Clinical |

ACOG Statement on Birth Settings

Washington, DC—Maureen Phipps, MD, MPH, FACOG, CEO of the American College of Obstetricians and Gynecologists (ACOG), released the following statement:


“At a time when the nation faces both an unprecedented pandemic and a maternal mortality crisis, it is critical that women have access to patient-centered, respectful care and are equipped with accurate information about the safest places to give birth. Data has long demonstrated that hospitals and accredited birth centers are the safest places to give birth. Although each woman has the right to make a medically informed decision about delivery, it is imperative that women be informed about the factors that are critical to reducing perinatal mortality rates and achieving favorable birth outcomes. This is especially important now when many pregnant women are faced with additional challenges and uncertainties associated with the COVID-19 pandemic. Although planned home birth is associated with fewer maternal interventions than planned hospital birth, it also is associated with a more than twofold increased risk of perinatal death (1–2 in 1,000) and a threefold increased risk of neonatal seizures or serious neurologic dysfunction (0.4–0.6 in 1,000). Unplanned home birth is especially unsafe and patients in need of critical support following a home birth may require emergency transfer, which does not benefit from the ongoing focused care afforded the labor and delivery unit.

“ACOG and its members, in collaboration with the health care team, are dedicated to providing patient-centered, respectful care. Obstetrician-gynecologists see firsthand the stress and uncertainty facing pregnant people, families, and their support networks during the COVID-19 pandemic, and this includes questioning the settings in which to give birth. However, even during this pandemic, hospitals and accredited birth centers remain the safest places to give birth. Physicians, certified nurse-midwives and certified midwives, and the entire health care team will work to ensure that precautions are taken to make labor and delivery safe, supportive and welcoming for their patients.

“The obstetrical community, including ACOG, the American Academy of Family Physicians, and the American College of Nurse-Midwives, has long advocated for patients to have the information they need to choose the safest place for delivery. We recently published a statement about the importance of patient-centered care during the COVID-19 pandemic, highlighting that health care teams at hospitals and accredited birth centers are dedicated to ensuring women have the safest, most respectful delivery possible. We are pleased that the American Academy of Pediatrics—which represents the continuum of the care team providing for newborns following delivery—has joined this important effort to educate patients, especially at a time when the current health care crisis is introducing confusion and uncertainty. ACOG and its members are dedicated to ensuring that women and infants have access to the best care, including during the COVID-19 pandemic, and will continue to work with the full health care team to promote evidence-based, respectful, and safe care.”

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