A new study of U.S. births in 47 states, from 2004 to 2014, indicates a small but growing trend: More women are foregoing hospitals in favor of birthing their babies at home or in natural birth centers.
The study finds that, overall, the percentage of out-of-hospital births rose from less than 1 to 1.5 percent overall in that 10-year period.
The study, written by Marian F. MacDorman at the Maryland Population Research Center at the University of Maryland in College Park, finds that 60,000 babies were born out-of-hospital in 2014. Of those, about 38,000 were born at home and the rest were born in birthing centers. Birthing at home is often a good choice for women who hope to avoid medical intervention, such as pain medication, during labor, in favor of natural childbirth. Often, women want to avoid hospitals out of fear that they will lose control of their birth experience. MacDorman says that many of these births are overseen by doulas and midwives, who seek out low-risk women for out-of-hospital births. MacDorman said that while home births are generally just as safe as hospital births, in about 10 to 15 percent of cases, women planning home births end up going to the hospital because of medical complications.
The study notes that, for the most part, women choosing to birth outside of hospitals are white. They are less likely to be obese, less likely to smoke, and more likely to have gone to college than women giving birth in hospitals. Moreover, about two-thirds of the women who birthed out of hospital paid out of pocket, which is true of only 5 percent of hospital births. Geographically, the Southern U.S. had the lowest number of out-of-hospital births, while the Pacific Northwest had the highest. Though the study does not seek to explain these statistics, one thing to note is that insurance providers almost never cover out-of-hospital births, which limits the women for whom they are a realistic option.
About 79 percent of home births and 90 percent of birthing-center births used midwives to help deliver the baby. Overall, only 8 percent of hospital births used midwives in the same period.