Home births see sharp rise in Pennsylvania
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Home births keep rising in Pennsylvania and the nation years after the pandemic surge.
Why it matters: The shift reflects a growing distrust of the traditional medical system, a push for more personalized maternity care, and shrinking rural access to hospitals.
By the numbers: Home births in Pennsylvania rose from 1.9% of live births in 2019 to about 3.3% in 2023, per the Centers for Disease Control and Prevention.
- In the U.S., home births rose from about 1% in 2019 to over 1.5% in 2023.
State of play: The U.S. maternal death rate is the highest of any high-income nation.
- Black mothers have more than 3 times the mortality rate of non-Hispanic white women.
- Those figures — coupled with the medical system's history of racial discrimination and overlooking women — drive some pregnant patients away from hospitals.
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."
- Home births are "a different power dynamic," says Michelle Palmer, fellow of the American College of Nurse-Midwives. "You're being invited to their home as a provider," and the patient calls the shots — from the menu to the birthing room.
Between the lines: Rural hospital closures may be pushing more women toward home births, too. About 12.4% of Pennsylvania women live more than 30 minutes from a hospital or birthing center — higher than the national rate of 9.7%, per a March of Dimes report.
- Home births are also common among Amish families, and Pennsylvania has the nation's largest Amish population.
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, 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.