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  • Rondi E. Anderson CNM, MS,

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    • Rondi E. Anderson has assisted home births for the past 20 years and currently operates a home birth practice in Lancaster County, Pennsylvania. She received her BS at Michigan State University and her MS at the University of Utah. She is featured in Sisters on a Journey: Portraits of American Midwives and has published two previous articles on home birth outcomes.

  • David A. Anderson PhD

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    • David A. Anderson is Assistant Professor of Economics at Centre College in Danville, Kentucky. He received his BA from the University of Michigan and his MA and PhD from Duke University. His previous research includes studies of marriage, social insurance, crime, and education.

David A. Anderson, PhD, Dept. of Economics, Centre College, 600 West Walnut Street, Danville, KY 40422.


As health care costs increase and a growing number of women are without insurance, the one health service that every family needs deserves further attention. Even for the 40% of births covered by Medicaid, safe birthing alternatives that permit a reduction in the $150 billion Medicaid burden would allow the United States to devote more resources to other urgent priorities. Informed birthing decisions cannot be made without information on costs, success rates, and any necessary tradeoffs between the two. This article provides the relevant information for hospital, home, and birth center births. The average uncomplicated vaginal birth costs 68% less in a home than in a hospital, and births initiated in the home offer a lower combined rate of intrapartum and neonatal mortality and a lower incidence of cesarean delivery.