Home Births Are on the Rise, Now How Do We Make Them Accessible?

A new study shows that since 2004, the number of births taking place at home has jumped 20 percent. This doesn't mean that home births are common; they still constituted less than 1 percent of the more than 4 million births in the United States in 2008. But this is the first time since 1990 that the practice has increased, not decreased. And given that funding has been disappearing for birth centers and midwifery programs, a 20 percent increase is significant.

It's hard not to pin this trend at least partly on the cult success of The Business of Being Born, the 2008 documentary produced by Ricki Lake that was apparently viewed by every pregnant white lady in New York City. The film makes the case for pregnant women to "get the hell out of the hospital," detailing nightmarish scenarios of doctors bullying mothers on the delivery table, pathologizing pregnancies, and creating interventions that eventually lead to panicked Cesarean sections. By contrast, home birth is presented as safe and natural, giving women control over their own bodies and birthing processes. The film's climax makes it clear that home birth is not for everyone, but it makes a strong case that we need an alternative to our screwed-up system.

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Critics of The Business of Being Born pointed out that the whole scenario reeks of class privilege, a fact that's not acknowledged in the movie. And it's true—home births are a largely affluent, white phenomenon at this point. The 2008 rate for white women was 1 in 100, three to six times higher than for any other race or ethnic group. It is technically cheaper than having a baby in a hospital, but it's not covered by insurance. So you really need a chunk of change and access to information to have a midwife, doula, and an idyllic bathtub birth.

Still, a substantial rise in home-birth success stories, even if it's just among the upper-middle class, can serve to de-radicalize home birth and send the message that it can be a safe and viable alternative. The more word of mouth spreads, the more political and financial support midwives will get, and the more pressure there will be to make their services accessible to everyone.