Hi Val, Look, I think it is important to be serious about this, rather than just responding angrily to a rabid madwife as before. The first thing to say is that I wish home births were safe, and could be recommened in the UK. I really hate the way that so many "normal" parts of life have sort of been institutionalised and removed from the home environment to hospitals. The classic current example is the hospice movement (which is wonderful, and above criticism) which is being portrayed by the media in a way that people are starting to beleive that they are not allowed to die at home. Home births are a practical proposition in some countries. Holland has always lead the way here. They are vastly superior for mother/baby, for bonding, for avoiding post-natal depression, for allowing other children in the family to participate. They are vastly superior psychologically to the overcrowded understaffed maternity units that exist in this country at the moment. I am aware of the data you quote but, with respect, your data does not give the whole picture. And again, with respect, as a lay person, it is difficult to get an overview of ALL the data. The problems of home deliveries are two fold; avoiding maternal death and avoiding foetal death. Some (but not all) of the midwives who do home deliveries are pretty good. Unfortunately, a lot are not, and a lot of them work outside the NHS as "independent" midwives. There is excellent data which show that you cannot predict with accuracy which pregnany will result in problems. You can exclude prospectively the obviously high risk ones, but there are no guarantees. And an experienced midwife can often spot in the early stages of labour that something is going wrong in time to get the customer to hospital. But sometimes no one, however experienced, spots the problems until they arise. And in the UK we do not have obstetric flying squads. If you are going to have a general system of home deliveries you must have a flying squad which has a doctor on the team who is capable of resuscitating both mother and child. And to do this he needs equipment, and quite a lot of equipment. He needs a range of drugs, he needs blood for tranfusion, he needs plasma expanders and so on and so forth. This does not exist in the UK. It should. If it did, we could have home deliveries safely, but it does not exist. Maternal death. This is, to be fair, extremely rare. The commonest acute cause of it is massive post partum haemorrhage. You have probably never seen one. I have. Thank god in a hospital. A 27 year old woman, second pregancy, not high risk, no problems, normal birth of baby then in the third stage, without warning, she bled. And I am talking LITRES of blood pouring out of her vagina. Fortunately, within a short time she had 3 peripheral lines, a CVP line, an anaethist, an obstetrician etc etc and her life was saved. Had she been having a home delivery in the UK she would have been dead. That is I admit a rare occurrence. But it happens. Is the pleasure of a home delivery worth the risk? You may say so. But ask your husband or your other children. Foetal death/brain damage This is much commoner. Unexpectedly, the baby comes out flat. Apgar 0. It does not breath. The midwife cannot intubate; she tries, but she does not have the experience to do it, becuase she only tries to do it once in a blue moon. The baby needs fluid, urgently. Midwifes cannot put up drips on babies and even if they could, they do not have the kit. And so it goes on. A neonatal paediatrian however in a hospital (and I have been that person) is doing it every day, has the experinece and has the kit. It took me three months under supervision from a very experienced senior registrar before I was happy and confident about intubating neonates. MIdwives do not have that expertese and what is more they do not have the training in anatomy, physiology etc that they would need to understand the training. (I can feel midwife hackles rising already - but it takes 2 years to train a midwife; it takes 6 years to train a doctor - what do you think they are learning about during that six years?) I have not intubated a baby now for ten years; I could probably still do it, but I sure as hell would not like to trial that hypothesis. I know my limitations. I know where my experience starts and ends. Midwives rarely do. They mean well, but they don't know what they don't know. If they did, they would not do home births in the UK So, in the UK you do not have the expertese at home, and there is no flying squad to get it to you in time. Yes, the small number of highly selected home births that take place have not had excessive morbidity.... but let homebriths become widespread and common and there will be disasters. Ask Tom. He is an experienced paramedic. Ask him how he would feel if was presented with an unconscious mother haemorrhagingm and a baby not breathing. And bare in mind that unexpected problems in so called low risk pregnancies with difficult deliveries tend to cause maternal and foetal difficulties at the same time. Diffcult birth predisposes to haemorrhage and foetal problems. Hospitals are horrible places to have babies compared with home, and yes these days you start to think about the increased risk of infection in the hospital. Nonetheless, you are safer there. The main problem about this issue is that there are a number of "right-on" rabid midwives who are so obessessed with the touchy-feely idealised home delivery that they forget about the risks, and they overestimate their abilities to deal with unexpected problems. We are talking about the LIVES of mother and babies, and you don't gamble with things like that. If you want home deliveries in the UK, then what you need to do is press for aunified system geared to home deliveries with properly equiped obstetric flying squads available in all areas. A tree-hugging, yaks-milk drinking, ten-green bottle singing, Guardian-reading, right-on midwife with an obsession about home deliveries and a knee-jerk hatred of the medical profession is no subsitute for 6 units of "O" negative blood and plasma expanders when a mother is unexpectedly bleeding to death. Until we have such a system (and I wish we DID have one) then sensible people will compromise - and I would heatily recommend some variant on the domiciliary midwife system where, when you go into labour, your own midwife who you have known throughout your pregnancy comes to your house, takes you into hospital to a midwife run unit, delivers the baby and takes you home a few hours later. It may not be totally "right on" for the looney-tune brigade, but it is a reasonable compromise and IT IS SAFE Phew! Sorry that was so long, but this is really important