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Study shows equal safety of giving birth at home and in birthing centers
Last reviewed: 02.07.2025
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For low-risk pregnancies, mothers and babies are just as safe with planned home births as with planned births in birth centers, a national study led by Oregon State University researchers finds.
The findings, published in the journal Medical Care, contradict long-standing concerns among doctors about home births, including a recent opinion from the American College of Obstetricians and Gynecologists, which considers hospitals and accredited birth centers the safest places to give birth. A birth center is a medical facility designed to provide a more natural, home-like environment than a hospital.
Researchers at Oregon State University analyzed two national registries of planned community births — births at home or in a birth center for low-risk pregnancies. It’s the largest study to examine how these settings compare in terms of health.
A low-risk pregnancy is defined as carrying one baby, delivering at term (at least 37 weeks), and having the baby in the breech position, with no serious maternal complications such as diabetes or preeclampsia. At least 70 percent of pregnancies are low-risk, says Marit Bovbjerg, an assistant professor at Oregon State University's College of Health Sciences.
Together, the two registries documented more than 110,000 births between 2012 and 2019, covering all 50 U.S. states, and the data showed no difference in safety between home and birth center births.
"Historically, doctors in the US have opposed planned home births but not planned births in birth centers, even though in both cases the mother needs to be transferred to a hospital if there are serious complications. Until now, we have had no evidence about the outcomes of home births compared with birth centers. Our study is the first to provide such evidence," said Marit Bovbjerg.
Bovbjerg and Melissa Cheney, a professor in Oregon State University's College of Liberal Arts and a licensed midwife, did not directly compare the safety of community births with hospital births, but noted that the majority of evidence around the world, including a 2020 report by the U.S. National Academies of Sciences, Engineering, and Medicine, supports the idea that planned community births are a safe alternative to hospital births.
"This means that in the U.S., we already had evidence that birth centers were comparable to hospitals for low-risk births," said Bovbjerg, who co-directs the Uplift Lab at Oregon State University with Cheney. "Our study compared home births with birth centers and shows that both community options are reasonable choices for people with low-risk births."
The researchers note that the number of home births in the U.S. has been increasing over the past two decades, and that 2% of U.S. births occur in one of two types of community settings that have similar providers and available interventions but different standards of practice, regulatory guidelines, and levels of integration into the health care system.
They added that planned home births resulted in fewer hospital transfers compared with planned birth centre births, which may be related to concerns about negative hospital experiences.
"They may fear loss of continuity with the same health care professional, as well as potential mistreatment and judgment upon arrival at the hospital," Cheney said, citing a national study of health care experiences in which many participants reported mistreatment, including being ignored, sworn at, yelled at or given an invasive procedure without consent.
"This is especially true for Black and Indigenous people who have been transferred to hospital after a planned home birth," she noted. "If previous hostile transfer experiences contribute to reluctance to transfer, we clearly need to work together to improve this process. Transfer from community settings is often necessary, and anything that interferes with necessary transfer is likely to cause harm."
The collaboration also included researchers from the American Association of Birthing Centers, Georgia State University, Frontier University of Nursing, the University of Denver and the University of British Columbia.