Health & Science

More Black families are avoiding hospital births — here’s why

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A new report released by the National Partnership for Women and Families has revealed that births outside of a hospital setting occured 20 percent more during 2020 than in the previous year. This number was even higher among people of color, particularly non-Hispanic Black people at 30 percent and Indigenous people at 26 percent more births outside of the hospital.

Births outside of a hospital setting are known as community births, and generally occur in the home or at community birthing centers with the assistance of folks like midwives, doulas, and sometimes friends and family as well. 

Midwives are healthcare professionals who specialize in pregnancy and delivery. They sometimes work in hospitals, but are also often able to work in community birthing centers or at people’s homes. Doulas are labor assistants who provide physical and emotional support to pregnant people throughout their pregnancy and postpartum period. 

Why do people choose community births?

In general, pregnant people may choose to have their babies outside of a hospital setting for reasons such as personal comfort or accessibility. People of color specifically may seek community birthing options because of the negative experiences they’ve had in traditional medical settings.

Research has shown that Black people experience better outcomes with the support of midwives and doulas than they do with only traditional medical staff like obstetricians. Pregnant people of color are able to have more autonomy and input in the birthing process when they use midwives, and are often able to work with other people of color who may be more empathetic and knowledgeable of their particular needs. 

The COVID factor

Another factor behind the increase in community births in 2020 was the COVID-19 pandemic. Between the rapidly spreading virus and the lockdown safety protocol in hospitals during that time, many people felt hesitant to enter hospital settings. 

The fact is, giving birth can be dangerous — and pregnant people are more and more frequently seeking more comfortable and safe options where they feel heard and respected. Birth is especially dangerous for Black people, who are three times more likely to die of a pregnancy-related cause than white people. 

Community births, midwives, and doulas offer an alternative solution to folks who may feel at risk or unheard in a hospital setting. People of color experience the highest risk of complications during pregnancy and delivery, so being able to work with community members, often other people of color, during this delicate time can not only improve outcomes, but provide much-needed comfort and relief. 


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Mckenna Saady is a staff writer and digital content lead for ParentsTogether. Before working for nonprofits such as the Human Rights Campaign and United Way, Mckenna spent nearly a decade as a child care provider and Pre-K teacher. Originally from Richmond, VA, she now lives in Philadelphia and writes poetry, fiction, and children’s literature in her spare time.