The State Of Home Birth In Utah

The Utah Women and Newborns Quality Collaborative (UWNQC) this week released their report and findings for out of hospital birth trends in the state. The report identifies a staggering increase in home and birth center birth in Utah (planned home births increased by 46% and births at birth centers increased by nearly 340%). Go Utah! With Utah ranking as one of the top states in the nation for planned out of hospital births, it's important that we recognize one of the key findings of the report. Most women in Utah experiencing out of hospital birth identify as White and non-hispanic.

Right here we were going to feed you a lot of data about health disparities in Utah. But we think you know. And if you don’t we will tell you briefly that Pacific Islanders, Native Americans, Hispanic/Latino, African American and Asian populations suffer the greatest health disparities in Utah. While in some of these populations infant mortality rates are dropping, overall care in early pregnancy has decreased across the board. Add to which, adolescent pregnancy has increased in all areas and postpartum health has decreased rapidly.  Sadly, no agency in Utah (that  we are aware of) is tracking birth and postpartum disparities among our LGBTQ+ community. 

Miracle Midwifery strives to decrease the disparities among communities of need and those who are most likely to experience unfair prenatal and obstetrical treatment. However, we must strive to decrease these disparities as a community by increasing access to services and options for families in need. Read: more government and private assistance for out of hospital birth and more midwives offering services to those most at risk.

As a multi racial Native American (Shoshone) and Latina woman, Krista is one of the only women of color to own a midwifery practice and birth center in Utah.  She's made it her mission to ensure Miracle Midwifery supports all families and has set up a private birth scholarship fund and accepts many payment options such as insurance, medicaid and tricare.  

Read the Utah Women and Newborns Quality Collaborative report and press release below:

(Salt Lake City, UT) – A new report from the Utah Department of Health (UDOH) shows that from 2000 to 2015, planned home births increased by 46% and births at birth centers increased by nearly 340% in Utah. While the overall rate of planned out-of-hospital births is small, at 3.2% in 2015, Utah ranks in the top five states nationally for planned out-of-hospital births.
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“In the early 1900s, almost all U.S. births happened outside of a hospital,” said Heather Bertotti Sarin, with UDOH and the Utah Women and Newborns Quality Collaborative. “Today, around 1.4% of U.S. births occur in an out-of-hospital setting. For the Central and Southwest areas of our state, we see about 5% of planned births occurring in a home or birth center.”

Findings from the report showed that women who planned out-of-hospital births compared with women who planned hospital births, were:

• more likely to identify as White and non-Hispanic,
• at a healthier weight prior to pregnancy,
• less likely to smoke; and
• women who had experienced five or more prior births.

“Despite these positive findings, e risks were identified. Women who planned out-of-hospital births were also more likely to initiate prenatal care late into their pregnancies, in the second or third trimesters. And some had obstetric risk factors such as multiple gestation or a history of cesarean section,” said Bertotti Sarin.
Approximately 6.6% of planned out-of-hospital birth attempts in Utah resulted in a transfer to a hospital facility.

“We acknowledge that women have the right to choose to deliver at home or in a birth center, and women are choosing this option more frequently. Our goal is to ensure that, when necessary, maternal or neonatal transfer to the hospital is as safe and seamless as possible. We want women and their families to get the best possible care, across birth settings, by creating tools that facilitate communication and interprofessional collaboration between out-of-hospital midwives and hospital staff,” said Dr. Erin Clark, a maternal-fetal medicine physician and chair of the Utah Women and Newborns Quality Collaborative, Out-of-Hospital Birth Committee.
The Utah Women and Newborns Quality Collaborative is a statewide, multi-stakeholder network dedicated to improving perinatal health in Utah. The collaborative was created in November 2013 and has since created the Utah Best Practice Guidelines: Transfer to Hospital from Planned Out-of-Hospital Birth to help hospital providers and midwives ensure the health and safety of women and their infants.

“The majority of women transferred to the hospital from a home or birth center have successful deliveries. We created the transfer guidelines to increase communication and safe hospital transfer for mothers and their newborns,” stated Bertotti Sarin.
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To download a copy of the report, Planned Out-of-Hospital Births in Utah, 2013-2015, visit https://bit.ly/2wIG3HB. For more information about the Utah Women and Newborns Quality Collaborative, visit http://health.utah.gov/uwnqc/index.html.