Home births seem to be the cool thing again, as new statistics have shown that more and more mothers are opting to deliver their babies in the comfort and familiarity of their own homes, or in the cozier and warmer environment of a birthing center.
The Centers for Disease Control and Prevention has issued a National Center for Health Statistics data brief, written by Marian F. MacDorman, T.J. Matthews and Eugene Declerq of the CDC. The brief said that the increase in out-of-hospital births began in 2004, and continued all the way to 2012. In 2011, out-of-hospital births increased by 1.26 percent, and in 2012, the increase was 1.36 percent.
"If this increase continues, it has the potential to affect patterns of facility usage, clinician training, and resource allocation, as well as health care costs," said the authors.
However, despite a recorded all-time high, the numbers still represent a small fraction of all births in the country.
The data brief also mentioned that the risk profile for out-of-hospital births was lower compared with that of hospital births. There were fewer out-of-hospital births to teen mothers, and there were fewer pre-term, low birth weight, and multiple births.
Only 3.2 percent of babies delivered in non-hospital settings had low birth weight, compared with 8.1 percent of babies born in hospitals in 2012. Furthemore, 4.4 percent of non-hospital deliveries were preterm ones, compared with 11.6 percent of preterm births in hospitals. Twins, triplets and other multiples accounted for 0.8 percent of non-hospital births, while in hospitals it was only 3.5 percent.
White women were the ones who drove this marked increase. The data brief explained that non-Hispanic white women comprised 2.05 percent of all out-of-hospital births in 2012. That's 1 in 49. Non-Hispanic black women comprised 0.49 percent of the total, or 1 in 200. American Indian women contributed 0.81 percent to the total, while Asian or Pacific Islander women comprised 0.54 percent of the total out-of-hospital births in 2012.
Of all out-of-hospital births in 2012, 66 percent, or about 35,000 were done at home while 29 percent, or 16,000 were done at a birthing center. In the same year, Alaska had the highest out-of-hospital birth rate, accounting for 6 percent of the total, and is followed by Montana with 3.9 percent, Oregon with 3.8 percent, Washington with 3.4 percent, Idaho with 3.4 percent, and Pennsylvania with 3.1 percent.
Lowest in the list were Rhode Island with 0.33 percent, New Jersey with 0.44 percent, and Illinois with 0.53 percent.
There are certainly risks with an out-of-hospital birth, due to lack of support in place, in terms of medical personnel and equipment, in the chance of an emergency. This is the reason why the American Academy of Pediatrics (AAP) has issued a policy statement requiring pediatricians to fully disclose to all mothers all possible risks when planning for an out-of-hospital birth.
"Pediatricians must be prepared to provide supportive, informed counsel to women considering home birth while retaining their role as child advocates in assessing whether the situation is appropriate to support a planned home birth," said the authors of the statement.
The AAP also outlined the requirements for a proper out-of-hospital birth, which includes at least two medical staff, and one of them must solely focus on the care of the newborn baby. Medical staff present at the birth must be trained at resuscitating an infant when necessary, and care of the newborn must comply with the standards followed by hospitals. Attending midwives must be certified by the American Midwifery Certification Board.
Another policy statement issued by the Committee on Obstetric Practice of the American Congress of Obstetricians and Gynecologists said that hospitals and birthing centers must respect the right of the mother to make an informed decision regarding her delivery of choice. She must be given full disclosure of the risks and benefits of what ever delivery mode she will be choosing.
Despite the fact that 13 states do not have any birthing centers, there was humble increase in he number of birthing centers across the country. In 2004 there were 170, while in 2013 there were 248.
The data brief has explained that in the 1900s, most of the births happened at home, but by 1940, more and more people preferred to give birth in hospitals. From 1969 until the 1980s, out-of-hospital births comprised only 1 percent of the total number of births in the country.
