More Moms Choosing to Give Birth at Home

In January 2012, the  CDC National Center for Health Statistics released a data brief  with  information  from the National Vital Statistics, Natality Data Files that shows that there has been a significant increase in the number of home births in the United States between 2004 and 2009.

 In 2009, there were over 26,000 home births. This is a 29% increase over the number of home births in 2004. The study found that the majority of the women who opted for home birth were over the age of 35 and had at least one and in many cases more than one, previous childbirths. About 90% of the women were also white, non-Hispanic in ethnicity. This group was the fastest growing as well increasing by 14% from 1994 to 2004 and 36% from 2004 to 2009.

The results indicate that the increase was prevalent in 31 of the 50 states with the northwestern area of the United States showing the highest percentage of increase and the southeast showing the lowest. Surprisingly, Montana had the highest percent of home births and only the District of Columbia and Vermont had significant decreases.

The results of this study have lead many people to question why women are opting for home delivery over the safety of a hospital delivery. Home delivery was the prevalent way for children to enter the world early in the 20th century but had been out of fashion for many years. According to the lead author of the brief Marian MacDorman, home birth is mostly a matter of person preference by the women.  “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.

In the year 2006, over 60% of the homebirth had a midwife in attendance. Of these, almost 20% were certified nursing attendant. In hospitals, only 7% of births are attended by a midwife. Very few physicians make home visits which explains why only 5% of home births had a doctor in attendance while 92% of hospital births are attended by doctors.  What is somewhat disturbing is that 33% of home births had neither doctor nor midwife. While it is hard to determine, these are most likely emergency situations where a family member or EMT helped to deliver the baby.

According to Medical News Today, The American College of Obstetricians and Gynecologists (ACOG) does not support planned home births because they believe “hospitals and birthing centers are the safest setting for birth”.  However, in an opinion statement released in 2011, their Committee on Obstetric Practice said it “respects the right of a woman to make a medically informed decision about delivery”, and women enquiring about planned births should be informed of the risks and benefits. Specifically this should tell them that although the risk is low, the most recent evidence shows “planned home birth is associated with a twofold to threefold increased risk of neonatal death when compared with planned hospital birth”.

With medical costs skyrocketing, it is important to consider that cost may be factoring into the decision to have a home delivery for some women. The average cost in the United States for a vaginal delivery is over $8,000 and for a C-section over $13,000 and this will vary by region. There is no way to really determine why more women are choosing to deliver their babies at home, but it will be interesting to see if the trend continues.