Midwives, Doulas and Out-of-hospital Births in the US

Midwives, Doulas and Out-of-Hospital Births in the US

Birth by the Numbers: Contemporary Trends in Home Birth (2016)

Come and explore the trends in Home Birth as Dr. Gene Declercq explores Home Births in the United States. Is anyone having home births? Who’s having them? Who’s attending them? What’s the future for home births? Slides include supplementary comments and information in the notes section. Download the PowerPoint file here.

Slides on Midwifery and Out of Hospital Birth (2016)

In conjunction with the release of The Boston Globe’s Q & A with Dr. Gene Declercq, be sure to use these slides on midwifery and out of hospital birth trends when sharing with your networks. Download the two PowerPoint files here: Midwife Attended Births and Out of Hospital Births and Proportion of Births Attended by Nurse-Midwives by State!

Midwives, Doulas and Out-of-Hospital Birth Reports

Choices in Childbirth surveyed 111 doulas in New York City as well as held four focus groups. The cumulative findings of this research include:
  • Cost is the most significant barrier to obtaining doula services.
  • The doula workforce is small and less diverse than the population of New York City, with women of color under-represented as well as doula services in languages other than English, Spanish, or French.
  • Access to doula care in underserved communities is extremely limited.
  • Fostering collaborative relationships between doulas, maternity care providers, and nurses would improve the impact of doula care.
  • Establishing positive hospital policies would improve the impact of doula care.
  • Doulas need support for the work that they do, including models of doula service delivery that minimize stressors and difficulties.
To view the full report, click here.
This report examines trends in out-of-hospital births in the United States during the periods 1990-2012. Highlights include:
  • The percentage of out-of-hospital births increased from 1.26% of U.S. births in 2011 to 1.36% in 2012, continuing an increase that began in 2004.
  • In 2012, out-of-hospital births comprised 2.05% of births to non-Hispanic white women, 0.49% to non-Hispanic black women, 0.46% to Hispanic women, 0.81% to American Indian women, and 0.54% to Asian or Pacific Islander women.
  • In 2012, out-of-hospital births comprised 3%–6% of births in Alaska, Idaho, Montana, Oregon, Pennsylvania, and Washington, and between 2% and 3% of births in Delaware, Indiana, Utah, Vermont, and Wisconsin. Rhode Island (0.33%), Mississippi (0.38%), and Alabama (0.39%) had the lowest percentages of out-of-hospital births.
  • In 2012, the risk profile of out-of-hospital births was lower than for hospital births, with fewer births to teen mothers, and fewer preterm, low birthweight, and multiple births.
To find out more from the full report, click here.
This report examines trends over time in home birth in the United States since 1990, using data from the National Vital Statistics System.
  • The report provides information and graphs showing that while there has been an overall increase in home births between 1990 and 2009, most of the rise is due to non-Hispanic white women.
  • Home birth rates among other groups declined overall since 1990, although in some subgroups the rates have gone up since the mid-2000s.
  • The report also discusses:
    • Geographic variation in home birth rates
    • What kind of providers attend these births
    • The risk profiles of women who deliver at home
To find out more, click here for the full report.

Talks from Dr. Gene Declercq

Gene Declercq gave this presentation at the Lawrence History Center for their symposium "The History & Future of Public Health in Lawrence, Massachusetts and Beyond" on April 7, 2018. Download the presentation here.
The Immigrant Midwives of Lawrence, MA and Their Role in Maternal and Infant Health
Lawrence, MA (4/7/2018)
Gene Declercq presented this presentation to the International Congress of Midwives 2017 in Toronto, Canada on June 20, 2017. Download the presentation here.
Implications for midwives of a concentration of births in larger hospitals in the U.S....if there is one.
International Congress of Midwives: Toronto, Canada (6/2017)
Gene Declercq presented this presentation to the International Congress of Midwives 2017 in Toronto, Canada on June 19, 2017. Download the presentation here.
Different settings, different mothers, different practice? A profile of midwife attended births in and out of hospitals in the US, 1990-2014
International Congress of Midwives: Toronto, Canada (6/2017)