Ever since Ricki Lake’s movie, “The Business of Being Born,” was released in 2008, home birth has been the subject of news stories and trend pieces, heated discussions and dire warnings from M.D.s. The film was influential to be sure. It brought home birth out from the fog of burning sage and into the clean-aired living rooms of Brooklyn apartment dwellers. It also influenced more than one woman to go the at-home route for childbirth.
But Lake’s movie can’t take all the credit (or blame, I suppose. Depends on your attitude). At the time the movie was released, home birth had already begun to reverse an almost 15-year steady decline, according to research coming out of the the Centers for Disease Control.
Their National Vital Statistics Report, released this week, found a sudden 3 percent jump in the number of births taking place outside of a hospital, starting in 2005 — a 5 percent jump in home births alone.
For the following three years, out-of-hospital births comprised a full one percent of all births in the country.
Of course, 1 percent is a tiny fraction, especially considering that 70 years ago, 44 percent of all births occurred outside a hospital. Still, 1 percent represents 38,568 actual births (24,970 of which took place at home). That’s not insignificant. There were 10,781 births in freestanding birth centers, according the report. The remainder of the non-hospital births happened in a clinic or the doctors office and “other” (probably all those babies born in McDonald’s drive-thrus, on planes and in taxi cabs).
So who are these thousands of women giving birth at home?
Most are non-Hispanic white women, over the age of 25 and who already have kids. While white women make up more than half of all hospital births, they make up 84 percent of all homebirths. Black women also have 8 percent of the homebirths yet they’re only 16 percent of hospital births. Hispanic women have 8 percent of the homebirths but are 25 percent of all hospital births.
Teens have the lowest rates of out-of-hospital births, while women over 40 (and especially over 45) are mostly likely to. The women with the most kids also made up the largest percent of the homebirths in the years studied.
Nearly three-quarters of all homebirths happen in rural counties with a population of less than 100,000.
Some states, like Vermont and Montana, saw twice the national rate of homebirth in their states in 2005 and 2006, while states like Louisiana and Nebraska had only .2 percent of the births.
Almost 61 percent of the homebirths were attended by midwives. Of that number, a quarter were attended by certified nurse midwives and the other 75 percent by lay midwives and certified professional midwives.
But why the jump? Researchers only speculated in the report, saying the high rural numbers may indicate a lack of services or transportation for a significant group of people. They also acknowledge religious beliefs can preclude some women from giving birth in hospitals. The report mentions the desire for low-intervention births and the fact that the more kids a woman had (or the older she was) the greater the chance she’d do it at home should mean something. Does it mean previous inadequate births in hospitals pushed them toward home? It would also be interesting to know what percent of homebirths were VBACs.
Also interesting is a report on what doctor’s say about the rise in c-sections.
The years covered in this study predate all the hubbub about home birth. A study of the following three years would tell us whether it really its a Hollywood trend likened to spa treatments as the Today Show reported last year.
What do you think? Why the rise in home births 2005? What triggered that?