Home births on the rise in U.S.

Between 1990 and 2004, the number of women who were choosing to give birth at home steadily declined. But in 2005 the trend turned, according to a new report released by the National Center for Health Statistics on Thursday.

The number of home births in the U.S. jumped by 29% from 2004 to 2009. Although home births are still rare - they account for less than 1% of all births - this is a pretty rapid increase, said Marian MacDorman, statistician at the Centers for Disease Control and Prevention.

"Forty, 50 years ago, there was this idea that hospital birth was more modern. Now it's the opposite."

The biggest increase was in non-Hispanic white women. About 1 in 90 births in that segment of the population is now a home birth, according to the report. Home births are most common among women over the age of 35 who have already had at least one child.

The data doesn't tell us why home births have increased, MacDorman said, but she can take a few educated guesses. Cost may be an issue; on average, home births cost about one third less than hospital births. Another reason may be dissatisfaction with the care women in labor receive at a hospital. Doctors and nurses are busy, often caring for more than one patient at a time whereas at home, a woman can have a midwife attending only to her.

Home births are all about personal choice, said Eileen Beard, senior practice advisor for the American College of Nurse-Midwives. Beard has been a midwife since 1977 and has attended the births of thousands of babies.

"It's 'attended,' not delivered," she said. "The mother is the one who delivers. We just catch."

Beard said women are becoming more aware that they have a choice when it comes to having their baby. Mothers often choose to deliver at home because they embrace the idea that giving birth is a normal, physiological process.

"It's difficult to have a normal birth in the hospital setting because of the culture of the hospital and interventions that are routine," Beard said.

At home a women is free to surround herself with the items and people she loves. She's able to move around and get into a birthing position that's comfortable. While this is possible at a hospital, procedures and routine make it more complicated. Feeling safe and relaxed leads to less need for medication, Beard said.

"The more control you have over what's happening makes a big difference."

Safety is always the number one concern. Home births have a lower risk profile than hospital births, with fewer babies born premature, fewer teen mothers and fewer multiple births, according to the report. That's because midwives do such a good job of choosing candidates, according to MacDorman.

Beard said certified midwives have guidelines and protocols they follow. Mothers should be healthy with no major medical problems or obstetrical complications. And if there's a problem during delivery, they don't hesitate to take the mother to a hospital.