Percentage of home births increased to highest levels since 1990

In 2021, the percentage of home births in the United States increased 1.41%, the highest rate of home births since at least 1990, according to data published in the National Vital Statistics Reports.

“With the start of the COVID-19 pandemic in early 2020 and concerns about giving birth in a hospital, interest in home births increased among pregnant women in the United States,” Elizabeth C.W. Gregory, MPH, a health scientist at the CDC National Center for Health Statistics, and colleagues wrote. “A previous report found that home births increased by 22% from 2019 to 2020, from 1.03% to 1.26%, reaching the highest level since at least 1990.”

Gregory and colleagues reviewed birth certificate data to identify planned and unplanned home births registered in the U.S., as well as race and ethnicity information for mothers.

The overall percentage of home births increased by 12% from 1.26% in 2020 to 1.41% in 2021.

Among non-Hispanic white women, the percentage of home births increased from 1.55% in 2019 to 1.87% in 2020, and then to 2.06% in 2021. These were increases of 21% and 10%, respectively.

The percentage of home births among non-Hispanic Black women increased more drastically from 2019 to 2020 — from 0.5% to 0.68%, which was a 36% increase. From 2020 to 2021, home births increased by 21%, reaching 0.82% in 2021.

Among Hispanic women, home births increased by 30% — from 0.37% to 0.48% — from 2019 to 2020. In 2021, home births increased to 0.55%, a year-over-year increase of 15%.

Analyses of year-over-year changes in home birth rates from 2020 to 2021 revealed that the percentage of home births increased among all women from January through April, decreased in May, increased by a nonsignificant percentage in June and July, then increased from August through December.

Non-Hispanic white women had the most consistent monthly increases in home birth, although non-Hispanic Black and Hispanic women also experienced increases in home births.

From 2019 to 2020, the percentage of home births increased by 11% to 68% in 40 states, with nine additional states and Washington, D.C., experiencing nonsignificant increases.

From 2020 to 2021, the percentage of home births increased by 8% to 49% in 20 states. The percentage of home births decreased in two states: New York and Connecticut. Eighteen other states plus Washington, D.C., had nonsignificant changes in their home birth rates.