The most recent study that I know of can be found here: http://www.cmaj.ca/cgi/content/short/cmaj.081869v1 You can click to get the full text in the top right of the page.

If you read through it you’ll note that they were careful to match homebirthing women to two other groups, first a matched group who planned hospital births with the same group of midwives and second with a matched group who planned hospital births with a physician/OB. By definition, in order for the women to be “allowed” to plan a homebirth with Registered Midwives in BC they would have had to meet the criteria for “low risk” and therefore the matched groups would have had to also. The groups were matched for age, parity, general income levels, etc. Looking at matched groups in this way would seem to be the only way to actually tease out the risks of both birth places.

The results of this study were that home birth was safer than hospital birth, although as usual it was reported in the media as “home birth is as safe as hospital birth”. That’s the media for you.

The rate of neonatal death was .35% in planned homebirths with midwives and .65% in planned hospital births with doctors. This is a difference of three babies per thousand births, and I’m not sure how statistically significant it is. But you can bet yer boots that if the difference had been the exact opposite, with the higher death rate in the homebirth category it would have been reported that giving birth at home would NEARLY DOUBLE the risk of your baby DYING! OMGeleventy!

The risk of c-section was also significantly higher in the hospital birth group, so comparing two groups where one has a higher rate of major abdominal surgery than the other and declaring that they are both “as safe” is sort of like saying that walking on the sidewalk is as safe as walking on the road, with the hidden bias that getting hit by cars occasionally is no big deal as long as you don’t die.

Keep in mind that “High Risk” and “Low Risk” are moving targets in the obstetric world, and may not even be meaningful categories.

I totally agree with the rest of your message about how hospital births have more intervention than is necessary, which has real effects on the mothers that have them, and that the lack of consent (screw informed consent, doesn’t even look like they get uninformed consent) is both worrying and wrong.