Logan Reid
Out-of-hospital birth, also known as community birth, is when a woman chooses to give birth outside of a hospital setting. This can be at home or in a freestanding birth centre. In the United States, most births take place in hospitals, but out-of-hospital births are becoming more popular. In 2018, 62% of out-of-hospital births took place at home. Out-of-hospital births are usually planned and attended by a qualified, licensed maternal and newborn health professional, most often a midwife. However, it is important to note that out-of-hospital births may not be suitable for high-risk pregnancies or those with certain medical conditions.
| Characteristics | Values |
|---|---|
| Other names | Community birth |
| Location | Home, freestanding birth centers, birth centers, midwifery units |
| Who it's for | Patients with low-risk, vertex, singleton, term pregnancies who have not had a previous cesarean delivery |
| Who attends | Midwives, physicians, maternal and newborn health professionals |
| Pros | Less stressful and more comfortable, fewer interventions, greater chance of natural childbirth, less chance of having a c-section, lower rates of obstetrical intervention, lower rates of NICU admission |
| Cons | Higher risk of newborn death and seizures, limited pain control options, limited resources available to care for a newborn with problems, higher rates of complications and death |
| Popularity | One in every 61 U.S. births (1.64%) in 2012, with 62% of out-of-hospital births at home |
Explore related products
What You'll Learn
Out-of-hospital births are becoming more popular in the US
Out-of-hospital births, also referred to as community births, can be planned or unplanned. In the United States, the majority of births have occurred in hospitals since the 1970s. However, out-of-hospital births are becoming more popular, with one in every 61 births (1.64%) taking place outside of hospitals. In 2018, 62% of these births occurred at home, while deliveries at freestanding birth centers made up roughly one-third.
There are several reasons why some people in the US may opt for an out-of-hospital birth. One reason is the perception of safety. Some patients may perceive out-of-hospital births as safer compared to hospital births due to factors such as health, pregnancy status, family needs, and religious or cultural values. Additionally, out-of-hospital births are associated with fewer obstetrical interventions, a higher rate of unassisted vaginal delivery, and a lower likelihood of obstetric interventions, including cesarean deliveries. Planned community births are also associated with decreased odds of obstetric interventions.
However, it is important to note that the safety of community births can be challenging to establish. The concept of safety in relation to birth settings varies depending on the perception of risk by patients, their families, and maternal and newborn health professionals. While some studies have found comparable outcomes between planned out-of-hospital and planned hospital births, others have reported increased perinatal mortality and neonatal morbidity and mortality for home births compared to hospital births. For instance, a US study showed that planned home births were associated with an intrapartum fetal death rate of 2.9 in 1,000, significantly higher than the rate of 0.13 in 1,000 for planned hospital births.
When considering an out-of-hospital birth in the US, it is recommended to choose a location with well-established regulations and agreements with local hospitals. It is also essential to ensure that the birth is attended by a qualified, licensed maternal and newborn health professional integrated into a maternity healthcare system. While family physicians can provide trusted guidance on the risks and benefits of community births, the American College of Obstetricians and Gynecologists (the College) believes that hospitals and accredited birth centers are the safest settings for birth.
Miami Valley Hospital: Premier Dayton, Ohio Healthcare
You may want to see also
Explore related products
Pros and cons of giving birth outside of a hospital
An out-of-hospital birth, also known as a community birth, can be planned or unplanned. Planned births typically take place at home or in a freestanding birth centre, with midwives assisting in most cases. While out-of-hospital births are uncommon, they are becoming an increasingly popular option in the United States.
Pros of Out-of-Hospital Birth
- Comfort: Giving birth outside of a hospital, especially at home, can provide a more comfortable and familiar environment.
- Natural delivery: Out-of-hospital births are associated with fewer interventions, a greater chance of natural childbirth, and a lower likelihood of a C-section.
- Personalised care: You may develop a close relationship with your midwife, who can provide personalised and continuous support throughout your pregnancy and birth.
- Visitor flexibility: Birth centres often allow more visitors, giving you the option to have a wider support network present during and after delivery.
- Early discharge: Delivering at a birth centre may allow you to return home sooner compared to a hospital birth.
Cons of Out-of-Hospital Birth
- Limited resources: Birth centres and home births have fewer pain relief options and limited medical resources to manage complications during delivery.
- Higher risk: Studies suggest that out-of-hospital births are associated with higher rates of adverse outcomes, including newborn death, seizures, and neonatal complications.
- Disruption: If complications arise, transferring to a hospital can be disruptive for both the mother and newborn, and may require immediate action.
- Cost: Insurance policies often cover hospital births but may not provide the same coverage for birth centre or home delivery options.
- Regulatory variations: Regulations and agreements with local hospitals vary across states and birth centres, so it is essential to research and choose a well-established and accredited facility.
Ultimately, the decision to give birth outside of a hospital should be made on a case-by-case basis, considering individual health, pregnancy status, family needs, and personal preferences. It is crucial to consult with qualified healthcare professionals to assess your specific circumstances and make an informed decision.
Aflac Hospital Indemnity: What's Covered and What's Not
You may want to see also
Explore related products
Safety and risks of community birth
Out-of-hospital births, also known as community births, can be planned or unplanned. Planned births usually take place at home with the assistance of midwives, while deliveries at freestanding birth centres have also increased in recent years.
