US home births reached highest level in 30 years in 2021

By Carma Hassan, Nov. 18: There were more than 50,000 home births in the United States in 2021, an increase of 12% over the year before and the highest level since at least 1990, according to a report released from the US Centers for Disease Control and Prevention’s National Center for Health Statistics.

This follows a 22% increase in home births between 2019 and 2020, “corresponding with the initial surge of COVID-19 cases in the United States,” the report says.

Home births increased by 21% for Black women, 15% for Hispanic women and 10% for White women in 2021.

Among the 30 states that reported more births at home, West Virginia had the highest increase: 49% between 2020 and 2021.

Despite the rise, home births still remain rare, accounting for 1.26% of all births in the US, according to the report.

Data for home births before 1990 is not available.

Planned home birth in the United States has been associated with an absolute risk increase of about 1 to 2 fetal or newborn deaths per 1,000 live births, according to the American Academy of Pediatrics. Infants born at home in the US also have an increased incidence of low Apgar scores and neonatal seizures.

The paediatrician group generally doesn’t recommend planned home births, but it does recognize a woman’s right to choose one.

The academy’s guidelines say home birth is best for women who have no preexisting or maternal disease and who can plan to have two medical providers present with the necessary skills and equipment.

Providers should have the training, skills and equipment needed for infant resuscitation, as some babies have difficulty breathing, and the nearest hospital should be a maximum of 20 minutes away, according to the guidelines.