Jessica Wilcox thinks her in-laws still view her ideas about childbirth as kind of out there, but it’s hard to argue with success: In the last five years or so, Wilcox has given birth to two boys and two girls -- each weighing more than 10 pounds -- at her northern Virginia home. And she hopes to do it again one or two more times.
Wilcox is part of a small but growing trend. While home births are still rare in the United States, they've posted a surprising climb in recent years, according to a government report out Thursday.
After declining from 1990 to 2004, the percentage of U.S. births that occurred at home jumped 29 percent from 2004 to 2009, when it hit the highest level since researchers began collecting data 20 years earlier.
Non-Hispanic white women were most likely to give birth at home in 2009, with one in every 90 births, or about 1.1 percent, in that group taking place at home. That represents an increase of 36 percent over 2004.
Still, Wilcox’s children represent only a tiny minority. In 2009, 29,650 U.S. births, or .72 percent of total births, occurred at home. Compare that to, say, 1940, when 40 percent of births took place at home.
Home births today tend to be more common among women 35 and older and among women with several previous children, according to the new report from the Centers for Disease Control and Prevention’s National Center for Health Statistics. They're most common in states with renegade reputations, such as Montana, which had the highest percentage of home births, nearly 2.6 percent, followed by Oregon and Vermont, with nearly 2 percent each.
“It’s women who are consciously rejecting the system,” says coauthor Eugene Declercq, professor of community health sciences at Boston University.
Although she's not older, that would describe Wilcox. Now 30, she delivered a baby in a hospital when she was 17 and gave him up for adoption. “It was a great hospital, but it was not a positive birth experience,” Wilcox says.
She didn’t like getting an epidural or an IV. She didn’t like all the poking and prodding by the nurses. And she didn’t like the fact she never saw the same doctor twice for her prenatal care. “I really wanted that personalized care that a midwife provides,” Wilcox says.
Her husband, Jeremy, 34, needed some convincing that it was safe to give birth at home, she says. “He was raised the same way I was: You get pregnant, you go to the hospital to have the baby.”
But now her husband likes to point out that he’s in good company: The son of Super Bowl-bound Tom Brady, New England Patriots’ quarterback, and his wife Gisele Bunchen, was born at home in 2010.
While the risk of death for a baby in a planned home birth is low, the scientific literature suggests it is two or three times higher than that for a newborn in a planned hospital birth, notes an opinion paper published last year by the American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice.
Home births actually had a lower risk profile than hospital births in 2009, though, according to Declercq and his coauthors. Hospital births were twice as likely to be low birth weight or preterm babies as home births. And just under 1 percent of home births involved more than one baby, compared with 3.5 percent of hospital births. In addition, women who opt for home births are less likely to be teenagers or unmarried. This all suggests that midwives who attend home births select low-risk women as candidates, the authors write.
“Home birth isn’t for anybody who walks in the door,” says Marsha Jackson, the certified nurse midwife who attended Wilcox’s first home birth. For example, Jackson says, her practice rarely accepts women who want to have a vaginal birth after a C-section, or VBAC, at home because of their elevated risk of a uterine tear.
Jackson cofounded BirthCare, a certified nurse midwife practice, back in 1987. Today, Jackson says, the group’s six midwives attend 25 to 30 births a month. About 60 percent are home births, while the rest are in BirthCare’s freestanding birth center in Alexandria, Va.
“The babies that we caught are now having babies with us,” she says. “That is wonderful. When we opened our practice, we never imagined that.”