Background: Family-centered maternity care is an approach based on mutually beneficial partnerships between health care providers and families. It offers new ways of thinking about the relationship among childbearing women, their families, and health caregivers. This study was designed to identify health care practices that promoted or limited a family-centered philosophy. Methods: A qualitative design, using reflexive interviews and focus groups, investigated the perspectives of 34, primarily African American women who used maternity services at a large urban hospital; some women traveled from rural areas for delivery. Inductive data analysis was conducted on the transcribed audiotapes of the interviews and groups.Results: Barriers to family-centered maternity care were categorized as issues in coordination of services among health caregivers, patient-health caregiver relationships and systems, and access to services. Facilitators of family-centered maternity care were identified as perceived response to high-risk patients, health-related support outside the hospital, and special resources. Narratives, or personal stories told by the women, were used to illustrate barriers and facilitators.Conclusions: Education about family-centered maternity care is vitally important for health caregivers. In clinical situations, each childbearing woman and her family should be treated as if they are extraordinary. In this way, practitioners can alter routines that cause the woman and her family to lose individualized care.