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Home Births on the Rise in the U.S.

Increase in Home Births Comes as Debate Over Safety Intensifies

Why More Women Are Giving Birth at Home continued...

"For example, a lot of concern about the rising C-section rate, rising medical interventions, induction of labor, episiotomy, and so forth," MacDorman tells WebMD.

"I think there's a certain group of women who maybe feel nervous about going to the hospital and maybe having a C-section they didn't want or something like that," she says.

Other experts say that rings true.

"They are people who have had control over their lives, so they want control over this," says Annette E. Fineberg, MD, an obstetrician-gynecologist in the department of women's health at the Sutter West Medical Group, in Davis, Calif.

Feinberg recently wrote a commentary for Obstetrics & Gynecology on the rise in home births, but she was not involved in the study.

She says many of her patients have voiced concerns about a hospital birth experience, hoping they'll have a better chance of delivering a baby vaginally if they give birth at home.

Sometimes, they're right, she says.

Home Births and C-Sections

"There is currently a cesarean epidemic in the United States," says Aaron Caughey, MD, PhD, chair of the department of obstetrics and gynecology and director of the center for women's health at Oregon Health and Science University, in Portland.

Caughey is researching home births but was not involved in the current study.

He points to the numbers: In 1996, 21% of births were C-sections, but by 2009, that number was 32%, a 50% increase, "making cesarean delivery the most common surgery that a woman under the age of 50 will have."

Fear of lawsuits has driven some doctors to order C-sections instead of waiting for labor to progress.

"The saying in the profession is that 'nobody is ever sued for the cesarean delivery they did too soon,'" Caughey says.

And many hospitals refuse to let women who've had one C-section deliver their next baby vaginally, even though most can do so safely, a policy that sends some women looking for other options.

At the same time, he says, it's clear that doing more cesareans hasn't improved the health of mothers or infants.

"There wasn't then a dramatic decline in birth injury. It's not like we somehow improved outcomes with that cesarean delivery," he says.

Most mothers and infants recover well after C-sections, but the procedures require a longer healing time than vaginal deliveries, up to four to six weeks, and there are additional risks of bleeding, infection, or reactions to anesthesia. 

In addition, the March of Dimes says babies born by C-section are more likely to have breathing problems than babies that are delivered vaginally. And though it's not clear why, moms who have C-sections are less likely to breastfeed.

C-sections may also cost more than vaginal births.

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