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Keywords:

  • birth certificate;
  • home birth;
  • out-of-hospital birth;
  • race and ethnic differences

Abstract:  Background:  After a gradual decline from 1990 to 2004, the percentage of births occurring at home increased from 2004 to 2008 in the United States. The objective of this report was to examine the recent increase in home births and the factors associated with this increase from 2004 to 2008.

Methods:  United States birth certificate data on home births were analyzed by maternal demographic and medical characteristics.

Results:  In 2008, there were 28,357 home births in the United States. From 2004 to 2008, the percentage of births occurring at home increased by 20 percent from 0.56 percent to 0.67 percent of United States births. This rise was largely driven by a 28 percent increase in the percentage of home births for non-Hispanic white women, for whom more than 1 percent of births occur at home. At the same time, the risk profile for home births has been lowered, with substantial drops in the percentage of home births of infants who are born preterm or at low birthweight, and declines in the percentage of home births that occur 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 had declines.

Conclusion:  The 20 percent increase in United States home births from 2004 to 2008 is a notable development that will be of interest to practitioners and policymakers. (BIRTH 38:3 September 2011)