Maternity and newborn care cost the United States over $50 billion annually—the largest category of hospital costs for Medicaid and commercial insurers—yet the United States ranks 50th in the world for maternal mortality and 36th for neonatal mortality. What is driving the maternity care crisis in the United States? Expensive and invasive medical interventions—designed to save lives in high-risk situations—have become routine, rendering them harmful instead of helpful, and costing billions of unnecessary dollars. The United States must improve outcomes and decrease costs. There is a clear solution: increase the percent of births attended by midwives and employ the midwifery model of care as the evidence-based standard.