Home Birth vs. Hospital Birth: Choosing What’s Right For You
Since all the drama that surrounded 2020, we have seen a rise of home births in the US. Many women did not want to face the limitations that hospitals placed on birth at the time. Some hospitals did not allow another person in the room at all, even the father. Some did not allow older siblings to come and visit after birth. I’m sure for adoptive / surrogate families, this was also tricky as more individuals are often involved. Given all this, home births increased by 22% from 2019 to 2020. Then, another 12% from 2020 to 2021. By 2021, the US reached their highest level of home births since 1990!
But is it safe?
Short answer, yes. For most normal, healthy pregnancies, yes, home births are safe. But there will be people out there that say otherwise, and some are not so kind about their opinions. Let’s look at the facts:
One study by The Lancet has shown that the risk of neonatal deaths does not change with a planned home birth versus in a hospital. (2)
The WHO states that the optimal C-Section rate is 10-15%. Anything less may be considered lack of access to care. Anything more may be considered interfering too much with the natural process of birth. The US C-Section rate is 30%+ which causes many people to question if birth in the hospital is actually safe. (The Netherlands C-Section rate is below 17%, and they have a country wide home-birth model of care.) (3)
Planned home births are often associated with fewer interventions. Fewer medical interventions usually lead to a more positive birth experience for the mother. A more positive birth experience may improve mental health outcomes for the mother as well. (5)
The US has the highest maternal mortality rate for almost every race. This leads many pregnant women to reconsider our traditional standard care. (4)
Why some women choose home birth:
Feel more autonomy / bad previous hospital birth experience
Want to keep their older children around
Comfort of their own home
More affordable than hospital bills
Desire to birth without medical interventions
Less stress, you don’t have to pack a bag and go anywhere.
Why some women choose hospital birth:
Feel safer with hospital staff “just in case”
Prefer to just arrive at hospital, instead of making plans for a home birth
Access to a NICU
Access to staff support after birth
Pain management options
Induction options - some women prefer to be induced especially when having older children, in order to plan better.
At the end of the day, I support options for women! Educated and informed choices are an amazing thing, but also a bare minimum. For one mother, home birth could be the right move. For the next, it may be a hospital birth. It’s important to choose a birth plan and place that you are comfortable and happy with!
Sources:
“Home Births in the U.S. Increase to Highest Level in 30 Years.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 17 Nov. 2022, www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/20221117.htm.
Hutton, Eileen K., et al. “Perinatal or neonatal mortality among women who intend at the onset of labour to give birth at home compared to women of low obstetrical risk who intend to give birth in hospital: A systematic review and meta-analyses.” EClinicalMedicine, vol. 14, Sept. 2019, pp. 59–70, https://doi.org/10.1016/j.eclinm.2019.07.005.
“Who Statement on Caesarean Section Rates.” World Health Organization, World Health Organization, www.who.int/publications/i/item/WHO-RHR-15.02#:~:text=Overview,both%20developed%20and%20developing%20countries. Accessed 2 Apr. 2025.
Hollander, Chris, et al. “Insights into the U.S. Maternal Mortality Crisis: An International Comparison.” Insights into the U.S. Maternal Mortality Crisis: An International Comparison, www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison. Accessed 2 Apr. 2025.
Volkert A;Bach L;Hagenbeck C;Kössendrup J;Oberröhrmann C;Okumu MR;Scholten N; “Obstetric Interventions’ Effects on the Birthing Experience.” BMC Pregnancy and Childbirth, U.S. National Library of Medicine, 27 July 2024, pubmed.ncbi.nlm.nih.gov/39068395/#:~:text=Results:%20In%20general%2C%20the%20participants,2023).