Birth: U.S. home births increase 20% from 2004 to 2008

Home births in the United States increased 20% from 2004 to 2008, reaching their highest level since 1990, according to a study published online Friday in the journal Birth.

The study’s authors, led by Centers for Disease Control and Prevention statistician Marian F. MacDorman, examined trends in home births by looking at birth certificate data from all 50 states. These provided information about maternal race and ethnicity, maternal age and marital status, whether infants were born prematurely, birth weight, place of birth and who attended the delivery.

While home births had declined gradually between 1990 and 2004, the team found, they began creeping back up in 2004. That year, there were 23,150 home births in the United States -- about 0.56% of total births. In 2008, there were 28,357 home births in the country, or 0.67% of total births.

The increase appears to be driven primarily by an increased interest among Caucasian women in giving birth at home, the authors wrote. In 2004, about 0.80% of births among Caucasian women were home births. In 2008, 1.02% were. The researchers calculated that approximately 94% of the increase in overall percentage of home births between 2004 and 2008 was because of this increase. According to the study, the percentage of home births among white women is three to six times higher than for any other race or ethnic group.

Also of interest: percentages of home births were generally higher in western states, and lower in the Southeast. In 2008, Montana had the highest percentage of home births -- 2.18%. Vermont was next at 1.96%, and Oregon was third at 1.91%. In all, 16 states had more than 1% home births, while 18 states had less than 0.50%.

The percentage of home births delivered by certified midwives or certified nurse-midwives increased from 15.8% in 2004 to 19.2% in 2008. The percentage of home births delivered by other midwives fell from 43.9% in 2004 to 42% in 2008. The vast majority of midwife-assisted births were planned home deliveries. The percentage of home births delivered by physicians -- most of which are unplanned home births, the authors noted -- fell from 8.7% in 2004 to 5.4% in 2008.

The increase in home births may be related to the popularity of movies like 2008’s “The Business of Being Born,” executive produced by actress Ricki Lake, or TV shows such as TLC’s “A Baby Story” that have followed women as they give birth at home in bed or in a bathtub. But the relationship may not be a simple one. The 2004-2008 increase actually began before many of the articles and movies about home births became popular, the authors noted, adding that the trend coincided with several statements of physician opposition to the practice of home births.

“Women choosing home birth may be a harbinger, as much as a result, of increased activism related to childbirth,” they wrote.