreditation of Birth Centers, Kennebunk, Maine (Dr Stapleton); AABC Perinatal Data Registry, Brattleboro, Vermont (Ms Wright); and El Rio Community Health Center, Frontier Nursing University, Tucson, Arizona (Dr Jolles). Corresponding Author: Diana R. Jolles, PhD, CNM, El Rio Community Health Center, Frontier Nursing University, 241 E Sky Light St, Tucson AZ 85737 (Diana.email@example.com). Funding was awarded to American Association of Birth Centers, Inc for Strong Start for Mothers and Newborns Initiative to conduct research on freestanding birth center care as a model of enhanced prenatal care and for development and implementation of the instrument for the collection of client experience data. Funding#1D1CMS331135-04-01 from February 2013 to July 2017. Additional funding came from a grant from the American Association of Birth Centers Foundation to support writing time for this data analysis. Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Each author has indicated that he or she has met the journal's requirements for Authorship. Submitted for publication: September 2, 2019; accepted for publication: October 29, 2019. The Journal of Perinatal & Neonatal Nursing: January/March 2020 - Volume 34 - Issue 1 - p 27-37 doi: 10.1097/JPN.0000000000000454 Buy Metrics Abstract In 2018, the Center for Medicare and Medicaid Innovation in the United States (US) released report demonstrating birth centers as the appropriate level of care for most Medicaid beneficiaries. A pilot project conducted at 34 American Association of Birth Centers (AABC) Strong Start sites included 553 beneficiaries between 2015 and 2016 to explore client perceptions of high impact components of care. Participants used the AABC client experience of care registry to report knowledge, values, and experiences of care. Data were linked to more than 300 process and outcome measures within the AABC Perinatal Data Registry™. Descriptive statistics, t tests, χ2 analysis, and analysis of variance were conducted. Participants demonstrated high engagement with care and trust in pregnancy, birth, and parenting. Beneficiaries achieved their preference for vaginal birth (89.9%) and breastfeeding at discharge through 6 weeks postpartum (91.7% and 87.6%). Beneficiaries reported having time for questions, felt listened to, spoken to in a way they understood, being involved in decision making, and treated with respect. There were no variations in experience of care, cesarean birth, or breastfeeding by race. Medicaid beneficiaries receiving prenatal care at AABC Strong Start sites demonstrated high levels of desired engagement and reported receiving respectful, accessible care and high-quality outcomes. More investment and research using client-reported data registries are warranted as the US works to improve the experience of perinatal care nationwide. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.