New Analysis Reveals Women Choosing Midwife-Led, Out-Of-Hospital Births At An Increasing Rate

Online, October 1, 2013 (Newswire.com) - An analysis, Recent Trends in Out-Of-Hospital Births, released today by the American College of Nurse-Midwives' peer-reviewed journal, the Journal of Midwifery & Women's Health (JMWH), reveals not only that women are choosing midwife-led, out-of-hospital births at an increasing rate in the United States, but also that the pace at which women are choosing this option appears to be accelerating.

Authors also found that substantially less out-of-hospital births occurred to adolescents and unmarried women in 2010 compared to 2004, and there were fewer preterm, low-birth-weight, and multiple births. The analysis confirms findings of previous studies suggesting that women are intentionally planning most of the out-of-hospital births. In fact, nearly all home births attended by midwives were reported as planned.

"This report adds to the body of evidence-based information available for women as they research their options for the right birth setting and provider," said ACNM CEO Lorrie Kline Kaplan, CAE. "Women are increasingly choosing midwives as their care providers both in and out of hospital in the United States. ACNM is working hard to ensure that more and more women understand midwife-led care regardless of where they choose to give birth."

Analyzing national birth certificate data from 2004 to 2010, the report authors Marian MacDorman, PhD, Eugene Declercq, PhD, and T.J. Mathews, MS, found a 41% increase in the proportion of home births and a 43% increase in birth center births, with 10% of the home birth rise and 14% of the birth center rise occurring within the last year.

"Our analysis shows that recent reports of the rise in home births are only part of the out-of-hospital birth story," said Dr. MacDorman. "We found that birth centers account for a significant and increasing proportion of out-of-hospital births and are a substantial contributor to the rate of out-of-hospital birth in the United States being at its highest since 1989."

As of 2010, about 1 in 85 US births occur outside of a hospital. Researchers found that number is highest among non-Hispanic white women, with 1 in 57 of their births occurring outside a hospital. Geographic disparities in women choosing out-of-hospital birth are also apparent, with the greatest prevalence of out-of-hospital births occurring in the Pacific Northwest and the lowest prevalence in the southeastern United States.

"States that had more home births tended to also have more birth center births," said Dr. Declercq. "This suggests that some states are more likely to have laws receptive to the idea of out-of-hospital births and supportive of midwifery practice to the full extent of the profession's education and training, while others may be more restrictive."

A recent study conducted by the American Association of Birth Centers (AABC) and also published in JMWH, The National Birth Center Study II, highlights the benefits for women who seek care at midwife-led birth centers. Findings also highlight longstanding evidence that midwife-led birth centers provide safe and effective health care for women during pregnancy, labor, and birth. Additionally, a 2013 survey conducted by Childbirth Connection, Listening to Mothers III, found that among women who had given birth in a hospital within the past year, 64% said they would consider a birth center and 29% a home birth for a future birth.

A 2012 ACNM survey of 1200 US women found that half of women surveyed want more discussion with their health care provider about place of birth-but most women are not receiving helpful information about these choices from their health care provider. Through the innovative awareness initiative, Our Moment of Truth™, ACNM is on a mission to improve women's health and maternity care in the United States by challenging every woman to become an active participant and decision maker in her health and to discover the full range of options available to meet her women's health care needs.