In CDC Report, Declercq and Colleagues Find Rise in Out-of Hospital Births.

The percentage of U.S. women choosing to give birth at home or in a birthing center rather than a hospital has grown by 56 percent in less than a decade, according to a new government report co-authored by a BUSPH researcher.

Still rare, out-of-hospital births accounted for 1.36 percent of U.S. births in 2012, according to the U.S. Centers for Disease Control and Prevention (CDC) report co-authored by community health sciences Prof. Eugene Declercq. A year earlier, 1.26 percent of births occurred away from a hospital, while just 0.87 percent of such deliveries took place in 2004.

Two-thirds of the out-of-hospital births occurred at home, the CDC team found, while another 29 percent occurred in a birthing center. Another 5 percent occurred in a clinic, doctor’s office or other location.

The CDC also reports that births outside the hospital carried a lower “risk profile” in 2012, with a smaller proportion of preterm and low birth weight babies than in hospital delivery rooms. Fewer births to teen mothers and fewer multiple births — both tied to greater health risks — occurred outside the hospital.

Other highlights of the report were:

• White women chose out-of-home births about four times more often than other ethnic groups — about 2 percent of whites, versus half a percent of blacks, Hispanics and Asians.
• The six states leading the charge in out-of-hospital births are Alaska, Pennsylvania, Idaho, Montana, Oregon and Washington, with 3 percent to 6 percent of births occurring at home or in a birthing center.
• Women in Rhode Island, Mississippi and Alabama accounted for only 0.33 percent to 0.39 percent of home births.
• About 4 percent of out-of-hospital births were preterm in 2012, compared with almost 12 percent of hospital births. Similarly, about 3 percent of out-of-hospital births were low birth weight, versus more than 8 percent in the hospital. By contrast, in 2004, nearly 7 percent of out-of-hospital births were preterm and about 5 percent were low birth weight.
• In the 36 states that have birth certificates that note whether the delivery took place as intended, 88 percent of home births took place as planned in 2012.

The findings are published in the March issue of the CDC’s NCHS Data Brief.

Besides Declercq, study authors included: Marian F. MacDorman and T.J. Mathews of the Centers for Disease Control and Prevention’s National Center for Health Statistics.

The researchers used data from the CDC’s National Center for Health Statistics National Vital Statistics System, Birth Data Files for 1990 to 2012, which includes data for all births occurring in the United States.