U.S. Home Births Increase 20 Percent from 2004 to 2008
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- Published on Tuesday, 24 May 2011 14:27
Home births in the United States increased 20 percent between 2004 and 2008, reversing a gradual 15-year decline from 1990 to 2004, according to a new study co-authored by a Boston University School of Public Health researcher.
The study, co-authored by Eugene Declercq, professor of community health sciences, and published online in Birth: Issues in Perinatal Care. found that the 28,357 home births in 2008 represent 0.67 percent of the approximately 4.2 million births in the United States -- the highest reported proportion since 1990.
"This research shows a distinct change in a long term trend with a larger number of women choosing home births, Declercq said. "While the numbers remain low, the trend is unmistakable."
This change was largely driven by a 28 percent increase in home births for non-Hispanic white women, for whom more than 1 percent of all births now occur at home. Rates of home birth for non-Hispanic black (0.30%), Hispanic (0.20%), Asian-Pacific Islander (0.27%), and American Indian (0.38%) mothers all remained low with little change since 2004.
Approximately 94 percent of the increase in the overall percentage of home births from 2004 to 2008 was due to the increase for non-Hispanic white women. At the same time, the risk profile for home births has decreased, with substantial drops in the percentage of infants born at home who are preterm or low birthweight, and born to teen and unmarried mothers.
Twenty-seven states had statistically significant increases in the percentage of home births from 2004 to 2008; only four states experienced declines. Montana had the highest percentage of home births (2.18%), followed by Vermont (1.96%) and Oregon (1.91%), whereas Mississippi, Louisiana, and Delaware (all at 0.2%) had the lowest rates. Of states with at least 100 home births annually, North Carolina, Virginia, Indiana, and Maryland all experienced an increase of at least 50 percent in home birth rates between 2004 and 2008. Vermont (-23%), Nevada (-18%), and Arkansas (-17%) reported the greatest decreases.
The American College of Obstetricians and Gynecologists in 2011 issued a statement disapproving of the practice of home birth. Nonetheless, as Marian MacDorman lead author of the report notes, "A significantly larger number of women in 2008 have chosen to opt for a home birth experience, a development that will be of interest to practitioners and policymakers."
Read the full study.
Image from Flickr user steve.ie.