Most tended to be low-risk pregnancies, and Pacific Northwest saw greatest increase
THURSDAY, March 24, 2016 (HealthDay News) — More women in the United States are choosing to deliver their babies at home or in birth centers, and it seems that appropriate selection of low-risk women is improving, according to research published online March 16 in Birth.
Marian MacDorman, Ph.D., research professor at the Maryland Population Research Center at the University of Maryland in College Park, and colleagues looked at birth certificate data over the years from 47 states and the District of Columbia. Out-of-hospital births increased from 0.87 percent of births in 2004 to 1.50 percent in 2014 (a 72 percent increase). The team also found that sociodemographic and medical risk status of out-of-hospital births improved substantially over that time period.
The Pacific Northwest had the highest rate of out-of-hospital births, while the deep South had the lowest. Mothers who gave birth at home were half as likely to be obese before getting pregnant, less likely to smoke, and more likely to plan on breastfeeding. They were also more likely to be college graduates. The researchers also found that 67.1 percent of the planned home births were self-paid, versus 31.9 percent of birth center and 3.4 percent of hospital births. In addition, 4.6 percent of planned home births were vaginal births after cesarean (VBACs) compared to 1.6 percent of hospital and birth center births.
“High rates of self-pay for the costs of out-of-hospital birth suggest serious gaps in insurance coverage, whereas higher-than-average rates of VBAC could reflect lack of access to hospital VBACs,” the authors write. “Mandating private insurance and Medicaid coverage could substantially improve access to out-of-hospital births. Improving access to hospital VBACs might reduce the number of out-of-hospital VBACs.”
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