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What Is the Percent of of Female Babys in a Hospital

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  • Central findings
  • In 2012, 1.36% of U.South. births were born outside a hospital, up from i.26% in 2011.
  • In 2012, ane in 49 births to non-Hispanic white women were out-of-hospital births.
  • The percentage of out-of-hospital births was by and large higher in the northwestern United states of america and lower in the southeastern United States.
  • Out-of-hospital births by and large had a lower adventure profile than infirmary births.
  • The risk profile of out-of-infirmary births declined from 2004 through 2012.
  • Summary
  • Definitions
  • Information sources and methods
  • About the authors
  • References
  • Suggested commendation

NCHS Data Brief No. 144, March, 2014

PDF Versionpdf icon (679 KB)

Marian F. MacDorman, Ph.D.; T.J. Mathews, M.South.; and Eugene Declercq, Ph.D.

Key findings

  • The percent of out-of-hospital births increased from 1.26% of U.S. births in 2011 to 1.36% in 2012, standing an increase that began in 2004.
  • In 2012, out-of-infirmary births comprised 2.05% of births to non-Hispanic white women, 0.49% to not-Hispanic blackness 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 betwixt 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 take chances profile of out-of-hospital births was lower than for hospital births, with fewer births to teen mothers, and fewer preterm, depression birthweight, and multiple births.

In 1900, almost all U.S. births occurred outside a hospital; however the proportion of out-of-infirmary births brutal to 44% by 1940 and to 1% by 1969, where it remained through the 1980s (i–3). Although out-of-hospital births are still rare in the The states, they have been increasing recently (4). If this increase continues, it has the potential to affect patterns of facility usage, clinician preparation, and resources resource allotment, equally well as health care costs (5–8). This report updates previous analyses (2,9) to examine contempo trends and characteristics of out-of-infirmary births, including home and birthing heart births, in the United States from 1990–2012, and compares selected characteristics with hospital births.

Keywords: home birth, birthing middle nascency, nativity certificates

In 2012, i.36% of U.Due south. births were born outside a infirmary, up from 1.26% in 2011.

  • Later a gradual decline from 1990–2004, the percentage of out-of-infirmary births increased from 0.87% of U.Due south. births in 2004 to 1.36% of U.S. births in 2012 (Effigy i), its highest level since 1975. In 2012, 53,635 births in the United States occurred out of a hospital, including 35,184 home births and 15,577 birthing middle births.

Figure 1. Percentage of births occurring out-of-hospital: U.s.a., 1990–2012

Figure 1 is a line graph showing the percentage of all out-of-hospital births and the percentages of births in the home and in birthing centers from 1990 through 2012 prototype icon

Annotation: Out-of-hospital births include those occurring in a habitation, birthing heart, dispensary or doctor'south office, or other location.
SOURCE: CDC/NCHS, National Vital Statistics System, nativity document data.

  • In 2012, two-thirds (66%) of out-of-infirmary births occurred at dwelling, and another 29% occurred in a freestanding birthing center. (The remaining 5% of out-of-hospital births occurred in a clinic or physician'south function or other location.)
  • The percent of home births increased from 0.84% in 2011 to 0.89% in 2012. This percentage has been increasing since 2004 (0.56%).
  • The pct of birthing eye births increased from 0.36% in 2011 to 0.39% in 2012. This percentage has been increasing since 2004 (0.23%).

In 2012, ane in 49 births to non-Hispanic white women were out-of-hospital births.

  • There were big differences in the percentage of out-of-hospital births by maternal race and ethnicity (Figure two). In 2012, the percentage of out-of-hospital births was two to four times college for not-Hispanic white women than for whatsoever other racial or ethnic group.
  • From 2011–2012, the percent of out-of-infirmary births increased significantly for non-Hispanic white (from one.89% to 2.05%), Hispanic (from 0.44% to 0.46%), and Asian or Pacific Islander [API (from 0.49% to 0.54%)] women. Increases from 2011–2012 were non statistically pregnant for non-Hispanic black and American Indian women.

Effigy 2. Percentage of births occurring out-of-hospital, by race and Hispanic origin of female parent: The states, 1990–2012

Figure 2 is a line graph showing the percentage of out-of-hospital births by race and Hispanic origin of mother from 1990 through 2012 image icon

Note: Non-Hispanic white, not-Hispanic black, and Hispanic data exclude New Hampshire in 1990–1992 and Oklahoma in 1990; these states did not study Hispanic origin on their birth certificates for these years.
SOURCE: CDC/NCHS, National Vital Statistics System, nativity certificate information.

