Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep;49(3):559-568.
doi: 10.1111/birt.12627. Epub 2022 Feb 25.

United States community births increased by 20% from 2019 to 2020

Marian F MacDorman  1 , Ruby Barnard-Mayers  2 , Eugene Declercq  2
Affiliations

United States community births increased by 20% from 2019 to 2020

Marian F MacDorman et al. Birth. 2022 Sep.

Abstract

Background: Anecdotal and emerging evidence suggested that the 2020 COVID-19 pandemic may have influenced women's attitudes toward community birth. Our purpose was to examine trends in community births from 2019 to 2020, and the risk profile of these births.

Methods: Recently released 2020 birth certificate data were compared with prior years' data to analyze trends in community births by socio-demographic and medical characteristics.

Results: In 2020, there were 71 870 community births in the United States, including 45 646 home births and 21 884 birth center births. Community births increased by 19.5% from 2019 to 2020. Planned home births increased by 23.3%, while birth center births increased by 13.2%. Increases occurred in every US state, and for all racial and ethnic groups, particularly non-Hispanic Black mothers (29.7%), although not all increases were statistically significant. In 2020, 1 of every 50 births in the United States was a community birth (2.0%). Women with planned home and birth center births were less likely than women with hospital births to have several characteristics associated with poor pregnancy outcomes, including teen births, smoking during pregnancy, obesity, and preterm, low birthweight, and multiple births. More than two-thirds of planned home births were self-paid, compared with one-third of birth center and just 3% of hospital births.

Conclusions: It is to the great credit of United States midwives working in home and birth center settings that they were able to substantially expand their services during a worldwide pandemic without compromising standards in triaging women to optimal settings for safe birth.

Keywords: COVID; home birth; out-of-hospital births.

PubMed Disclaimer

References

REFERENCES

    1. MacDorman MF, Declercq E. Trends and state variations in out-of-hospital births in the United States, 2004-2017. Birth. 2019;46(2):279-288.
    1. MacDorman M, Declercq E. Trends and characteristics of United States out-of-hospital births 2004-2014: new information on risk status and access to care. Birth. 2016;43:116-124.
    1. Hubbard K. Pandemic propels interest in out-of-hospital births. In: U.S. News and World Report 2021.
    1. Gildner TE, Thayer ZM. Birth plan alterations among American women in response to COVID-19. Health Expect. 2020;23(4):969-971.
    1. Schmidt CN, Cornejo LN, Rubashkin NA. Trends in Home birth information seeking in the United States and United Kingdom during the COVID-19 pandemic. JAMA Netw Open. 2021;4(5):e2110310.

Publication types

LinkOut - more resources