Home births across the nation rose by 20 percent over four years, according to new government figures, an indication that more women are choosing to give birth in the privacy and comfort of their own homes.
And Montana mothers are following the trend.
One of those women is LeeAnne Storey, 30, and her husband, Lucas, 34, of Billings. After hours of exhaustive research, the couple chose to have both of their children — Andreas, 4, and Maeve, 3 — at home using a midwife.
"It wasn't a casual decision," LeeAnne said. "We weren't opposed to the medical establishment, but we didn't view pregnancy as a disease. We saw it as a miraculous event ... and we saw our midwife as a guardian of that experience."
During the birthing process, she was surrounded by the sights, smells and comforts of home in a "gentle, non-intimidating environment." And, LeeAnne said, she had the flexibility to walk around, climb the stairs, soak in the bathtub and nestle in her own bed.
The couple also felt empowered and in control of their own experience, Lucas said. Hospitals have always been a source of anxiety for him, so the option of having their children at home meant less stress, more control and fewer potential medical interventions.
The childbirth classes the couple attended with their midwife increased their knowledge of the birthing process, he said. So, instead of being scared during labor and delivery, he knew exactly what to expect.
"At home, I felt I was more involved and was the first one to hold our son," Lucas said. "I think fathers often feel out of place. Being at home and with (the midwife's) direction, I had a specific role in helping LeeAnne. I felt useful."
Less than 1 percent of U.S. births occur at home. But the proportion of home births is markedly increasing, according to researchers at the Centers for Disease Control and Prevention. The spike in home births occurred between 2004 and 2008, rising from 23,150 in 2004 to 28,357 home births in 2008. Between 1990 and 2004, the number of home births had been trending downward.
Twenty-seven states had significant increases during those four years. Montana, Vermont and Oregon recorded the highest percentage -- about one in 50 births were at home in those states, according to the CDC. In 2008, Montana had the highest number of home births, 275, or 2.18 percent, according to the CDC research.
Montana has a long history of midwifery and has been licensing midwives since 1991, according to the Montana Board of Alternative Health Care. The longevity of the practice could explain, in part, why Montana had the highest percentage increase in home births. The number of licensed midwives has also increased from 17 in 2004 to a current 23.
"We've been able to practice openly, legally and in a sound way, with good outcomes for 20 years," said Pat Schwaiger, a registered nurse and licensed midwife in both Montana and Wyoming. "Montana midwives have validity."
There is no simple explanation for the uptick in home births, said Schwaiger. Some contend the increase is driven by economics, but she disagrees.
"Cost is not the main reason," Schwaiger said.
She charges $3,500 for a home birth, which includes all pre- and post-natal visits as well as labor and delivery. Some insurance plans cover home births. A normal delivery at a Billings hospital costs between $4,446 and $6,946 and does not include pre- or post-natal visits. Most insurance plans cover hospital births.
The majority of Schwaiger's clients are college-educated professionals with good jobs and incomes. Couples are increasingly attracted to home births because they have more of a say in what happens before, during and after delivery, Schwaiger said.
Schwaiger attributes much of the growth to enhanced communication and modern technology.
"Midwives used to rely on word of mouth," Schwaiger said. "Now, people find me online."
The increase in home births is especially notable because physician organizations have been increasingly opposed to home births, including The American College of Obstetricians and Gynecologists. The organization has long argued that home births can be unsafe.
The CDC research counters that argument to some degree. Home births involving medical risks were less common between 2004 and 2008, according to the CDC research. The number of babies born prematurely fell by 16 percent. By 2008 only 6 percent of all home births involved preterm births, according to the CDC.
The increase in homebirths was driven by white women, according to the CDE report. One in 98 white mothers had their babies at home in 2008, the most recent statistics available.
Only about 1 in 357 black women give birth at home, and only 1 in 500 Hispanic women did, according to the CDC.
For all races combined, about 1 in 143 births were at home in 2008, up from 1 in 179 in 2004.
"It's all about bringing one more safe option to women," LeeAnne said. "One size does not fit all."