Out-of-Hospital Births Increase After 15-Year Decline, Government Report States

March 5, 2010 — Reversing a 15-year trend, the percentage of infants born at home rose slightly in 2005 and remained stable in 2006, according to a report published Wednesday in the Centers for Disease Control and Prevention's National Vital Statistics Reports, USA Today reports. Marian MacDorman, a demographer at CDC's National Center for Health Statistics, said it is not clear what caused the slight increase. Despite the shift, the proportion of births that take place in settings other than a hospital still totals less than 1%.

According to the report, out-of-hospital births accounted for 0.87% of U.S. births in 2004, increasing to 0.9% in 2005 and remaining steady through 2006. In 2006, there were 38,568 out-of-hospital births, of which 24,970 occurred at home and 10,781 occurred in free-standing birth centers.

The report also found that the proportion of out-of-hospital births varied among states. For example, out-of-hospital births represented more than 2% of total births in Vermont and Montana but only 0.2% of total births in Louisiana and Nebraska. MacDorman said factors such as weather, hospital proximity and attitudes toward home birth might account for the state-by-state variations. In addition, the report found that the proportion of home births increased only among non-Hispanic white women, MacDorman said.

Midwives attended the majority of home births in 2006, although more than one-third of home births were delivered by other birth attendants, such as family members or emergency medical technicians, the report said. Physicians attended 7.6% of home births in 2006, a decline from 21.6% in 1990. The American College of Obstetricians and Gynecologists has officially opposed home births since 2007 because of safety concerns. The American Medical Association endorsed ACOG's position the following year.

Infants born out of the hospital were less likely to have low birthweights, be premature or be multiples, suggesting that women are being screened to determine if they are low-risk candidates for home birth, the report said (Rubin, USA Today, 3/3).