More women across the U.S. are choosing to give birth outside of hospitals. In Alaska, where the number of babies born out of hospitals is quadruple the national average, that includes birth centers and home births.

Women choose to have their babies outside of hospitals for a variety of reasons. According to a state epidemiology bulletin from the Department of Health and Social Services, a recent nationwide study showed these range from feelings of comfort and control to a desire for fewer medical interventions.

The state compared the larger study to an analysis of in-state births outside of hospitals from 2013 through 2018. Experts discovered that out of the 65,030 births in Alaska during those years, nearly 93% happened in a hospital with just over 5% occurring in a birth center and 1.4% at home.

The state says out-of-hospital births in Alaska grew from a low of 6.3% in 2013 to a high of 7.1% in 2017. Compared to the country as a whole, this high is more than four times the national percentage of out-of-hospital births in the same year.

Most out-of-hospital births, according to the state, were among white, college-educated women with more than one child who hadn't had a cesarean section. Common forms of payment included insurance, Medicaid and self-payment.

"Alaska is one of a small number of states where Medicaid is an accessible payment method for women choosing [out-of-hospital] maternity care, which may contribute to Alaska’s high proportion of [out-of-hospital] births," the state wrote.

The state says out-of-hospital births are most common in the Matanuska-Susitna region, though experts are not sure of the reason behind that.

"Based on the regional distribution patterns presented here, geographic isolation does not appear to be a driving factor for Alaska’s high frequency of [out-of-hospital] births," the state wrote. "Low [out-of-hospital] birth rates in the Northern and Southwest Regions may be due in part to limited access to [out-of-hospital] midwifery services and the Alaska system of regionalization, in which women in isolated communities give birth in regional hospitals or Anchorage when higher level care is needed."

The regions of Alaska that have the highest percentage of out-of-hospital births include the Mat-Su at 19.4% and Southeast at 9.9%.

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