Planned home birth is a subject of ongoing controversy. The American College of Obstetricians and Gynecologists' (ACOG) Committee on Obstetric Practice states that hospitals and birthing centers are the safest setting for birth, but they respect the right of women to make medically informed decisions about their delivery site . The American Academy of Pediatrics (AAP) concurred with this statement . The American College of Nurse Midwives (ACNM)  and the American Public Health Association (APHA)  have policy statements supporting the practice of planned out-of-hospital birth in select populations of women. The World Health Organization (WHO) has released a statement indicating women can choose to deliver at home if they have low-risk pregnancies, receive the appropriate level of care, and formulate contingency plans for transfer to a properly-staffed/equipped delivery unit if problems arise . In the Dutch system, pregnant women without medical complications are asked to choose where they want to give birth: at home or in a short-stay hospital setting. The home birth rate in the Netherlands is the highest in the developed world, although it has declined from 35 percent of all births in 1997-2000 to 29 percent of all births in 2005-2008 .
This topic will discuss planned home birth. Delivery at birth centers and unplanned home birth are reviewed separately.
UNITED STATES NATALITY DATA
Prevalence of home birth — The United States National Center for Health Statistics reports birth data based on state vital statistics records, which are determined from the Standard Certificate of a Live Birth (ie, birth certificate). Prior to 1989, births were identified as either occurring in or out of a hospital (eg, home, car, office). Since 1989, a specific category for home births was included on the Standard Certificate. Since 2003, some states have changed their Standard Certificate to identify planned versus unplanned home births and, by 2008, there were 27 states which reported planning status, accounting for 68 percent of all home births.
In 2009 (the most recent complete figures available), there were 44,121 out-of-hospital births in the United States: 29,650 were home births and 12,169 occurred in free standing birthing centers . Thirteen percent of the home births were unplanned in 2008 (range 1 to 33 percent among the 27 states reporting these data). From 1989 to 2003, the overall rate of home births in the United States declined from 0.69 to 0.57 percent of births, or by an average of 0.01 percent annually. The 2009 figures represent a substantial increase in both absolute numbers and rate, reaching 0.72 percent of all births, the highest United States home birth rate since 1990 [7-10]. Almost all of the increase was attributed to births among non-Hispanic white women.