The safety of community birth is a complex issue as the perception of risk varies among patients, their families, and maternal and newborn health professionals. Several factors are critical in reducing perinatal mortality rates and achieving positive outcomes for community births. Firstly, appropriate candidate selection is crucial. Community birth is generally recommended for low-risk pregnancies with a single fetus in vertex presentation and no previous cesarean delivery. Patients with high-risk pregnancies should opt for planned hospital births to minimise the chances of adverse outcomes.
Secondly, the presence of a qualified, licensed maternal and newborn health professional is essential for all planned community births. This professional should be integrated into a maternity healthcare system and be able to provide counselling about the risks and benefits of community birth. They should also meet or exceed the International Confederation of Midwives Global Standards for Midwifery Education. In the United States, midwives certified by the American Midwifery Certification Board are preferred due to their lower perinatal morbidity and mortality rates.
Thirdly, access to safe and timely transportation to nearby hospitals is vital. In the event of complications, the ability to transfer to a higher level of care promptly can significantly impact the outcome. Geographic access is another critical factor, as some communities may lack obstetric physicians or hospitals, limiting birthing options for residents.
While planned community births are associated with decreased odds of obstetric interventions and increased odds of unassisted vaginal births, they also carry a higher risk of neonatal death, seizures, and low Apgar scores compared to planned hospital births. This increased risk is relatively small, with an excess of about one death per 1,000 planned out-of-hospital deliveries. However, these events can be devastating, and patients should be counselled on the risks and benefits of community birth to make medically informed decisions.
Memorial Day: Are Hospitals Operational or Closed?
You may want to see also
Explore related products
Qualifications of health professionals at out-of-hospital births
An out-of-hospital birth, also known as a community birth, can take place at home or in a freestanding birth centre. In the United States, the majority of births are planned to occur in a hospital, but a small percentage of Americans (1.64% in 2018) choose to give birth outside of a hospital.
Out-of-hospital births are typically assisted by midwives, though they can also be attended by physicians. Midwives are qualified to provide prenatal care, care during labour and birth, and postnatal care for the mother and newborn. They are also trained to provide breastfeeding support and childbirth education. In the US, midwives can be certified by the American Midwifery Certification Board, or they can be Certified Professional Midwives (CPMs) who are certified by the North American Registry of Midwives (NARM). CPMs are specifically educated and experienced in out-of-hospital settings.
Physicians who attend out-of-hospital births typically provide prenatal and postnatal care in an office setting. They are qualified to identify and manage risks and complications, making them optimal care providers for women with serious health problems or risk factors. Family physicians can also provide trusted guidance and counselling to patients considering an out-of-hospital birth.
It is important for patients to carefully inquire about the qualifications, experience, and relationships with physicians of any midwife who is not a Certified Nurse-Midwife (CNM), CPM, or Certified Midwife (CM).
Woodard Herring Hospital: Standing Tall or Fallen?
You may want to see also
Explore related products
Insurance coverage for out-of-hospital births
An out-of-hospital birth, also known as a community birth, can be planned or unplanned, with most planned births taking place at home with the assistance of midwives. In 2018, 62% of out-of-hospital births occurred at home, while one-third took place at free-standing birth centres. While out-of-hospital births are uncommon, they are becoming increasingly popular in the United States.
When it comes to insurance coverage for out-of-hospital births, there are a few things to consider. Firstly, it is important to understand your insurance plan and what it covers. Some insurance companies may cover a large portion of pregnancy- and birth-related care, but there may still be out-of-pocket expenses. It is a good idea to call your insurance provider and confirm what is covered and what is not. Additionally, it is crucial to ensure that the providers you plan to use, such as the hospital or birth centre, are in-network with your insurance to avoid unexpected out-of-pocket costs.
In the United States, hospital indemnity insurance is a popular option for expecting parents. These plans typically pay a set amount per admission, which can help cover the costs of both the mother and the child. Short-term disability insurance is another option to consider, as it can provide income replacement during pregnancy and the postpartum period.
If you are considering an out-of-hospital birth, it is essential to understand the potential risks and benefits. While out-of-hospital births have been associated with lower rates of obstetrical intervention, they have also been linked to higher rates of complications and infant death. It is important to consult with a qualified healthcare professional to assess your individual risks and make an informed decision about your birth plan.
Additionally, some birth centres and midwives use billing services to help facilitate reimbursement from insurance companies. However, it is important to note that insurance companies may be less responsive to third-party billers. Seeking guidance from individuals with personal experience in navigating insurance reimbursement for out-of-hospital births can also be beneficial.
Inflating a Hospital Air Mattress: A Step-by-Step Guide
You may want to see also
Frequently asked questions
An out-of-hospital birth, also known as a community birth, is when a baby is born outside of a hospital setting, usually at home or in a freestanding birth centre.
Giving birth outside of a hospital means that you will likely feel more comfortable in your own environment. You may also have a close relationship with your midwife and there will be a greater chance of a natural childbirth. There are also fewer interventions and a lower chance of having a C-section.
There are limited pain control options and fewer resources available to care for a newborn with problems. There is also a higher risk of newborn death and seizures. If there are problems, moving you and your baby to a hospital can be disruptive.
Out-of-hospital births are recommended for low-risk pregnancies. If you have health issues or your pregnancy is high-risk, a hospital birth is the safest option.
In the United States, most births are planned to occur in a hospital. However, out-of-hospital births are becoming increasingly popular, with 1.64% of births occurring outside of a hospital. In 2018, 62% of out-of-hospital births took place at home.
