Maternal Characteristics Associated with Intended Home Birth: Insights from 2024 CDC Natality Data

Faculty Mentor

Logan T. Cowan, PhD, MPH & Joanne Chopak-Foss, PhD, FASHA

Location

Russell Union Ballroom

Type of Research

Completed

Session Format

Poster Presentation

College

Jiann-Ping Hsu College of Public Health

Department

Department of Biostatistics, Epidemiology, and Environmental Health Sciences

Abstract

Background

Intended home births, representing a small proportion of deliveries in the United States, have gained popularity in recent years. This study examines maternal sociodemographic and health factors associated with intended home delivery.

Methods

We performed a cross-sectional study using 2024 birth certificate data from the National Vital Statistics System. We used logistic regression to assess the association between maternal characteristics (Age, Nativity, Residence, Race, Marital Status, Education, WIC Status, Insurance Status, Smoking, BMI, Weight Gain, Prenatal Visits, and Birth Order) and intended home delivery compared with clinic/hospital delivery.

Results

After adjustment, U.S.-born women had substantially higher odds of intended home birth than foreign-born women (aOR 6.12, 95% CI: 5.80-6.46). Compared with non-Hispanic White women, non-Hispanic Black (aOR 0.52, 95% CI: 0.49-0.56) and Hispanic women (aOR 0.36, 95% CI: 0.34-0.38) had markedly lower odds. Strong socioeconomic gradients were observed. Married women had over threefold higher odds than unmarried women (aOR 3.54, 95% CI: 3.37-3.71), and women not participating in WIC had twice the odds (aOR 2.03, 95% CI: 1.93-2.14). Compared with Medicaid-covered births, self-pay deliveries had substantially higher odds (aOR 73.62, 95% CI: 70.04-77.39), representing the strongest association observed. Intended home birth was also strongly associated with birth order (≥3 vs 1: aOR 2.73, 95% CI: 2.63-2.84) and nonsmoking during pregnancy (aOR 7.63, 95% CI: 6.12-9.51), consistent with lower clinical risk profiles.

Conclusions

Intended home birth in 2024 was more common among socioeconomically advantaged, U.S.-born, multiparous, and lower-risk women and less common among racially and ethnically marginalized populations. These findings suggest that planned home birth more often reflects resource-supported preference than constrained access, underscoring the need for equitable expansion of integrated community-based maternity care.

Program Description

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Start Date

4-23-2026 10:00 AM

End Date

4-23-2026 12:00 PM

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Apr 23rd, 10:00 AM Apr 23rd, 12:00 PM

Maternal Characteristics Associated with Intended Home Birth: Insights from 2024 CDC Natality Data

Russell Union Ballroom

Background

Intended home births, representing a small proportion of deliveries in the United States, have gained popularity in recent years. This study examines maternal sociodemographic and health factors associated with intended home delivery.

Methods

We performed a cross-sectional study using 2024 birth certificate data from the National Vital Statistics System. We used logistic regression to assess the association between maternal characteristics (Age, Nativity, Residence, Race, Marital Status, Education, WIC Status, Insurance Status, Smoking, BMI, Weight Gain, Prenatal Visits, and Birth Order) and intended home delivery compared with clinic/hospital delivery.

Results

After adjustment, U.S.-born women had substantially higher odds of intended home birth than foreign-born women (aOR 6.12, 95% CI: 5.80-6.46). Compared with non-Hispanic White women, non-Hispanic Black (aOR 0.52, 95% CI: 0.49-0.56) and Hispanic women (aOR 0.36, 95% CI: 0.34-0.38) had markedly lower odds. Strong socioeconomic gradients were observed. Married women had over threefold higher odds than unmarried women (aOR 3.54, 95% CI: 3.37-3.71), and women not participating in WIC had twice the odds (aOR 2.03, 95% CI: 1.93-2.14). Compared with Medicaid-covered births, self-pay deliveries had substantially higher odds (aOR 73.62, 95% CI: 70.04-77.39), representing the strongest association observed. Intended home birth was also strongly associated with birth order (≥3 vs 1: aOR 2.73, 95% CI: 2.63-2.84) and nonsmoking during pregnancy (aOR 7.63, 95% CI: 6.12-9.51), consistent with lower clinical risk profiles.

Conclusions

Intended home birth in 2024 was more common among socioeconomically advantaged, U.S.-born, multiparous, and lower-risk women and less common among racially and ethnically marginalized populations. These findings suggest that planned home birth more often reflects resource-supported preference than constrained access, underscoring the need for equitable expansion of integrated community-based maternity care.