Although I have not read this book - I just want to second all of your reasons that home delivery is just a bad idea. Had I been a home delivery person, chances are Henry and I both would not have made it. His emergency crisis came while I was in active labor, and without Neonatal specialists, and probably the most skilled OB Mike or I will ever see in our lifetime, it would have been a terrible tragedy.

I really enjoyed this book because it did offer both sides of the debate. It was engaging and presented both sides without getting into scare tactics. I had a midwife for 3 of my 4 births. If I would have had more children I would have had a home birth. I even know a family who lost a child during a homebirth and the midwife was arrested and went to court. Interesting enough the family who lost the child still felt good about their decision and testified on behalf of the midwife.

In the case of the story line the family would have been home alone with no way to get any help. (phone lines down & roads undriveable)It seems to me the family had a better result then if they had a Dr. and couldn't make it to the hospital. No physician would have come to their home to help them or sat with them for hours during the labor. And remember, the midwife would have taken her to the hospital if it was possible.

Another twist in the story line is the mother hid her medical history and could have done the same thing with a doctor and so that affected the outcome. In the midwife practices that I have gone to any high risk pregnancies are either referred to a specialist or duel managed with a Dr. So the mother's choice to hide information is more critical in this situation.

I feel women who choose to use a midwife are well aware of the possible consequences and have a right to chose which birth option they want. I read the story and had the exact opposite reaction. I was thinking how awful to go through that experience alone- they were lucky to have a midwife there. And without giving away the end, as a mother I would hope if I was in that position the midwife would make the same choice.

I have to say I completely disagree with the premise that planned homebirths should be outlawed. If you want to regulate lay midwives and make sure there are certifications, by all means. But planned homebirths are just as safe.

Case in point - I had one last fall with a CNM. It was my third child. I was not high risk. It was, by far, the best experience I've had giving birth. My most complicated, frustrating birth? My first, in a hospital.

Please, try and clarify where the line should be drawn. I'm entitled to my birth choice and no law is going to stop me from having the rest of my babies at home - it will just be a "oops, I gave birth at home while my friend/midwife was over for dinner."

As a Nurse I too can see where you are coming from. However, I am currently applying to midwifery school so I will have to say I am a little bias.

I don't think Homebirths should be outlawed, that is controlling womens options. When the women is low risk, homebirths can be a beautiful and meaningful option.

Let me put it another way, when you are going through the most dramatic and changing moment of your life where would you rather experience it? In a familliar place with people you love and trust or an unfamiliar place? Maybe it is because the way I see hospitals is that it is a place you go when you are sick. Pregnancy is not a sickness.

I think everyones desire is to have a happy healthy baby and mother. Outlawing home births I don't think is the option, regulating and training midwives would be more beneficial for all.

http://www.unfpa.org/mothers/midwives...
http://www.webmd.com/baby/news/200202...

I would agree with you, except there are *many* midwives who have extensive obstetrical training, and in this province (BC, Canada) are heavily regulated & managed by the college of midwives.

Lay midwives? Absolutely not -- as far as I'm concerned, that's the same as having a planned unattended childbirth, and as a paramedic, that just screams "terrible idea!" to me. But a planned homebirth with a competent, trained midwife is an excellent alternative to those who prefer not to be in a hospital setting.

Wow! The idea that most of the reasons for which women choose homebirth are selfish is completely ridiculous. Most hospitals and ob-gyns do not actually practice scientific, evidence-based medicine. Instead, they practice CYA medicine. There is also strong evidence that the "cascade of interventions" is caused by elective inductions done for the convenience of the OB. I highly recommend reading Marsden Wagner or Henci Goer for more information on the realities of hospital vs. planned homebirth.

LeiAnn, I totally agree with you. I think the exact same thing that women should be willing to go to the hospital --EVEN WHEN that's not the most comfortable or "beautiful experience" they could have-- so they don't put their child (or themselves) in unnecessary risk! Like you said at the very beginning, it's only the very few that will need emergency intervention, but those few darn well better have it available to get IMMEDIATELY.
Just wanted to say I agree with you on everything.

Having lost a baby right after birth, I would not have had a home birth. It's great when everything goes right, but if there is a problem be in the place where everything can be done easily to sustain life. There is nothing worse than losing a child

When I read this book several years ago, I was so outraged by what happened in it that I felt like I needed to rant. Since then, I have not entirely changed my mind, but on whether homebirth should be outlawed, I think I was too harsh. I still think it's a ridiculously bad idea to rely on one person's judgment where your and your child's life is at stake (especially when that person's expertise is in question). On the other hand, my opinion of lay midwives has not changed. When lives are at stake, the person you rely on should be properly trained and fully capable, as well as fully accountable for the way they take care of those lives.

I definitely agree that something needs to be done about lay midwives ... But I also think something should be done about fear mongers who turn a book review into a lecture on the evils of home birth and the glories hospital birth. There are good and bad aspects to both.

I wouldn't be so against home births, if only the woman was effected, but there is an human being that doesn't have a voice. If there is even a tiny remote chance something could go wrong, which there is, one should put their child's safety first, by being in the hospital.

I am a registered nurse working with CNMs in a freestanding birth center. I felt compelled to comment because of the assumption that a woman choosing a hospital may give up comfort but chooses a safer environment in which to birth. That's just not clinically true. Birth in a hospital can be risky because minor interventions can easily lead to more serious interventions. C sections can save lives and they can cause worse outcomes for mom and baby. Most of the moms I give care to have chosen to birth outside of a hospital because of the risks related to laboring and birthing in hospital. I myself birthed 3 babies in the birth center I work at and I am pretty confident that my first birth and possibly my third would have ended in Csections were it not for patient, competent CNMs. There is something to be said for a better understanding of normal labor and I just don't think health care professionals in hospitals have this.
That being said, birthing at home makes me nervous. Even the most careful midwives are subject to the unknown. We can control what we do and how we respond to situations but we can't control everything else. So when the perfect storm hits we could be screwed and in labor and delivery, time is crucial. But I am a cautious person. I work with and have met many women who have had wonderful home births.
Finally, about the book itself, it just made me sad. Death in birth is awful. I really liked how it was written and how the author lingered in the grey area so well. My heart went out to the family whose mother died and the family whose mother was charged with the death. I would recommend it!