Out-of-hospital births in California 1991–2011

Objective:we investigated the frequencies and characteristics of out-of-hospital births in a 20-year period in california, where 1 of every 7 births in the united states occurs.study design:birth certificate records of deliveries in california between 1991 and 2011 were analyzed. out-of-hospital births were assessed by year, parity, gestational age and maternal race/ethnicity.results:in the 20-year period there were 10 593,904 deliveries, of which 46 243 occurred out of hospital (0.44%). out-of-hospital births decreased from 0.54 to 0.38% per year between 1991 and 2004, and increased from 0.41% in 2005 to 0.61% in 2011. in contrast, preterm out-of-hospital births declined from 7.2% in 2006 to 5.0% in 2011. the frequency of vaginal birth after cesarean in the out-of-hospital birth cohort increased from 1.2% (n=19) in 1996 to 4.2% (n=82) in 2011.conclusion:california birth records from a 20-year period show an increase in out-of-hospital births from years 2005 to 2011, following a period of decline from 1991 to 2004.