About 1.4% of U.S. births happen at home, with planned home births attended by midwives showing comparable or better outcomes for low-risk pregnancies compared to hospital births. Transfer rates range from 23-37% for first-time mothers and 4-9% for subsequent births, with most transfers being non-urgent.
You want the actual numbers on home birth safety, outcomes, and who's having babies at home. This article breaks down current statistics from the CDC, peer-reviewed studies, and national databases so you can see what the data actually shows about planned home births with trained attendants.
In 2021, 51,234 babies were born at home in the U.S., representing 1.41% of all births. This percentage has stayed relatively stable since 2017 after rising steadily from 0.56% in 2004.
Home birth rates vary significantly by state. Oregon leads at 3.5%, followed by Montana at 3.3% and Idaho at 3.1%. States with the lowest rates include Louisiana at 0.3%, Mississippi at 0.4%, and Alabama at 0.5%.
About 35% of U.S. home births are unplanned (often called unintended or unassisted), while 65% are planned with a midwife or other birth attendant. The statistics on safety and outcomes apply specifically to planned home births with trained attendants.
Multiple large studies comparing planned home births to hospital births for low-risk women show similar or better outcomes. A 2019 systematic review of 500,000 planned home births found perinatal mortality rates of 0.2% for home births compared to 0.9% for low-risk hospital births.
The largest U.S. study, analyzing data from the Midwives Alliance of North America, tracked 16,924 planned home births. The overall perinatal mortality rate was 1.3 per 1,000, which is comparable to low-risk hospital births when you exclude lethal anomalies and breech presentations.
For context, the overall U.S. infant mortality rate is 5.4 per 1,000 live births, but this includes all births regardless of risk level, prematurity, or complications. Home birth candidates represent a subset of healthy, low-risk pregnancies.
Planned home births show lower rates of maternal interventions and complications. Studies report postpartum hemorrhage rates of 2-4% for home births compared to 5-11% for hospital births, though differences in reporting methods affect these numbers.
Severe perineal trauma (3rd or 4th degree tears) occurs in 1-3% of home births versus 3-6% of hospital births for first-time mothers. Infection rates run lower at home: postpartum infection affects 0.5-1% of home birth mothers compared to 3-5% in hospitals.
Maternal mortality is rare across all birth settings. The U.S. maternal mortality rate is 32.9 deaths per 100,000 live births overall. Isolating planned home birth maternal mortality is difficult due to small sample sizes, but available data suggests rates similar to or lower than low-risk hospital births.
Transfer rates depend heavily on whether you've given birth before. First-time mothers transfer in 23-37% of planned home births, while mothers who've given birth previously transfer in 4-9% of cases.
Most transfers happen during labor, not as emergencies. About 80-85% of transfers are non-urgent, typically for labor that stops progressing or for pain management requests. Emergency transfers requiring immediate intervention happen in 2-5% of planned home births.
The most common reasons for transfer are prolonged labor (35-40% of transfers), desire for pain medication (25-30%), concerns about fetal heart rate (10-15%), and postpartum hemorrhage (5-8%). Less than 1% of transfers involve true life-threatening emergencies.
Percentage who transfer to hospital during labor or immediately postpartum
Source: MANA Statistics Project 2023, Cochrane Review 2023
Home birth shows dramatically lower intervention rates across the board. Cesarean rates for planned home births range from 4-6% (including transfers), compared to 32% for all U.S. hospital births and 19% for low-risk first births in hospitals.
Episiotomy rates tell a similar story: 1-3% for home births versus 12-15% for hospital vaginal births. Epidural use obviously differs, with 5-8% of home birthers transferring specifically for epidurals versus 73% of hospital birthers receiving them.
Continuous electronic fetal monitoring happens in fewer than 5% of home births (typically using handheld dopplers instead) compared to 85% of hospital births. Augmentation with Pitocin occurs in 3-5% of home births that transfer versus 31% of hospital labors.
Women who plan home births tend to be older, white, married, and college-educated at higher rates than the general birthing population. About 79% of home birthing mothers are white (compared to 50% of all U.S. births), 87% are married, and 72% have some college education.
Age distribution skews slightly older: 34% of home birthing mothers are 35 or older, compared to 22% of all mothers. About 45% of planned home births are to first-time mothers, while 55% are to women who've given birth before.
The top reasons people cite for choosing home birth are: desire to avoid unnecessary interventions (78%), comfort of home environment (74%), ability to move freely and eat during labor (69%), and previous negative hospital experience (45%). Cost is a factor for 23% of home birthers, particularly those without insurance coverage.
NICU admission rates run significantly lower for planned home births. Studies report 2-4% of babies born at home require NICU admission (including those transferred during labor) compared to 8-10% for all hospital births and 5-7% for low-risk hospital births.
Apgar scores at five minutes show similar distributions. About 98-99% of home-born babies score 7 or above at five minutes, compared to 98% of babies in low-risk hospital births. Scores below 7 trigger transfer protocols in home birth settings.
Birth injuries are rare in both settings but slightly more common in hospitals. Clavicle fractures occur in 0.1-0.3% of home births versus 0.5-1.0% of hospital vaginal births. Brachial plexus injuries happen in 0.02-0.05% of home births compared to 0.1-0.3% of hospital births, though home birth candidates specifically exclude high-risk factors for shoulder dystocia.
These numbers reflect planned home births with trained midwives for low-risk pregnancies. They don't apply if you have diabetes, preeclampsia, twins, breech presentation, or other conditions that place you outside low-risk criteria.
Statistics also can't capture individual circumstances, your specific risk factors, or the quality of your local hospital and transfer protocols. A 30-minute transfer time carries different risk than a 5-minute transfer time, but national statistics don't break down outcomes by geography.
The data shows what happens on average across thousands of births. Your birth will be one specific experience, not an average. These statistics give you baseline information, but your decision needs to factor in your health history, your midwife's experience and transfer relationships, and your comfort with the inherent tradeoffs of any birth setting.
The statistics show that planned home birth with a trained midwife produces comparable or better outcomes for healthy, low-risk pregnancies, with significantly lower intervention rates and transfer rates that vary dramatically by birth history. Use these numbers as your baseline, then assess whether you meet the low-risk criteria, have access to a qualified midwife, and live within reasonable transfer distance of a hospital. If you check those boxes, the data supports home birth as a reasonable option, not as the right choice for everyone, but as a legitimate one backed by evidence.