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KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.Contact the Health & Wealth desk.

A Growing Number of Births Happen Outside Hospitals


A growing number of births in the United States are happening outside of hospitals, according to the National Center for Health Statistics. The Missouri Department of Health and Senior Services reported two percent of births in Missouri took place in homes, birth centers, and in family practices in 2013. The number of out-of-hospital births has been on the rise since 2006 in Missouri because it’s becoming an attractive alternative for some families.

Credit Michaela Tucker / KBIA

Isabel Peterson didn’t expect she would be having a home birth.

“I used to tell my friends that my two biggest fears in life were childbirth and prison,” Peterson said.

But after marrying her husband Dwight and getting pregnant, Peterson says she didn’t want to be scared anymore, so she began researching her options.

The couple decided to have their baby at home with the guidance of a midwife from Columbia Area Midwives, a collective of Certified Professional Midwives (CPM) with independent practices.

Other expecting parents are making similar decisions. The Missouri Department of Health and Senior Services reported 1,504 out-of-hospital births in 2013. The recent increase in out-of-hospital births in Missouri mirrors national trends. According to the National Vital Statistics Reports’ data on births in 2013, 1.4 percent of deliveries took place outside of hospitals and the largest number of home births occurred since they began reporting on place of delivery in 2013.

CPM Kim James said clients seek out her practice because it’s similar to that of an OB/GYN, but said she has the ability to spend more time with her clients each visit.

“I set aside an hour for all the other things that are going on as a mother prepares to become a mother again, or for the first time, and all of the psychological aspects and the practical kinds of preparations for having a new baby in her life,” James said.

James said the relationship she builds with clients during the visits helps them relax and have a natural birth.

But even in the traditional setting of the hospital, University of Missouri School of Medicine Assistant Professor and OB/GYN Courtney Barnes said patients are seeking personalized care.

“It’s actually been great to talk to patients and figure out what they want and we have made some huge changes in our hospital because they understand that some of the traditional hospital practices are not good for mother/infant bonding,” Barnes said.

But Barnes said she agrees with the official recommendations of the American College of Obstetricians and Gynecologists, which state that hospitals and birth centers are the safest places to give birth.

“Most of us think of labor as this beautiful, wonderful, low-risk, natural thing, [but] there can be pretty significant complications, and being in a hospital allows us to take care of those complications,” Barnes said.

Beyond the medical risks, there are financial obstacles for expecting mothers seeking nontraditional birthing options. Peterson said her insurance doesn’t cover home birth. But she and her husband are willing and able to cover the cost because of the confidence it brings her as she prepares to give birth.

“People rely so heavily on their doctor to make decisions for them and I feel so much more confident that I’m making the decisions,” Peterson said.

As Peterson nears the end of her pregnancy, she feels fully prepared after working with her midwife and taking a childbirth class with her husband.

“Getting all the fear out of the way and now feeling as prepared as we do, it just makes these next couple weeks happy for us, so, we just can’t wait to meet our baby,” she said.

For now, Peterson said it’s just a waiting game until they welcome their child.

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