  • When the longer-term tendency is examined, the percentage of out-of-hospital births increased for all racial and ethnic groups from 2004–2012. The increment was largest for non-Hispanic white women, whose percentage of out-of-hospital births increased from ane.twenty% in 2004 to ii.05% in 2012. From 2004–2012, the pct of out-of-hospital births increased from 0.45% to 0.49% for non-Hispanic black women, from 0.38% to 0.46% for Hispanic women, from 0.64% to 0.81% for American Indian women, and from 0.38% to 0.54% for API women.
  • About 89% of the total increase in out-of-hospital births from 2004–2012 was due to the increase among non-Hispanic white women.
  • Hispanic women had the highest proportion of out-of-hospital births in 1990 simply the everyman proportion in 2012.

The percentage of out-of-hospital births was generally higher in the northwestern Usa and lower in the southeastern United States.

  • More than than iii% of births occurred exterior a hospital in 2012 for six states: Alaska (6.0%), Montana (3.nine%), Oregon (three.8%), Washington (3.4%), Idaho (three.iv%), and Pennsylvania (3.1%). Between two% and 3% of births occurred outside a hospital for five states (Utah, Vermont, Indiana, Wisconsin, and Delaware) (Effigy 3).
  • In contrast, the percent of out-of-infirmary births was less than 1% for southeastern states from Louisiana to Georgia, every bit well equally for a few other states throughout the country.

Figure 3. Percentage of births occurring out-of-infirmary, by state: Usa, 2012

Figure 3 is a map of the United States showing the percentage of out-of-hospital births by state for 2012 image icon

Annotation: Access data table for Figure 3 pdf icon [PDF – 108KB].
SOURCE: CDC/NCHS, National Vital Statistics System, birth certificate data.

  • Overall, 45 states had statistically significant increases in the percentage of out-of-hospital births from 2004–2012, and for 27 states, the percent increment was 50% or more. No states had statistically significant declines in the percentage of out-of-hospital births from 2004–2012. Regional patterns were similar to those for 2011.

Out-of-infirmary births mostly had a lower adventure profile than infirmary births.

  • In 2012, i.9% of out-of-hospital births were to teen mothers, compared with 7.ix% of hospital births (Figure 4). Nonetheless, a greater pct of out-of-hospital (19.0%) than hospital births (fourteen.9%) were to mothers aged 35 and over.
  • Well-nigh 4.4% of out-of-hospital births were built-in preterm (less than 37 completed weeks of gestation), compared with eleven.6% of infirmary births.
  • Similarly, 3.2% of out-of-infirmary births were low birthweight in 2012, compared with 8.1% of infirmary births.
  • Multiple births comprised 0.8% of out-of-hospital births and 3.five% of hospital births.

Effigy 4. Pct of births occurring in- and out-of-infirmary, by selected risk factors: Us, 2012

Figure 3 is a map of the United States showing the percentage of out-of-hospital births by state for 2012 image icon

SOURCE: CDC/NCHS, National Vital Statistics Organisation, birth document data.

The take a chance contour of out-of-hospital births declined from 2004 through 2012.

  • The proportion of out-of-hospital births to teen mothers declined from four.iii% in 2004 to one.9% in 2012, and the proportion of these births to mothers aged 35 and over declined from 20.0% in 2004 to 19.0% in 2012 (Figure v).
  • The proportion of out-of-infirmary births that were born preterm declined from vi.7% in 2004 to 4.four% in 2012, and the proportion born at low birthweight declined from 4.8% to 3.2%. The proportion with a multiple nativity remained about the same at less than 1.0%.

Effigy five. Change in take chances profile for births occurring out-of-infirmary: The states, 2004 and 2012

Figure 5 is a bar chart comparing the percentages of out-of-hospital births to teen or older mothers, and births that were preterm, low birthweight, or multiple-birth in 2004 and 2012 paradigm icon

SOURCE: CDC/NCHS, National Vital Statistics System, nativity certificate data.

Summary

Although all the same relatively rare, out-of-hospital births have accounted for a growing share of U.S. births since 2004. In 2012, i.36% of U.S. births were born outside a hospital, upward from ane.26% in 2011 and 0.87% in 2004. The 2012 level is the highest level since 1975 (iii). About of the full increase in out-of-infirmary births from 2004–2012 was a event of the increase amid non-Hispanic white women, and by 2012, 1 in 49 births to non-Hispanic white women (two.05%) occurred outside a hospital.

In 2012, 6 states had 3%–6% of their births occur outside a infirmary. For an additional five states, between ii% and 3% of their births were out-of-hospital births. Variations in the percentages of out-of-hospital births by land may be influenced by differences in state laws pertaining to midwifery practice or out-of-hospital births (x–11), also as by the availability of a nearby birthing centre (8). The number of U.South. birthing centers increased from 170 in 2004 to 195 in 2010 and to 248 in January 2013; 13 states notwithstanding did non have a birthing center in the most recent period (8).

Compared with infirmary births, dwelling and birthing center births tended to accept lower gamble profiles, with fewer births to teen mothers and fewer preterm, low birthweight, and multiple births. From 2004 through 2012, there was a reject in the risk profile of out-of-hospital births, with fewer births in 2012 than in 2004 to teen and older mothers and fewer preterm and depression birthweight births (3,4). The lower take chances profile of out-of-hospital than hospital births suggests that appropriate selection of low-take a chance women equally candidates for out-of-hospital nascence is occurring (ix).

