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Medicaid pays for about half the births in the United States, at very high cost. Compared to usual obstetrical care, care by midwives at a birth center could reduce costs to the Medicaid program, according to Potential Medicaid Cost Savings from Maternity Care Based at a Freestanding Birth Center, published in Volume 4, Issue 3 of Medicare and Medicaid Research Review. This study draws on information from a previous study of the maternal and infant outcomes of birth center care to determine whether such care reduces Medicaid costs for low income women. Costs to Medicaid are derived from birth center data and from other national sources of the cost of obstetrical care. The authors estimate that birth center care could save an average of 1,164 dollars per birth (2008 constant dollars), or 11.6 million dollars per 10,000 births per year. As Medicaid faces continuing cost increases and budget constraints, policy makers may want to consider a larger role for midwives and birth centers in maternity care for low-risk Medicaid pregnant women.