Planned Home Births versus Hospital Births: Are More Babies Being Born At Home?

mother and baby

A recent uptick in planned home births over the last decade has many expectant mothers wondering, “Is a home birth right for me?” During a home birth, the mother gives birth at home rather than in a hospital or birth center. Generally, a midwife assists the mother during labor and delivery, although in some cases a nurse or doctor may also be present. While both the American Academy of Pediatrics and the American College of Obstetrics and Gynecologists state “hospitals and birthing centers are the safest settings for birth in the United States,” the groups say they “respect the right of women to make a medically informed decision about delivery.”

HOW MANY WOMEN GIVE BIRTH AT HOME?

New CDC data shows the rate of home births is indeed on the rise, albeit slowly, according to a 2014 report in Time Magazine. Still, the vast majority of women are choosing to give birth in a hospital. The rate of home births rose from 1.26% in 2011 to 1.36% in 2012. The majority of births occurring outside a hospital are also low-risk: they’re more likely to be full term with a safe birth weight.

Higher risk births, like multiple births or births to women under the age of 20, are more likely to occur in a hospital. This data underscores the fact that women who are choosing to give birth at home are doing so, in part, because they have low-risk pregnancies; women with higher risk pregnancies or who are at risk for complications continue to choose a hospital setting. Home births are rising primarily among non-Hispanic white women.

One of the challenges in understanding this change in birthing patterns is that women who plan to give birth at home, but ultimately transfer to a hospital, aren’t always accounted for in this data. Neither are women who plan to give birth in a hospital but end up delivering at home, often due to circumstances outside their control, like the baby arriving much faster than anticipated.

WHY DO WOMEN PLAN A HOME BIRTH?

According to the Mayo Clinic, there are many factors that might influence a woman’s decision for a home birth, including:

  • A desire to give birth in a familiar, safe and relaxing setting
  • A desire to wear one’s own clothes during labor and birth
  • A desire to be surrounded by people of one’s choice
  • A desire to give birth with minimal to no medical intervention
  • A desire to control the labor position or other aspects of the birthing process

Additionally, the Mayo Clinic says that cultural or religious norms and concerns, as well as a history of fast labor or concerns about the cost of hospital births can play a role in influencing a woman’s decision to plan a home birth.

Health care providers may caution a woman against a home birth if she has a history of diabetes, chronic hypertension, a seizure disorder, or has developed pregnancy-related complications, such as pre-eclampsia. A home birth is generally not considered safe for women who are pregnant with multiples, who have previously had a C-section, and/or have a baby who is in a breech position for delivery.

While planned home births still remain a very small percentage of the births occurring each year, they continue to be an increasingly popular option for some expectant mothers. Understanding the reasons a woman may choose to plan a home birth is important for delivering high-quality prenatal care.

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