Declercq Co-Authors CDC Data Brief on Home Births.

Gene Declercq, professor of community health sciences at BUSPH, has co-authored a data brief on home births for the National Center for Health Statistics, an arm of the Centers for Disease Control and Prevention.

Gene DeclerqThe brief tracks trends in home births from 1990-2009, showing that after a decline from 1990 to 2004, the percentage of U.S. births that occurred at home increased by 29 percent — from .56 percent in 2004, to .72 percent in 2009. In 2009, the percentage of home births to non-Hispanic white women was three to five times higher than for any other racial or ethnic group.

Home birth rates also varied geographically, with the percentage generally higher in the northwestern U.S. and lower in the southeastern U.S. In 2009, Montana had the highest percentage of home births (2.55 percent), followed by Oregon (1.96 percent) and Vermont (1.91 percent).

“Studies have suggested that most home births are intentional or planned home births, whereas others are unintentional or unplanned, because of an emergency situation (i.e., precipitous labor, labor complications, or unable to get to the hospital in time),” the brief says. “Although not representative of all U.S. births, 87 percent of home births in a 26-state reporting area (comprising 50 percent of U.S. births) were planned in 2009.”

Women may prefer a home birth over a hospital birth for a variety of reasons, including “a desire for a low-intervention birth in a familiar environment surrounded by family and friends, and cultural or religious concerns. Lack of transportation in rural areas and cost factors may also play a role, as home births cost about one-third as much as hospital births,” the brief says.

Other findings include:

• Compared with hospital births, home births are more common among older married women with several previous children.One in five home births were to women aged 35 and over, compared with 14 percent of hospital births. About half of home births were third- or higher-order births, compared with 28 percent of hospital births.
• Home births have been found to have a lower risk profile than hospital births.The percentage of home births that were preterm was 6 percent, compared with 12 percent for hospital births. The percentage of home births that were low birth weight was 4 percent, compared with 8 percent for hospital births. The lower risk profile of home births “suggests that home birth attendants are selecting low-risk women as candidates for home birth.”

Co-authors on the brief were Marian F. MacDorman and T.J. Mathews, of the CDC’s National Center for Health Statistics, Division of Vital Statistics.

The full brief is available here: http://www.cdc.gov/nchs/data/databriefs/db84.htm

submitted by: Lisa Chedekel

chedekel@bu.edu