Time to reconsider what is safe for mother and baby, and what is not
Debates about homebirth have a long tradition of producing more heat than light.1 This is not because people on opposite sides of the fence have a lack of reasonable arguments. Those opposing homebirth rightly argue that, irrespective of how well selection processes work, unexpected complications can and do arise and that several of these cannot be remedied within the home environment. Proponents, on the other hand, argue that complications are rare and that the home environment protects against undue interference in what is basically a natural process. They assert that hospital births lead to interventions that are not risk-free and are disproportionately frequent compared with the benefit that can be derived from them. Undeniably, there is truth to both sides of the debate. Both arguments boil down to an issue of numerators and denominators. As risk is everywhere, the issues are what and how much risk is acceptable and how much action is warranted to avoid that risk. Having both mother and baby to consider does not simplify matters. Essentially, this is what fuels the debate and produces the heat, because there is little light that can be shed on any of these questions.