Not all hospital transfers are for emergency procedures as you suggest – in the Canadian study 89.9% of the planned homebirth group managed spontaneous vaginal delivery, 3% assisted vaginal delivery and 7.2% caesarean.

I planned a homebirth but transferred to hospital during labour at the advice of my midwives – it certainly wasn’t an emergency, merely a precaution. As Helen has said, a back up hospital is standard procedure for homebirth attended by registered midwives.

“My concern is with overstated claims that situations involve no risk, when they clearly DO involve risk.”

Concern troll is concerned.

Elise remember also that by staying away from the hospital the homebirthers may have helped other data look better. Avoiding overworked doctors strung out on caffeine etc and out of control diseases has it advantages!

Not only overworked doctors but also midwives. When my wife was in labour in the hospital and she needed something I had to go around looking for them as they were nearly always off somewhere else busy assisting in another birth or deeply engrossed with their paperwork. At least with a home birth you’d have their exclusive attention (which may be one reason you see benefits).

whether they are trekking to the South Pole, climbing Mt Feathertop, or having a baby

One of these things is not like the others,
One of these things just doesn’t belong
Can you tell me which thing is not like the others
By the time I finish this song?

And, Elise, for the second or third time, this. is part. of. a. normal. homebirth. plan, to have a hospital on standby. You seem to be saying that anything short of a “freebirth” isn’t a homebirth. But that’s not what midwives who are advocating home birth are advocating. Your argument is solipsistic.

The cost of walkers, climbers, canoeists and other adventurers coming to grief and needing rescue is one that alpine communities and the like the world over have always been willing to bear since they are part of tourism and the local economy. Huge efforts are made to ensure that people are well informed around safety, equipment and training issues to minimise risk and cost. Accidents and freak conditions still arise, and community facilities are there ready to be used. As skepticlawyer pointed out there is no reason why fees can’t be charged in national parks to meet some of these costs. As a walker and one time avid trekker insurance was always an accepted cost and extra fees for national parks would have seemed reasonable to me. Bush walking, trekking and even mountaineering are actitivities hugely popular with women by the way.

The home births issue is quite different and with political ramifications well beyond the cost of insurance. We could solve much of our soaring health costs and hospital bed situation if childbirth were less medicalised and home birthing became the norm again. Training of midwives is already so much more stringent than in the past and liaison and transfer services in the event of rare emergencies more streamlined.

I hope that Nicola Roxon takes the insurance guaruntee for midwives beyond the current two year commitment. Perhaps, given time and with doctors already overloaded and over expensive to boot, we can hope for a move back to home deliveries and yes, medically supervised if necessary. Perhaps what we need is the sort of fashionable rage that occurred with the Lamaze natural childbirth movement of the post-war era. I’m not sure that discussing home birthing within the topic of risk helps to generate the common-sense acceptance of home-birthing as the norm that healthy women should opt for.

I have no cause for anger. I have no emotional axes to grind on the topic of childbirth. Some of my friends certainly do, including Susan – the one with the difficult birth in the Netherlands.

My concern is with overstated claims that situations involve no risk, when they clearly DO involve risk.

People should properly evaluate the risks they take, and take appropriate mitigating actions, whether they are trekking to the South Pole, climbing Mt Feathertop, or having a baby.

Having a hospital on standby is a mitigating action – it is, as such, a recognition of the potential risks involved in childbirth. Anything less would be like climbing Mt Feathertop in bad weather, alone, without an EPIRB. Bloody stupid.

Some people may get away with taking such risks, more by luck and the help of others, than good judgement or planning on their own part.

If you want data, I suggest searching Pub Med for malnourished and maternal death. Or if you want some really upsetting data, try searching genital mutilation and maternal death.

Or you could continue being ignorant and angry. Whatevs.

The point is that there is little practical similarity between first and third world homebirths and that attempting to equate the two is an act of either supreme ignorance or desperation. Go find some real arguments as to why western midwives shouldn’t be insured, will you?