"Planned out-of-hospital birth was associated with a higher rate of perinatal death than was planned in-hospital birth (3.9 vs. 1.8 deaths per 1000 deliveries, P=0.003; odds ratio after adjustment for maternal characteristics and medical conditions, 2.43; 95% confidence interval [CI], 1.37 to 4.30; adjusted risk difference, 1.52 deaths per 1000 births; 95% CI, 0.51 to 2.54). The odds for neonatal seizure were higher and the odds for admission to a neonatal intensive care unit lower with planned out-of-hospital births than with planned in-hospital birth." [1]
"Midwife home births had a significantly higher total neonatal mortality risk than deliveries by hospital midwives (1.26 per 1000 births; relative risk [RR], 3.87 vs 0.32 per 1000; P < .001). Midwife home births of 41 weeks or longer (1.84 per 1000; RR, 6.76 vs 0.27 per 1000; P < .001) and midwife home births of women with a first birth (2.19 per 1000; RR, 6.74 vs 0.33 per 1000; P < .001) had significantly higher risks of total neonatal mortality than deliveries by hospital midwives. In midwife home births, neonatal mortality for first births was twice that of subsequent births (2.19 vs 0.96 per 1000; P < .001). Similar results were observed for early neonatal mortality. The excess total neonatal mortality for midwife home births compared with midwife hospital births was 9.32 per 10,000 births, and the excess early neonatal mortality was 7.89 per 10,000 births." [2]
[1] http://www.nejm.org/doi/full/10.1056/NEJMsa1501738 [2] http://www.ajog.org/article/S0002-9378(14)00275-0/abstract
Like, these are "am I willing to make this tradeoff" numbers similar to choosing to drive to work daily, rather than "fuck no, go to the hospital" numbers.
Look up earlier in the thread for my comment, but anecdotally, almost every parent that I have told my story to has changed their opinion on home birth vs. hospital birth.
It's an educated and sourced one, as opposed to your flippant comment.
> There are plenty of board-certified midwives
Not only are there plenty of midwives which are not that, how meaningful board accreditations are depends strongly on the board, CNMs are true professionals[0], CPMs are pointless layabouts.
> birthing centers
The comment I was replying to was about homebirth.
Birthing scenters are usually professionally staffed, attendant to hospitals, carrying necessary emergency materials and will immediately transfer to their linked hospital in case of complications. And good birth centers will plain refuse at-risk patients and direct them to hospitals.
> Importantly, a great deal of risk can be ascertained before labor
Which is already included in the statistics above.
[0] and even with CNMs homebirth mortality is significantly higher than hospital birth.
From what I've seen, hospital-associated ones are bait-and-switch. If you show up early, then you take longer than allowed and they transfer you to the regular hospital. If you show up late, then they also transfer you!!! (this shockingly lame excuse was actually used on a friend) Clearly, there is a purposely narrow window because the hospital makes more money if you end up in the regular hospital area.
I find it strange that you think homebirth midwives don't carry necessary emergency materials. Just considering the obviously visible example, every one I've seen lugs around an oxygen tank.