The Baby Friendly Hospital (BFH) Initiative is a worldwide effort to improve breastfeeding rates through supportive hospital practices. The purpose of this project was to assess maternal perceptions of the perinatal care provided and confidence with newborn care at a Midwestern medical center as they initiated practice changes toward BFH designation. The COMFORTS scale was completed by 101 mothers prior to discharge after birth. Mean score on total scale was 208.07 plus/minus 25.33/240, indicating a high satisfaction with care, though first time mothers' satisfaction was lower (mean=200.72 plus/minus 27.30, t=-2.21, p=0.03). Mothers at the Birth Center perceived greater choice (t=2.46, p=0.02) and initiate early skin-to-skin care more frequently (FET=9.49, p=0.03) than mothers at the hospital unit. First time mothers were less confident with newborn care (t=-4.92, p=0.00) than mothers with an older child. Although satisfaction was high there is room for improvement as practice changes are being made.