1) I agree that Australia and America aren't the UK - however there hasn't been a decent study in the UK concerning home birthing. So until there is, I'm afraid it's the best that we have. 2) From what I can see homebirth.org.uk have an agenda that they are trying to push. 3) Shoulder dystocia, I agree that the evidence is there that it occurs more often in hospital (and that is where hospitals should be changing their practice by allowing slow delivery) - but, the management you link to contains... 2. Call appropriate staff: * Senior midwife * 2nd midwife * senior obstetrician * anaesthetist * paediatrician * Explain to the patient and family what is happening And while the Zavanelli manoeuvre is 'hardly ever done' that doesn't mean that it's never done - and then you are looking at a caesarean. 4) 'Home birth is more risky - Where is your UK based evidence?" Where is you evidence that it isn't? the intrapartum care consultation on the NICE website says, Perinatal mortality involved 3 babies in 860 planned home births, 1 baby in 733 planned CLU births and no babies in 563 planned MLU births. No further details were given regarding the perinatal deaths. There were more low birth weight infants in the CLU group (p=0.04). Furthermore, there were 5 infants out of 860 in the home birth group who received assisted ventilation for more than 24 hours, but none in the MLU and CLU groups. It finishes that section of the guidelines with the conclusion, "With relation to women’s and babies’ outcomes for home births, there is a lack of good quality evidence. Limited quality evidence shows less intervention and higher maternal satisfaction with a planned home birth compared to a planned birth in hospital. The evidence of overall perinatal mortality is ambiguous. However, there is evidence that booking home birth has a higher intrapartum- related perinatal mortality than booked hospital birth. In studies where information was given, hospital ‘control’ groups generally consisted of higher risk populations than those groups planning birth at home." The full document is here. The whole 'wooly-emotion' bit is from the document that you linked to. It struck me as strange as well, and trust me - there are crazy people out there who would rather have an 'experience'. Lets face it there are crazy people out there who beat their children to death because they think they are 'possessed'. The initial quote about perinatal mortality in consultant led units is from the initial NICE consultation. To be honest - I think that this discussion we are having (and I don't know about you, but I'm enjoying it) revolves around the lack of decent UK studies. NICE states that the UK studies aren't really up to scratch (same document, and yes I'm summarizing a bit) and I think that there really does need to be a decent study to sort it out once and for all. Kirsten - I take it you are a midwife? Might I ask whereabouts?