ArticleBirth (Berkeley, Calif.)2019
Trends and state variations in out-of-hospital births in the United States, 2004-2017.
Article in Birth (Berkeley, Calif.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 98 papers, 2 of them syntheses that pooled it.
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Who cites it
98 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Impact of travel time to health facilities on perinatal outcomes: a systematic review with narrative synthesis and meta-analysis.Journal of global health · 2026Pooled it
- Care of the Postpartum Patient in the Emergency Department: A Systematic Review with Implications for Maternal Mortality.American journal of perinatology · 2023Pooled it
- Manifestations of Anti-Black Racism and Worry About Pregnancy and Birthing While Black: A Cross-sectional Secondary Analysis of Giving Voice to Mothers.Journal of racial and ethnic health disparities · 2026Article
- Postpartum Health Disparities During the Birth Hospitalization in the United States: A Scoping Review.Journal of racial and ethnic health disparities · 2026Article
- Trends and adverse pregnancy outcomes associated with post-traumatic stress disorder: a population-based study of delivery hospitalisations.Archives of gynecology and obstetrics · 2026Article
- Short-term exposure to ambient air pollution and emergency ambulance dispatches for precipitous labor: a time-series study in Guangzhou, China.Scientific reports · 2026Article
- Environmental Risk and Adverse Perinatal Health Indicators in New York City: A Geospatial Hotspot Analysis.Journal of urban health : bulletin of the New York Academy of Medicine · 2026Article
- Article
- Racial Disparities in Breastfeeding Behaviors and the Role of Prenatal Care Timing.Journal of racial and ethnic health disparities · 2026Article
- Maternal Nativity and Residence in US Territories and Preterm Birth.JAMA network open · 2026Article
- Out-of-hospital births and neonatal outcomes: a retrospective cohort study from a level IV NICU and review of regulatory frameworks.Frontiers in pediatrics · 2026Article
- "The Very Best That It Could Be and a Lot Better Than I Would Have Imagined": Birthing People's Experiences of Transfer From Community to Hospital.Birth (Berkeley, Calif.) · 2025Article
- Parental decision making regarding level of newborn screening participation in the homebirth setting.Journal of community genetics · 2025Article
- An exploration of perinatal healthcare providers' perspectives on respectful maternity care in the United States: a scoping review.BMC pregnancy and childbirth · 2025Article
- Making the "Birthing-Friendly" hospital designation better.Health affairs scholar · 2025Article
- Pregnancy and Birth Trends Across Australia, the United States of America and the United Kingdom.Journal of clinical medicine · 2025Review
- Stratifying Risk for Postpartum Depression at Time of Hospital Discharge.The American journal of psychiatry · 2025Article
- The Benefits of Licensed Midwifery and Community Birth Among BIPOC Birthing People in New Mexico.Birth (Berkeley, Calif.) · 2025Article
- Give birth in rural hometowns or urban areas? Place of delivery among rural migrant working mothers in the Pearl river delta, China.BMC pregnancy and childbirth · 2025Article
- Feasibility and Acceptability of a Multimedia Childbirth Education Intervention for Black Women and Birthing People and Their Birth Companions.Healthcare (Basel, Switzerland) · 2025Article
38 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
backgroundOut-of-hospital births have been increasing in the United States, although past studies have found wide variations between states. Our purpose was to examine trends in out-of-hospital births, the risk profile of these births, and state differences in women's access to these births.
methodsNational birth certificate data from 2004 to 2017 were analyzed. Newly available national data on method of payment for the delivery (private insurance, Medicaid, self-pay) were used to measure access to out-of-hospital birth options.
resultsAfter a gradual decline from 1990 to 2004, the number of out-of-hospital births increased from 35 578 in 2004 to 62 228 in 2017. In 2017, 1 of every 62 births in the United States was an out-of-hospital birth (1.61%). Home births increased by 77% from 2004 to 2017, whereas birth center births more than doubled. Out-of-hospital births were more common in the Pacific Northwest and less common in the southeastern states such as Alabama, Louisiana, and Mississippi. Women with planned home and birth center births were less likely to have a number of population characteristics associated with poor pregnancy outcomes, including teen births, smoking during pregnancy, obesity, and preterm, low birthweight, and multiple births. More than 2/3 of planned home births were self-paid, compared with 1/3 of birth center and just 3% of hospital births, with large variations by state.
conclusionsLack of insurance or Medicaid coverage is an important limiting factor for women desiring out-of-hospital birth in most states. Recent increases in out-of-hospital births despite important limiting factors highlight the strong motivation of some women to choose out-of-hospital birth.
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