Great article! The medical profession horribly underestimates (if they don't just dismiss it completely) the importance of feeling safe and supported in order for labour to go smoothly. For some women a hospital might do this (especially if they've been scared and not helped to address those fears), for others it definitely doesn't. I recommend anything written by Sheila Kitzinger and 'Birthing from Within' by England and Horrowitz. Great writers who helped me prepare for 2 home births after an unnecessarily traumatic hospital one.

I found this article annoying in the extreme.
English women do birth at home more often than in Australia or America, but that is because there are Hospitals much closer to those English homes if something goes wrong.
Australia is a much larger country, with larger distances to hospitals in general.

As far as I am concerned, women who birth at home are selfish .
They are looking after what they want, and not considering their babies.
Babies don't care where they are born.

Years ago, when all women birthed at home, the rates of maternal and baby deaths was high.
When they moved into hospitals, the mortality rates decreased.

I wanted the best chances for my baby, so I had her in a hospital, and all was well.
I didn't want to take the chance of birthing at home... at least half an hour from any hospital, only to find one of many complications happened.

I could never live with myself if my 'choice' resulted in any harm happening to my baby.
Having said that, I still believe women should have the choice to birth at home if they please.

Simply a reversion to the pre-medical era of giving birth ie the early 1900s. All the misplaced confidence of a Russian roulette survivor.

To those who believe home birthers are misguided, selfish or worse...

Years ago when all babies were born at home many women and children died in giving birth. Yes, can't dispute this, but the present in the rich world is different.

Many of the problems that accompanied birth are not here and now relevant in the most part, or they can be screened for. For example; placenta praevia, which causes severe haemorrhage, can be detected, women are not suffering from malnutrition (a significant cause of morbidity and mortality); we have antibiotics to combat post-partum infection; we have trained birth attendants. I could go on...

Hospitals have however created problems that did not exist before - For example; women should be allowed to give birth in whatever position they want to - reclining or semi reclining unless that is what the woman wants is lunacy (imagine being forced to crap in that position); there is no evidence to support continuous foetal monitoring as improving outcomes, but it does create panic and increase interventions. I could go on...

I do not know of a single woman who would willingly risk the life of her baby - we make our choices after reading the evidence and understanding the risks. I am pretty sure that your average home birther has done a lot more work and research on this than your average hospital birther, and the data says that for a low risk pregnancy the outcomes are no worse for a planned home birth with a trained attendant, than for a hospital birth.

Wherever it takes place, every woman has to live with the consequences if a birth goes wrong. To imply that home birthers do not care about their baby's welfare is utterly outrageous. You may not agree with her, but perhaps if you took the time to listen and understand, you might might not be so quick to judge her motives.

You might also surprise yourself.

So the home birthers cherry-pick the healthy best prospects and where anything goes wrong the stats will be against the hospital and medical specialists where the ambulance arrived?

I don't care what decision a woman makes if she is to be responsible for the outcomes both good and bad. However Taxpayers are right to get interested where it could impact on hospital services, stretched as they always are, and something gone awry is expensive to fix, if it can be fixed at all.

It is up to government to have proper regulation and accreditation in place. Can we trust the present federal government to do what is warranted and effective? Not so sure on that one. But the State health departments are usually dependable in identifying the regulatory flaws and they are unfortunately up for the extra hospital costs.

There seems to be an assumption that things *will* go wrong in birth - but this isn't the case. There is a risk, yes, but for many pregnancies that risk is very low.

If you find it hard to think about the different levels of risk, you could compare a low risk pregnancy to crossing a quiet street and a high risk pregnancy to crossing a motorway. I don't think you'd try to cross a city motorway on foot, but neither would you travel 2 miles to the next bridge to cross a small street in a small town, would you? Prenatal screening and looking at evidence based data is equivalent to looking at the road and the number and speed of the cars in order to decide where and how to get across.

Finally, a home birth, even one which needs an ambulance transfer (although I can't comment if helicopter or plane transfer is needed) typically costs a lot less than a hospital one - it isn't hard to work out why. If more people who are suitable for safe home births had a home birth then the hospitals wouldn't be so stretched and could take better care of those who really do need their facilities - either from the start or as transfers