North Carolina home births have nearly doubled since the pandemic
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While still relatively small compared to overall live births, the number of births occurring inside the home has surged in North Carolina, especially since the pandemic — mirroring what's happening nationally.
Why it matters: The shift reflects a growing distrust of the traditional medical system and a desire for more personalized maternity care.
By the numbers: About 1% of U.S. live births happened at home in 2019, and in 2023, more than 1.5% did, per the Centers for Disease Control and Prevention.
- In North Carolina, 0.5% of live births (604) took place at home in 2019; by 2023, that share had swelled to 0.96% (1,155 total home births).
Flashback: During the pandemic, many expectant patients in North Carolina feared virus exposure at hospitals, noted the Charlotte Ledger.
Between the lines: Certified professional midwives cannot legally deliver babies or provide medical services in North Carolina. This has forced them to operate "underground," the Raleigh News & Observer reported in 2019.
- As of 2023, certified nurse-midwives (registered nurses who've completed a nurse-midwifery education program and passed certain exams) can legally deliver babies at hospitals, at clinics, and at home in North Carolina without a physician's supervision.
Zoom in: Some families opt for home births to avoid the steep hospital bills associated with giving birth. But insurance doesn't always cover the cost of a home birth, so patients may have to cover the flat rate of a midwife.
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 three 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 — make some patients wary of giving birth in a typical hospital setting.
What they're saying: Sakina O'Uhuru, a nurse-midwife in Charlotte, pointed to the high maternal mortality rate among Black patients as a reason those mothers-to-be are particularly interested in home births these days, Spectrum News reported.
- "Some of that is related to unresponsive providers who aren't validating their voices," O'Uhuru said.
Reality check: Safety data on U.S. home births is limited.
- Providers often require patients to be considered low-risk to give birth at home.
- Additionally, the home must be within a relatively short drive to a hospital, just in case.
What we're hearing: "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 during a home birth, says Michelle Palmer, board member and fellow of the American College of Nurse-Midwives.