Thread: Slight increase in home births reverses 15-year decline

Slight increase in home births reverses 15-year decline

By Rita Rubin, USA TODAY

After a steady 15-year decline, the percentage of U.S. babies not born in a hospital rose slightly in 2005 and remained stable in 2006, according to a government report released Wednesday.

Even so, the proportion of out-of-hospital births is still less than 1% — a far cry from the 44% in 1940, the authors write in National Vital Statistics Reports.

MIDWIVES: Qualifications vary

In 2004, out-of-hospital births represented 0.87% of total U.S. births, rising to 0.9% in 2005 and staying at that level in 2006. That year, 38,568 births occurred out of a hospital, including 24,970 at home and 10,781 in a free-standing birth center.

"I don't really know what caused that little jump," says lead author Marian MacDorman, a demographer with the National Center for Health Statistics, part of the Centers for Disease Control and Prevention. "I guess we'll keep monitoring it."

The proportion of out-of-hospital births in 2005-2006 varied among states, from more than 2% in Vermont and Montana to 0.2% in Louisiana and Nebraska. Factors such as weather, proximity to a hospital and attitudes toward home birth among women and local doctors might play a role in state-by-state differences, MacDorman says.

Besides state differences, there were also ethnic differences. The increase in home births occurred only among non-Hispanic white women, MacDorman notes.

While midwives attended the majority of home births in 2006, more than a third of babies born at home were delivered by "other" birth attendants, such as a family member, emergency medical technician or taxi driver.

Physicians delivered only 7.6% of babies born at home in 2006, compared with 21.6% in 1990. In 2007, the American College of Obstetricians and Gynecologists, citing safety concerns, issued a policy statement opposing home birth. The following year, the American Medical Association passed a resolution supporting the OB/GYNs' position.

In 2006, birth certificates in 19 states — representing about half of all U.S. births — asked whether a home birth was planned or unplanned. In those states, which the authors note are not representative of the entire U.S. population, about one in six home births, or 17%, were unplanned. They likely were emergencies that might have involved rapidly progressing labor or other complications.

Even including emergency home births, babies born at home still were less likely to be low birth weight, a multiple or premature, the authors write. That suggests pregnant women are being screened to see if they are low-risk candidates for home birth, according to the report.

"Could more women deliver at home? Absolutely," says co-author Eugene Declercq, a professor of maternal and child health at Boston University. The question, Declercq says, is whether they want to. The proportion of home births in the USA is comparable to that of other industrialized countries except for the Netherlands, the authors write, where about 30% occur at home.

http://www.usatoday.com/news/health/201 ... 4_ST_N.htm

People born at home better never run for president because there isn't any hospital copy of a birth certificate for them to show anyone. I know because I was born at home in a small town in Kentucky in the 1940s.