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U.S. Home Births Continued Steady Increase in 2012

Report cites improving safety profile

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

TUESDAY, March 4, 2014 (HealthDay News) -- The percentage of U.S. women choosing to give birth at home or in a birthing center rather than a hospital has grown by 56 percent in less than a decade, according to a new government report.

Although hardly the norm, out-of-hospital births accounted for 1.36 percent of U.S. births in 2012, according to the U.S. Centers for Disease Control and Prevention. A year earlier, 1.26 percent of births occurred away from a hospital, while just 0.87 percent of such deliveries took place in 2004.

"That's a pretty good jump in a single year, and it's been a continuing trend since 2004," said T.J. Mathews, a demographer with the CDC's National Center for Health Statistics.

The new numbers reflect the ever-growing popularity of home births aided by midwives, said Lynn Johnson, midwife and administrator of Women's and Children's Services at Huntington Hospital in New York.

"More people are talking about midwifery birth and having their experience as they would like to have it," Johnson said, adding that some women worry about losing their autonomy and having a doctor call the shots during delivery.

Two-thirds of the out-of-hospital births occurred at home, the CDC found, while another 29 percent occurred in a birthing center. Another 5 percent occurred in a clinic, doctor's office or other location.

The CDC also reports births outside the hospital carried a lower "risk profile" in 2012, with a smaller proportion of preterm and low birth weight babies than in hospital delivery rooms.

This would appear to run counter to a recent Cornell study that found the risk of a baby dying is nearly four times higher when delivered by a midwife at home than by a midwife at a hospital.

Mathews said the reduced risk of home childbirth compared to hospital birth likely stems from good screening by obstetricians, who advise women facing a dicey delivery to give birth in a medical setting.

"If you're planning a home birth, then you're hopefully having a conversation with your physician or your midwife about whether it's a good idea," he said. "If there is risk, women seem to be going to the hospital, or giving birth near a hospital."

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.

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