About 1.4% of all births in the United States happen at home, based on the most recent CDC data from 2021. That translates to roughly 51,642 home births out of nearly 3.7 million total deliveries. While this is a small share, it represents the highest level recorded since at least 1990, driven by sharp increases during and after the COVID-19 pandemic.
How Home Birth Rates Have Changed
Home births in the U.S. surged 22% from 2019 to 2020 and another 12% from 2020 to 2021. In raw numbers, that meant a jump from about 38,500 home births in 2019 to over 51,600 in 2021. The monthly percentage peaked in January 2021 at 1.51% of all births, likely reflecting pandemic-related concerns about hospital exposure and visitor restrictions.
Before this spike, the home birth rate had been slowly climbing for over a decade after hitting its lowest point in the mid-2000s. But the pandemic compressed years of gradual growth into just two years.
Rates Vary Significantly by Race
Non-Hispanic White women have the highest home birth rate at about 2.1% of all births in 2021. Black women had a rate of 0.82%, and Hispanic women 0.55%. All three groups saw dramatic percentage increases during the pandemic: Black women’s home birth rate jumped 36% between 2019 and 2020 alone, the largest relative increase of any group.
Overall, the demographic profile of home birth mothers skews in a few clear directions. About 84% of women who give birth at home are non-Hispanic White, compared to roughly 57% of hospital births. Women choosing home birth are more likely to be 35 or older (24% versus 18% for hospital births), married, and already have at least one child. One surprising finding: a higher proportion of home birth mothers have less than a high school education (24.6%) compared to hospital birth mothers (12.2%), which may partly reflect religious or cultural communities where home birth is traditional.
How the U.S. Compares Globally
At around 1.4%, the U.S. home birth rate is actually higher than the median across the European Union, which sits at just 0.3%. The major outlier is the Netherlands, where about 16.3% of all births happen at home, supported by a well-integrated midwifery system and national health coverage for home deliveries. Denmark comes in second at 1.4%, followed by Germany at 1.3% and Belgium at 1.1%. Most other EU countries fall well below 1%.
Who Attends Home Births
The majority of home births are attended by midwives. CDC data shows that 62% of home births had a midwife present: 19% were certified nurse-midwives (who have nursing degrees and graduate training) and 43% were other types of midwives, such as certified professional midwives or direct-entry midwives. The remaining births were attended by physicians, family members, or no one at all, which reflects the fact that not every home birth is planned.
Transfer Rates and Safety
Not every woman who plans a home birth finishes at home. A large Canadian study found that about 21% of women who planned home births were transferred to a hospital during labor. The transfer rate depends heavily on whether you’ve given birth before. First-time mothers have a 23% to 37% chance of needing a hospital transfer, while women who have previously delivered vaginally face only a 4% to 9% transfer rate. Most transfers are not emergencies but happen because labor stalls or the mother requests pain relief.
The safety picture is nuanced. Planned home births are associated with fewer interventions for the mother, including lower rates of cesarean sections, episiotomies, and assisted deliveries. However, the American College of Obstetricians and Gynecologists notes that planned home birth carries roughly double the risk of perinatal death compared to hospital birth (about 1 to 2 per 1,000 births) and triple the risk of neonatal seizures or serious neurological problems (about 0.4 to 0.6 per 1,000). These are still small absolute numbers, but the relative difference is significant.
What Home Birth Costs
The average cost of a home birth in the United States is about $4,650, which is substantially less than an uncomplicated vaginal hospital delivery, typically billed at $10,000 to $15,000 or more before insurance. The catch is that insurance often doesn’t cover home births. Only about 21% of home birth practices reported charging a different fee for insured clients, and when they did, the average charge was $5,050, roughly 9% more than the uninsured rate. For many families, a home birth means paying entirely out of pocket.