Apr 30, 2022 - Health

More people of color gave birth outside hospitals in 2020, report finds

Photo of a room with an orange bed and a bathtub next to it
The Mary Ellen Pleasant birthing suite at the San Francisco Birth Center as seen on April 6, 2020 in San Francisco, California. Photo: Lea Suzuki/The San Francisco Chronicle via Getty Images

More people are choosing to give birth at home or in birth centers, with the sharpest increases among Black and Native American communities, according to a new report released by the nonprofit advocacy organization National Partnership for Women and Families (NPWF).

Why it matters: The U.S. has one of the highest maternal mortality rates in the world, and it disproportionately impacts Black and Native women, who are three times and two times more likely to die from pregnancy-related complications respectively.

  • The move to give birth outside the hospital could serve as a cost-effective solution that tears down barriers to safe and individualized care, the report says.

By the numbers: Overall, community birth settings — defined as birth centers and home birth care usually led by midwives — increased by 20% from 2019 to 2020 in contrast to the average annual increase of 0.05% from 2004 to 2019.

From 2019 to 2020, community births increased:

  • 30% among Black women
  • 26% among Native American women
  • 24% among Hispanic women
  • 18% among both white and Asian women
  • 13% among Native Hawaiian and Pacific Islander women

Details: While concern about COVID-19 exposure in hospitals contributed to these upticks, NPWF notes that community births give people the ability to retain more autonomy, a factor that's especially important for people of color who often face "discrimination and structural racism in hospitals that result in lower-quality care."

  • Black, Indigenous, Hispanic and Asian and Pacific Islander women "disproportionately experience births with severe maternal morbidity relative to white, non-Hispanic women," according to the report.
  • "In the long term, we must fundamentally re-imagine what a high-quality, equitable maternal care system looks like, and develop that system," the report states.

What they're saying: "There is strong evidence to support community birth as a high-value care model to advance birth equity," Aubre Tompkins, president of the American Association of Birth Centers, said in a statement.

  • "It is critical that barriers in policy and payment be removed to improve access in all communities and especially for birthing people and families of color."

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