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To explore the role of the birth center model of care in rural health and maternity care delivery in the United States. All childbearing families enrolled in care at an American Association of Birth Centers Perinatal Data Registry user sites between 2012 and 2020 are included in this descriptive analysis. Between 2012 and 2020, 88 574 childbearing families enrolled in care with 82 American Association of Birth Centers Perinatal Data Registry user sites. Quality outcomes exceeded national benchmarks across all geographic regions in both rur