Home Births in the U.S. Continue to Rise

Lily Dane

According to a new government report, the number of women in the U.S. who are choosing to give birth at home or at a birthing center instead of a hospital has increased by 56% in less than ten years.

Out-of-hospital births accounted for 1.36 % of births in the U.S in 2012, up from 1.26 % in 2011. In 2004, only 0.87 % of such births occurred, according to the U.S. Centers for Disease Control and Prevention.

Home Births in the U.S. Continue to Rise

T.J. Mathews, a demographer with the CDC’s National Center for Health Statistics, said that’s a significant increase:

“That’s a pretty good jump in a single year, and it’s been a continuing trend since 2004.”

Lynn Johnson, midwife and administrator of Women’s and Children’s Services at Huntington Hospital in New York, told Everyday Health that the numbers show the growing popularity of midwife-assisted births:

“More people are talking about midwifery birth and having their experience as they would like to have it,” Johnson said, adding that some women worry about losing their autonomy and having a doctor call the shots during delivery.

The CDC found that two-thirds of the out-of-hospital births occurred at home, and another 29 percent occurred in a birthing center. Another 5 percent occurred in a clinic, doctor’s office or other location.

Births outside of the hospital carried a lower “risk profile” in 2012, with less pre-term and low birth weight babies than in hospitals.

Dr. James Byrne, chair of Ob/Gyn for Santa Clara Valley Medical Center and a clinical professor at Stanford University School of Medicine, said there are several reasons for the improving safety profile of non-hospital births:

“The women with risk factors are less likely to be delivering at home, which is wise and safe for the public.”

Byrne also said that a new focus on “physiologic labor”, in which the labor process is allowed to unfold at a slower, more natural pace, has improved the safety of birth both at home and in the hospital.

A landmark study in the peer-reviewed Journal of Midwifery & Women’s Health (JMWH) showed that among low-risk women, planned home births result in lower rates of intervention without an increase in adverse outcomes for mother and child.

Mana.org reports:

This study, which examines nearly 17,000 courses of midwife-led care, is the largest analysis of planned home birth in the U.S. ever published.

The results of this study, and those of its companion article about the development of the MANA Stats registry, confirm the safety and overwhelmingly positive health benefits for low-risk mothers and babies who choose to birth at home with a midwife. At every step of the way, midwives are providing excellent care. This study enables families, providers and policymakers to have a transparent look at the risks and benefits of planned home birth as well as the health benefits of normal physiologic birth.

Of particular note is a cesarean rate of 5.2%, a remarkably low rate when compared to the U.S. national average of 31% for full-term pregnancies. When we consider the well-known health consequences of a cesarean — not to mention the exponentially higher costs — this study brings a fresh reminder of the benefits of midwife-led care outside of our overburdened hospital system.

Home birth mothers had much lower rates of interventions in labor.

While some interventions are necessary for the safety and health of the mother or baby, many are overused, are lacking scientific evidence of benefit, and even carry their own risks. Cautious and judicious use of intervention results in healthier outcomes and easier recovery, and this is an area in which midwives excel. Women who planned a home birth had fewer episiotomies, pitocin for labor augmentation, and epidurals.

Only 1% of babies required transfer to the hospital after birth, most for non-urgent conditions.

The six states with the highest out-of-hospital births are Alaska, Pennsylvania, Idaho, Montana, Oregon and Washington, with 3 percent to 6 percent of births occurring at home or in a birthing center.

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