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Health Team

More moms giving birth at home; doctors warn of risks

Posted May 23, 2011 5:30 p.m. EDT
Updated May 23, 2011 9:34 p.m. EDT

Pregnancy

New government figures show more women are choosing to give birth at home, but some doctors say there are serious health issues those families should consider.

Kayti Lathrop delivered each one of her five children at home.

“My husband and I were looking for just a personal, quiet, no-drama experience to have a baby,” she said.

More moms are making the same choice. New numbers from the Centers for Disease Control and Prevention show home births are up 20 percent.

“They're going to be at home, they're going to be in a very soothing physical environment (and) they're in their surroundings,” said Dr. Jacques Moritz, a gynecologist at St. Luke’s-Roosevelt Hospital Center in New York.

Most moms who give birth at home use a midwife. That way, sterile instruments are used and there's oxygen on hand, but doctors warn there can be complications.

“Every once and a while, a birth at home can go awry,” Moritz said.

Studies show the risk of newborns dying can be higher during home deliveries. Doctors also recommend that only women with low-risk pregnancies consider them.

Even with minor complications in the last delivery, Lathrop said she has no regrets.

“Women have been doing this for centuries, and they’ve been doing a really good job at it. I just trusted that I could do this,” she said.

Fewer than 1 percent of U.S. births occur at home, according to the new figures, which are for 2004 to 2008. Home births had been declining from 1990 to 2004.

The increase was driven by white women – 1 in 98 had their babies at home in 2008, the most recent year for which the statistics were available. Only about 1 in 357 black women give birth at home, and just 1 in 500 Hispanic women do.

"I think there's more of a natural birth subculture going on with white women – an interest in a low-intervention birth in a familiar setting," said the lead author, Marian MacDorman of the CDC's National Center for Health Statistics.

For all races combined, about 1 in 143 births were at home in 2008, up from 1 in 179 in 2004.

Geographically, 27 states had significant increases during those four years. Montana, Vermont and Oregon had the most home births – about 1 in 50 births were at home in those states.

Alaska's rate was nearly as high, and it's clear that some home births occur because women are in remote locations and are not able to get to hospitals in time for delivery.

The increase is notable because doctors groups have been increasingly vocal about opposing home births.

The American College of Obstetricians and Gynecologists has for years warned against home births, arguing they can be unsafe, especially if the mother has high-risk medical conditions, if the attendant is inadequately trained or if there's no quick way to get mother and child to a hospital if something goes awry.

Doctor participation in home births declined by 38 percent from 2004 to 2008. The percentage of home births attended by certified midwives and nurse-midwives grew, meanwhile.

Exactly how unsafe home births are is a matter of medical controversy, with studies offering conflicting conclusions. And some argue that hospitals present their own dangers of infection and sometimes unnecessary medical interventions.

The CDC researchers did find that home births involving medical risks became less common from 2004 to 2008. Home births of infants born prematurely fell by 16 percent, so that by 2008 only 6 percent of all home births involved preterm births. That's less than half the percentage in hospitals.

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Associated Press writer Mike Stobbe contributed to this report.