Out-of-Hospital Births Increase in US

March 4, 2014

In 1900, almost all U.S. births occurred outside a hospital; however the proportion of out-of-hospital births fell to 44% by 1940 and to 1% by 1969, where it remained through the 1980s. Although out-of-hospital births are still rare in the United States, they have been increasing recently. If this increase continues, it has the potential to affect patterns of facility usage, clinician training, and resource allocation, as well as health care costs. A new NCHS report updates previous analyses to examine recent trends and characteristics of out-of-hospital births, including home and birthing center births, in the United States from 1990–2012, and compares selected characteristics with hospital births.

Key Findings from the Report:

  • The percentage of out-of hospital births increased from 1.26% of U.S. births in 2011 to 1.36% in 2012, continuing an increase that began in 2004.
  • In 2012, out-of-hospital births comprised 2.05% of births to non-Hispanic white women, 0.49% to non-Hispanic black women, 0.46% to Hispanic women, 0.81% to American Indian women, and 0.54% to Asian or Pacific Islander women.
  • In 2012, out-of-hospital births comprised 3%–6% of births in Alaska, Idaho, Montana, Oregon, Pennsylvania, and Washington, and between 2% and 3% of births in Delaware, Indiana, Utah, Vermont, and Wisconsin. Rhode Island (0.33%), Mississippi (0.38%), and Alabama (0.39%) had the lowest percentages of out-of hospital births.
  • In 2012, the risk profile of out-of-hospital births was lower than for hospital births, fewer births to teen mothers, and fewer preterm, low birthweight, and multiple births.