Birth certificate data show that pregnant women in the United States increasingly agree with the adage that there is no place like home.
From 2004 to 2008, home births in the United States increased by 20%, according to a study published online today in Birth: Issues in Perinatal Care. The 28 357 home births represented 0.67% of all US births in 2008, the highest reported proportion since 1990.
Researchers from the National Center for Health Statistics and Boston University’s School of Public Health reported that the upsurge largely was driven by a 28% increase in home births among non-Hispanic white women, for whom more than 1% of births occur at home. Overall, 27 states had statistically significant increases in home births; 4 states had significant decreases. Montana captured the top spot with 2.18% of births taking place at home in 2008.
Notable figures in the study are a 16% decrease in preterm infants born at home, from 7.1% in 2004 to 6% in 2008, and a 17% decrease in low-birth-weight infants born at home, from 5.3% in 2004 to 4.4% in 2008. Also, home births delivered by physicians decreased by 38% to 5.4%. About two-thirds were delivered by certified nurse-midwives, certified midwives, and other midwives.
The increase in home births comes at time of mounting physician opposition to the practice, the authors said. In 2007, the American College of Obstetricians and Gynecologists (ACOG) issued a policy statement opposing home births because of safety concerns for mothers and infants. The American Medical Association supported the ACOG statement.
A variety of factors contribute to a woman’s decision to give birth at home, the authors noted. Some want minimal medical intervention in a familiar surrounding while others have cultural or religious reasons. Transportation and cost also may play roles.