Although not representative of all U.S. births, 88% of home births in a 36-state reporting area (comprising 71% of U.Due south. births) were planned in 2012 (3). Unplanned home births are more likely than planned home births to be born preterm and at low birthweight (12).

Definitions

Out-of-infirmary birth: Birth that occurs outside a hospital. This includes births occurring in a abode, birthing center, clinic or medico's office, or other location.

Home birth: Nascence that takes place in a residence (dwelling).

Birthing center nascence: Birth that takes identify in a freestanding birthing center not attached to a hospital.

Preterm birth: Nascence occurring before 37 completed weeks of gestation.

Low birthweight: Infant weighing less than ii,500 grams at birth.

Multiple nascence: Refers to an private alive birth from a multiple (for example, twin, triplet, or higher-guild multiple) pregnancy.

Data sources and methods

This report is based on information from the Centers for Disease Command and Prevention'due south National Center for Health Statistics National Vital Statistics System, Birth Information Files for 1990–2012. These data files include data for all births occurring in the United states of america and include information on a wide range of maternal and infant demographic and health characteristics (iii). The nativity data files are available for download. Data may also be accessed through the interactive information tool, VitalStats.

Reporting of separate data on home and birthing center births began with the 1989 revision of the U.S. Standard Document of Birth. Prior to 1989, births were reported as occurring in or out of a hospital, with no detailed breakup of type of out-of-hospital birth.

The 2003 revision of the U.S. Standard Certificate of Nascence added a information item on planning status of habitation birth. However, due to the staggered implementation of the 2003 revision among U.S. states, only 36 states (comprising 71% of U.S. births) reported information on planning status of home birth in 2012 (3). The 36-state area is non representative of the overall U.S. population because it is non a random sample of U.Due south. births.

Well-nigh the authors

Marian F. MacDorman and T.J. Mathews are with CDC's National Middle for Health Statistics, and Eugene Declercq is with Boston Academy School of Public Health.

References

  1. Wertz RW, Wertz DC. Lying-in: A history of childbirth in America. New York: The Gratuitous Press. 1977.
  2. MacDorman MF, Menacker F, Declercq E. Trends and characteristics of domicile and other out-of-hospital births in the Usa, 1990–2006. National vital statistics reports; vol 58 no eleven. Hyattsville, Medico: National Heart for Health Statistics. 2010.
  3. National Eye for Health Statistics. VitalStats–Births.
  4. Martin JA, Hamilton Be, Osterman MJK, et al. Births: Final data for 2012. National vital statistics reports; vol 62 no 9. Hyattsville, MD: National Middle for Health Statistics. 2013.
  5. Boucher D, Bennett C, McFarlin B, Freeze R. Staying domicile to give nascence: Why women in the Us choose home birth. J Midwifery Womens Health 54(2):119–26. 2009.
  6. Health Management Associates. Midwifery licensure and discipline programme in Washington Country: Economic costs and benefits. Washington Country Section of Health. October 31, 2007.
  7. Stapleton SR, Osborne C, Illuzzi J. Outcomes of care in birth centers: Sit-in of a durable model. J Midwifery Womens Health 58(ane):3–xiv. 2013.
  8. American Clan of Nascence Centers. AABC Press Kitexternal icon [Accessed December 5, 2013].
  9. MacDorman MF, Declercq E, Mathews TJ. Contempo trends in out-of-hospital births in the U.s.a.. J Midwifery Womens Wellness 58(five):494–501. 2013.
  10. Midwives Brotherhood of North America. Legal status of U.S. midwivesexternal icon [Accessed Dec v, 2013].
  11. Declercq E, Stotland NE. Planned dwelling birthexternal icon In: Lockwood CJ, Rose BD (editors). UpToDate. Waltham, MA. 2009 [Accessed December eight, 2013].
  12. Declercq E, MacDorman MF, Menacker F, Stotland Northward. Characteristics of planned and unplanned dwelling births in 19 states. Obstet Gynecol 116(1):93–9. 2010.

Suggested citation

MacDorman MF, Mathews TJ, Declercq E. Trends in out-of-infirmary births in the Us, 1990–2012. NCHS data brief, no 144. Hyattsville, Md: National Center for Wellness Statistics. 2014.

Copyright information

All material appearing in this report is in the public domain and may be reproduced or copied without permission; commendation as to source, all the same, is appreciated.

National Center for Health Statistics

Charles J. Rothwell, M.Southward., G.B.A., Director
Jennifer H. Madans, Ph.D., Associate Director for Scientific discipline

Partition of Vital Statistics

Delton Atkinson, M.P.H., Yard.P.H., P.M.P., Director

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Source: https://www.cdc.gov/nchs/products/databriefs/db144.htm

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