Is the Pandemic to Blame for the Spike in US At-Home Births?

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Typically, at-home births account for about 1% of all births in the US. But due to fear of contracting COVID-19, visitation restrictions for family members, and in some cases, babies not being allowed to stay in the mother’s room, many moms are deciding against delivering at a hospital.

This is backed up with data according to the findings released Thursday, December 9, 2021, by the Centers for Disease Control and Prevention’s National Center for Health Statistics. This new data shows home births spiked in 2020, up 22% from the year before and the highest in thirty years. National Vital Statistics Reports Volume 70, Number 15 November 2, 2021 (cdc.gov)

“The percentage of home births rose each month March through December in 2020 compared with the same period in 2019,” Elizabeth Gregory, a CDC scientist and lead author of the study stated. “The timing of the increases in home births generally corresponds with the initial surge of COVID-19 cases in the United States.”

Other findings in this study included:

  • For non-Hispanic White women, the percentage of home births increased 21%,
  • For non-Hispanic Black women, the percentage of home births increased 36%,
  • For Hispanic women, the percentage of home births home increased by 30%.

From 2019 to 2020, the percentage of home births increased in 40 states. Increases ranged from 11% for Wisconsin to 68% for South Dakota.

Although out-of-hospital births have been on the rise, professional organizations say they can be risky.

The American College of Obstetricians and Gynecologists released a statement, in part, saying: “Data has long demonstrated that hospitals and accredited birth centers are the safest places to give birth. Although each woman has the right to make a medically informed decision about a delivery, it is imperative that women be informed about the factors that are critical to reducing perinatal mortality rates and achieving favorable birth outcomes.” ACOG Statement on Birth Settings | ACOG

Also, according to ACOG, home births are associated with more than double the risk of a baby dying between 22 weeks gestation and seven days after birth. At-home births are at three times the risk of infant seizures or serious neurologic disorders.

In another ACOG paper, they recommended that women should be informed that several factors are critical to reducing perinatal mortality rates and achieving favorable home birth outcomes. These factors include the appropriate selection of candidates for a home birth; the availability of a certified nurse-midwife, certified midwife, or midwife whose education and licensure meet International Confederation of Midwives Global Standards for Midwifery Education, or physician practicing obstetrics within an integrated and regulated health system; ready access to consultation; and access to safe and timely transport to nearby hospitals.

This data also coincides with data from the Department of Health and Human Services showing that in-person hospital visits significantly declined and telehealth increased. DHHS stated, “massive increases in the use of telehealth helped maintain some health care access during the COVID-19 pandemic, with specialists like behavioral health providers seeing the highest telehealth utilization relative to other providers.” The report found that the share of Medicare visits conducted through telehealth in 2020 increased 63-fold, from approximately 840,000 in 2019 to 52.7 million.

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