Nov 18, 2022 - Health

CDC: Home births surged during pandemic

Illustration of a crib sitting beneath a mobile with a hanging medical cross

Illustration: Annelise Capossela/Axios

The pandemic caused a 30-year high in U.S. births at home in 2021 as people avoided hospitals that were being swamped with COVID-19 cases, the Centers for Disease Control reported on Thursday.

Why it matters: The findings offered another view of the pandemic’s effects on maternal health and how, of the nearly 52,000 home births recorded last year, the greatest increases were among Black and Hispanic women.

What they found: While home births rose an average of 2% from 1990 to 2019, they jumped 22% between 2019 and 2020, said Elizabeth Gregory, a researcher who co-authored the report.

  • The overall percentage of people giving birth at home in 2021 — 1.41% — was the highest level since at least 1990.
  • It was as high as 1.51% in January 2021, when COVID vaccines weren’t widely available and one person in the U.S. was dying from the virus every 28 seconds.

What they’re saying: “For the first time in my whole career, women were more afraid of the hospital than afraid of birth,” said Maria Iorillo, a licensed midwife in San Francisco who has been assisting in home births for nearly 40 years.

  • Iorillo told Axios how she began fielding six calls a day in the early months of the pandemic asking about home births. She normally received perhaps three a week.
  • Home births were a comforting, more cost-effective alternative for low-risk pregnant patients, Iorillo added, especially when hospitals were restricting who could accompany people.
  • A home setting also offers more autonomy to people of color, who can face discrimination and structural racism that result in lower quality hospital care, per an April report from the National Partnership for Women and Families.

Flashback: COVID played a role in 1 in 4 maternal deaths the first two years of the pandemic, with Black pregnant women facing a mortality rate that was nearly three times higher than their white peers, according to an oversight report to Congress.

  • For the first time in at least 14 years, Latinas have a higher maternal mortality rate than white women.

Zoom in: A growing number of hospital closures and a lack of access to obstetric services in rural areas have previously caused a spike in out-of-hospital births, according to CMS data covering 2004-2014.

  • At an average of $4,650, home births can cost a fraction of hospital stays, which can be upward of nearly $19,000. But that figure fluctuates depending on location.
  • U.S. Americans could see $321 million in savings for every 1% that shifts toward home births instead of hospitals, estimates a report from the International Journal of Environmental Research and Public Health.

Yes, but: Iorillo has seen the interest in home birth slow down as the pandemic enters a different phase and birth rates continue to decline.

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