NEW YORK - The number of out-of-hospital births, including home births and birthing-center deliveries, are up in New York and nationwide.

According to data from the Centers for Disease Control and Prevention, more than 1 percent of deliveries in New York in 2012 were out-of-hospital births, up from just 0.75 percent in 2004. Meanwhile, nationally, the risk profile for non-hospital births was lower than hospital births.

Michele Giordano, executive director of the nonprofit advisory group Choices in Childbirth, said women increasingly are seeking more control in the birth process, such as how, when and where the baby is delivered and by whom.

"Women aren't getting the level of care they want." she said, "and the reason why women are making a wide range of choices and seeking doulas and seeking home births and seeking options outside of the medical model is because they want to be treated with respect. They want to be at the center of their health care decision-making."

Giordano warned that all non-hospital births are not reactions to a hospital experience but sometimes simply reflect a desire for a safe and comfortable birthing experience. The CDC also found that nationally, more than 50,000 babies were born at home in 2012, the highest since 1975, and far fewer out-of-hospital births were born preterm or low birth weight than hospital births.

Giordano said few birthing centers providing alternative childbirth options exist in New York. And while many critics view non-hospital births as unsafe, Katherine Morrison, medical director for the Birthing Center of Buffalo, said hospitals actually have become less safe as the U.S. maternal mortality rate is now higher than in any other developed country.

"In 1987, our maternal mortality rate was nine per 100,000 births, and now it's 18.8 per 100,000 births," she said. "So we are unnecessarily intervening and killing mothers in the hospital. and nobody in the hospital wants to discuss that."

The CDC found that in 2012, out-of-hospital births had a lower risk profile than hospital births. About four percent of non-hospital births were born preterm, compared with more than 11 percent of hospital births - and about three percent of non-hospital births were low birth weight compared with about eight percent of hospital births.

More information about out-of-hospital births can be found online at cdc.gov. International non-hospital birth information can be found at savethechildren.org.


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Even for Virginians who think they're too busy to exercise, experts say there's one surefire way to squeeze in a modest workout: walking.

Although often considered a more casual activity, walking can be beneficial for heart health when a person may not have the time to go to the gym. Dr. Ameya Kulkarni, an interventional cardiologist at Kaiser Permanente and chair of its Cardiovascular Institute of the Mid-Atlantic States, said finding time to get in a workout or the space for a treadmill are common barriers people face in trying to exercise - but there are plenty of ways people can sneak in a few steps.

"If you're not finding time to exercise, I say park as far as you can in the parking lot from your work or from the grocery store, and that extra five to ten minutes of extra walking - done, let's say, two or three times a day - is walking you wouldn't have done otherwise," he said. "So, there's sort of opportunities to find exercise in the course of your regular day."

Another common barrier is the weather, especially as chilly fall breezes turn into the frosty winds of winter. Kulkarni recommended trying mall-walking, since malls are open year-round. The American Heart Association recommends people walk 150 minutes a week. That's just 30 minutes a day to stay active and on the path to a healthier lifestyle.

While walking is heart healthy, Kulkarni said he finds there are some misconceptions about just how healthy it really is. He said a workout doesn't have to be vigorous or strenuous in order to be effective, and wants people to understand that any exercise is a step in the right direction.

"What I don't want people to think is, 'If I don't do it perfectly, then I can't do it at all.' Any amount of activity is better than none," he said. "And so, if you can get up and get moving a couple times a week, and that's all you can do, it's a great start - and you'll build from there."

For people looking to lose weight and build endurance, Kulkarni added that walking can be the start that develops into much fuller workouts. For anyone looking to do a group walk for a good cause, the American Heart Association is holding one of many "Heart Walks" on Nov. 5 on the National Mall in Washington, D.C.

An Arizona women's health clinic has devised a novel workaround to help women end their pregnancy without running afoul of the state's strict anti-abortion law.

The plan involves giving the woman an examination and ultrasound in Arizona, and then getting a prescription for a two-dose abortion medication via telehealth with a California doctor, who sends the pills to a California border town for pickup.

Dr. Gabrielle Goodrick, medical director of Camelback Family Planning in Phoenix, said she believes the plan is legal.

"They can't control what we talk to our patients about in terms of education and information that is not regulated by the government," Goodrick asserted. "The doctor-patient relationship is what it is. We firmly believe that what we're doing is within the framework of the law."

An Arizona judge recently lifted a temporary injunction blocking enforcement of the state's abortion law, but some prosecutors, including the Maricopa County Attorney, have vowed not to prosecute abortion cases.

Goodrick noted because Arizona law bans mailing abortion medications, she advises women to take both pills in California and not bring them back to Arizona. She pointed out her clinic is not performing abortions, just providing information.

"They will have to go there and take the medicine in California and return to Arizona," Goodrick explained. "And then we will do a follow-up with them to make sure that the medication was successful. They also have a physician, myself, or the clinic that they can call with any questions or any complications."

Goodrick suspects her lawyer -- if she asked -- would likely advise against the plan and admitted it is "probably pushing the boundaries." But she emphasized the superheated rhetoric surrounding the abortion issue obliges her to take a stand for her patients.

"National organizations are just not willing to push against these bullies," Goodrick contended. "These politicians are passing completely unconstitutional laws trying to restrict interstate travel, trying to threaten patients and intimidate providers."

As the World Trade Organization meets this week, students across the country are pushing the Biden administration to support more access to COVID-19 tests and treatments globally.

The WTO General Council meets Thursday and Friday. At the meeting, University students will urge the U.S. to back expanding a temporary waiver of Trade-Related Intellectual Property Rights beyond vaccines. The expansion would make it easier for countries such as India and South Africa to produce tests and treatments.

Jasmine Zettell, an intern for the Trade Justice Education Fund and a student at the University of Washington, said the waiver would help more people get the vaccine more quickly.

"If we are able to waive that intellectual property right for other countries to produce tests and treatments, then we can see the test and treatment strategy being rolled out in low- and middle-income countries," Zettell explained.

Letter-writing campaigns and rallies to put pressure on the Biden administration are going on at schools across the country this week, including at the University of Washington. Industry groups for the producers of COVID-19 therapeutics say expanding the waiver will undermine the ability of the U.S. to innovate and compete.

Zettell countered there is a pressing need to expand access to the products in other parts of the world.

"This kind of ongoing inequality of putting big pharmaceutical monopolies and capitalistic gains over human rights is causing huge numbers of avoidable hospitalizations and deaths each day," Zettell argued.

Zettell hopes creating more awareness about the issue will spur her fellow students to speak out.

"At our university, we really have ample access to COVID resources," Zettell noted. "So I feel some students are taking that for granted and are not necessarily aware of the reality that low- and middle-income countries are experiencing by not having these resources."