United States' out-of-hospital births increased to nearly 60,000 in 2014, continuing a decade-long increase. Data from the National Center for Health Statistics indicates that out-of-hospital births increased from 0.87% of US births in 2004 to 1.50% in 2014, an increase of 72%. Out-of-hospital birth rates increased for all race/ethnic groups, but most rapidly for non-Hispanic white women.
Out-of hospital birth rates varied significantly by state and region of the country, with the highest rates in the Pacific Northwest, and lowest in the Deep South.
Although the costs of out-of-hospital births are much less than for hospital births, high rates of self-pay for the costs of out-of-hospital birth suggest that many women have difficulty in getting their insurance plan (or Medicaid) to pay for services. For 50% of out-of-hospital births, women had to pay out-of-pocket for the costs of their labor and delivery, compared with only 3% for hospital births.
"Mandating private insurance and Medicaid coverage for out-of-hospital births could substantially improve access to this birthing option, now requested by an increasing number of women," said Dr. Marian MacDorman, co-author of the BIRTH analysis.
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Marian F. MacDorman et al. Trends and Characteristics of United States Out-of-Hospital Births 2004-2014: New Information on Risk Status and Access to Care, Birth (2016). DOI: 10.1111/birt.12228