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Home Births on the Rise in the U.S.

Increase in Home Births Comes as Debate Over Safety Intensifies

Midwives See Increased Interest

The majority of babies that are born at home, about 60%, are delivered by midwives, the study found.

And midwives say they've noticed an increase in demand.

"We started out our practice doing eight to 12 births per month and now we're doing twice that number," says Alice Bailes, a certified nurse midwife who has a practice in Alexandria, Va., with Marsha Jackson, who is also a certified nurse midwife.

The women who come to them, they say, are well informed, and are looking to avoid invasive births and procedures they may not want. They also may have been born at home themselves and want to continue the tradition.

"Women are having fewer babies and they do a lot of research. The Internet is available," Jackson says. "They do a lot of research to look at all the different options to be sure that the practitioner that they work with is going to help them have the type of birth that they desire."

Weighing the Risks of Home Birth

Even in normal pregnancies that have progressed without a hitch, Caughey says things that happen during labor and delivery can make the birth risky to mother or baby.

"I think that the evidence would suggest that if you have a birth far away from the ability to do an emergency cesarean delivery, complications could occur that could lead to morbidity and mortality in the babies," Caughey says.

"What is that number? It's maybe one per thousand or two per thousand," babies that will run into trouble, he says. "It's not a big number. It's not a dramatic number."

"That needs to be played off a person's preferences, what a person wants, and what risks they want to take."

For healthy, normal pregnancies, Fineberg thinks home births are a reasonable option.

But she worries that some women who are opting for birth at home, particularly mothers who are over age 40, may not realize the increased risks they face.

"Statistically, they have a much higher chance of having interventions in labor, that's been shown in quite a few studies," she says.

From a midwife's perspective, women with pre-existing medical conditions should probably avoid home birth.

"If you have heart conditions, high blood pressure, gestational diabetes, multiple births, or breech births, those aren't the people we feel are appropriate candidates for home birth," Jackson says.

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