Home births are on the rise. Why does it matter?
By Mats Delsing, MSc, Consulting Account Manager — October 20, 2025
Across the U.S., more patients are giving birth at home rather than in hospitals. What does this mean for maternal and infant wellbeing? What is driving the shift, and what are the implications for health systems committed to health equity and trust?
What we know, and what we don’t know
- Trust is a decisive factor. A history of unethical practices in medicine and experiences of not feeling fully heard in clinical encounters have eroded trust, particularly among women and historically marginalized communities. For some, home birth represents greater agency, cultural alignment, and a sense of safety that feels absent in institutional settings.
- Safety data on home births is limited. Even though some studies highlight the potential risks associated with home delivery, there is a lack of consistent, high-quality data. This makes it harder to compare settings and make fully informed choices.
- Access to maternity care matters. In 2022, limited access affected more than 2.3 million women of reproductive age and roughly 150,000 births. Approximately 35% of counties across the U.S. have no access to a birthing hospital, birth center offering obstetric care, and obstetric providers. These so-called “maternity care deserts” increase travel time, narrow options, and can push families toward out-of-hospital births.
Solutions we support
We urge healthcare stakeholders to meet patients where they are, close the gaps that affect whether needs are met, help patients make informed decisions, and support them, regardless of the choices they make. This requires:
- Fostering trusting relationships. Adopting and strengthening clinical practices that prioritize listening, cultural humility, shared decision-making, and respectful, trauma-informed care, are crucial to make patients feel seen and safe, regardless of setting.
- Strengthening informed choices. Provide clear, culturally responsive education on birthplace options and establish consistent outcome data across settings, enabling families to choose what best fits their values and risk tolerance.
- Building integrated care pathways. Where home and birth-center deliveries occur, develop formal partnerships, consultation lines, and transfer protocols between midwives, doulas, and hospitals to keep families safe across the continuum of care.
- Expanding equitable access. Address maternity care deserts by supporting community-based models, sustainable staffing, and policies that reduce cost and distance barriers.
- Measure lived experience and be accountable. Track patient-reported experience measures, disaggregated by race/ethnicity, geography, and Social Determinants of Health (e.g., insurance status, income, housing stability, transportation access) to inform strategy and evaluate progress.
Meeting this moment calls for collaborative, integrated approaches that advance both clinical and relational excellence. At Advancing Health Equity, we translate equity principles into concrete practices, policies, workflows, training, and metrics that improve outcomes and rebuild trust.
Sources and recommended reading
- Axios – Home births climb as distrust of hospitals grows
- March of Dimes – Maternity Care Deserts Report
Author note: Mats Delsing, MSc (he/him) serves as Consultant Account Manager at Advancing Health Equity. He is passionate about translating complex health concepts into clear, actionable insights that promote fairness in healthcare.