More U.S. Babies Born at Home: Report

Home birth is seen as viable option for some women, experts say

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Thursday, January 26, 2012

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Childbirth

THURSDAY, Jan. 26 (HealthDay News) -- The rate of home births in the United States has made a dramatic upturn since 2004, reversing a trend of decline throughout the 1990s, government health officials said Thursday.

Births taking place outside of the traditional hospital setting increased 29 percent between 2004 and 2009, from 0.56 percent of all births to 0.72 percent -- almost 30,000 births -- according to a new report from the U.S. Centers for Disease Control and Prevention.

"The increase has been driven by non-Hispanic white women," said lead report author Marian MacDorman, a statistician at CDC's National Center for Health Statistics. "For non-Hispanic white women, home births increased 36 percent."

Although it isn't clear why the rate is increasing, MacDorman thinks it has a lot to do with individual preference.

"A lot of women really like the idea of home birth because they want a lower-intervention birth. A lot of women are worried about higher C-section rates and other types of intervention that happen once you go to the hospital," she said.

The report uses data from the National Vital Statistics System, Natality Data Files for 1990 to 2009, which include all births in the United States, with a range of demographic and health information on mothers and their infants.

Highlights of the report include:

Among white women, home births increased 36 percent, from 0.80 percent in 2004 to 1.09 percent in 2009.
For white women, home births account for one in every 90 births.
In other racial and ethnic groups, home births are less common.
Home births are more common among women aged 35 and over, and among women who have had other children.
Births that occur in the home more often involve lower-risk pregnancies, with fewer among teenagers or unmarried women, and fewer preterm, low birth weight or multiple births.
In 2009, home births varied from a low of 0.2 percent in Louisiana and the District of Columbia, to a high of 2 percent in Oregon and 2.6 percent in Montana.

Saraswathi Vedam, chair of standards and practice for the Home Birth Section of the American College of Nurse-Midwives, thinks more women are making informed decisions about where to give birth.

"Women and families have started to question the widespread use of obstetric interventions and want to control the environment they give birth in," she said.

Some of the benefits of home birth are privacy, comfort and continuing care from someone who they feel a more personal relationship with, such as a midwife, she said.

"Home birth was seen as a counterculture thing, but it's becoming more mainstream. People understand it's not home birth at all costs -- one can always change their mind and go to the hospital," Vedam said.

The biggest objection to home birth has been concerns about safety of the mother and infant should something go wrong.

"Everybody is concerned with safety," Vedam said. "Women who are healthy and have a profile of having a good outcome for them and their babies have come to understand that the equipment and personnel a hospital has to offer is not necessary for all women. It's most appropriate for women and infants who have medical indications that could benefit from what the hospital offers."

SOURCES: Marian F. MacDorman, Ph.D., statistician, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention, Hyattsville, Md.; Saraswathi Vedam, C.N.M., chair, Home Birth Section, American College of Nurse-Midwives, Division of Standards and Practice; Jan. 26, 2012, CDC report, Home Births in the United States, 1990-2009

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