Home births climb as distrust of hospitals grows
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The rate of home births in the U.S. keeps climbing years after the pandemic surge.
Why it matters: The shift reflects a growing distrust of the traditional medical system and demand for more personalized maternity care.
By the numbers: About 1% of U.S. live births happened at home in 2019 — in 2023, more than 1.5% did, per the Centers for Disease Control and Prevention.
State of play: The U.S. maternal death rate is the highest of any high-income nation.
- And, per 2023 CDC data, Black mothers have more than 3 times the mortality rate of non-Hispanic white women.
- Those figures — along with the medical system's not-so-ancient history of racial discrimination and overlooking women — scares some pregnant patients away from giving birth in a typical hospital setting.
What we're hearing: "In general, patients have distrust of the established medical system — especially Black patients," says Veronica Gillispie-Bell, a Black OB-GYN and representative of the American College of Obstetricians and Gynecologists. "In the 17 years I've been in practice, there's definitely been a shift."
- While a patient is the guest during a hospital birth, at a home birth "it's a different power dynamic," says Michelle Palmer, board member and fellow of the American College of Nurse-Midwives. "You're being invited to their home as a provider," and the patient makes the rules about what they can eat, which rooms they can labor in, and who can be around.
Reality check: Safety data on U.S. home births is limited.
- Some studies suggest that giving birth at home is associated with an increased risk of perinatal and neonatal death, but data collection problems may exist.
- If you only consider low-risk patients who are attended by qualified providers and have clear hospital transfer plans in case of emergency, births at home have comparable outcomes to those in birth centers, 2024 research suggests.
What we're watching: As Medicaid cuts and the government shutdown lead to the overburdening and closures of more hospitals in rural and underserved areas, pregnant patients may face more obstacles to getting personalized care, regardless of where they plan to deliver.
