U.S. Home Births Continued Steady Increase in 2012
Report cites improving safety profile
Dr. James Byrne, chair of Ob/Gyn for Santa Clara Valley Medical Center and a clinical professor at Stanford University School of Medicine, agreed with that assessment.
"The women with risk factors are less likely to be delivering at home, which is wise and safe for the public," Byrne said.
For example, fewer births to teen mothers and fewer multiple births -- both tied to greater health risks -- occurred outside the hospital.
Byrne added that a new emphasis 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.
In addition, many midwives now work with a woman's full medical team, which improves the safety of home delivery. "That can greatly facilitate prompt and effective consultations if problems arise," Byrne said. "It eliminates a lot of barriers."
Byrne said some women should rule out home delivery out-of-hand -- those with prior C-sections, women who are morbidly obese and women at risk for breach birth.
Other highlights of the report follow:
- White women chose out-of-home births about four times more often than other ethnic groups -- about 2 percent of whites versus half a percent of blacks, Hispanics and Asians. "They've consistently had higher rates for a while now," Mathews said of whites. "If they're getting good results and they're talking to each other, it becomes more of a normal option for that population."
- The six states leading the charge in 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.
- Women in Rhode Island, Mississippi and Alabama accounted for only 0.33 percent to 0.39 percent of home births.
- About 4 percent of out-of-hospital births were preterm in 2012, compared with almost 12 percent of hospital births. Similarly, about 3 percent of out-of-hospital births were low birth weight versus more than 8 percent in the hospital. By contrast, in 2004, nearly 7 percent of out-of-hospital births were preterm and about 5 percent were low birth weight.
- In the 36 states that have birth certificates that note whether the delivery took place as intended, 88 percent of home births took place as planned in 2012. This indicates these home births were not surprises, Mathews said.
The findings are published in the March issue of the CDC's NCHS Data Brief.