Home Birth On the Rise

Home births at highest level since 1990

The number of women having babies at home increased 20% between 2004 to 2008 according to a new study in the journal Birth: Issues in Perinatal Care.  The change is mainly due to a 94% increase in home births in white women, the authors said.

Home births increased significantly in 27 states during this period; only four states saw declines. Montanahad the highest increase. Reproductive statistics expert and lead author Marian F. MacDorman of the National Center for Health Statistics at the Centers for Disease Control and Prevention says home births are at the highest level since 1990.

“Women may prefer a home over a hospital birth for a variety of reasons including a desire for a low intervention birth in a familiar environment surrounded by family and friends,” MacDorman said. “Cultural or religious concerns, lack of transportation in rural areas and cost factors may also play a role as total costs for home births are about 1/3 those for a hospital birth.”

MacDorman said risks associated with home births also went down during this period. “It might mean home birth midwives and practitioners are doing a better job of selecting low-risk women for home births.”

Women with a high risk of complication and therefore not good candidates for a home birth include those over 40 years of age, weighing 300 pounds or more and have high blood pressure or diabetes, MacDorman said.

The AmericanCollegeof Obstetricians and Gynecologists issued a statement in January that says although the risk of planned home births is low, evidence shows it does carry a two- to three-fold increase in the risk of newborn death than hospital births.

“As physicians, we have an obligation to provide families with information about the risks, benefits, limitations and advantages concerning the different maternity care providers and birth settings,” said Richard N. Waldman, M.D., ACOG president. “It’s important to remember that home births don’t always go well, and the risk is higher if they are attended by inadequately trained attendants or in poorly selected patients with serious high-risk medical conditions such as hypertension, breech presentation, or prior cesarean deliveries.”

ACOG says the best available data show hospitals and birthing centers are the safest place for labor and delivery.