I should say that in the two disasters I saw from home births, both were done by uncertified midwives who kept the mother in labor at home way too long when other intervention was called for, resulting in dead or severely brain damaged babies. Not surprisingly, this did not give me a good impression of home deliveries. It's only fair to admit, though, that there is a difference between uncertified and certified midwives, and perhaps things would have been different with certified midwives who knew what they were doing.
Still, though, I'm not quite ready to give my full blessing to home deliveries. Like most neonatologists, I've seen babies come out bad unexpectedly from supposedly low risk deliveries, and when that happens, frankly, it's good to have a neonatologist around. Sure, midwives are trained in newborn resuscitation, but unless you resuscitate depressed babies all the time - like neonatologists do - you're not going to be that good at it.
In the comments to that long ago post, several people cited literature about the safety of home versus hospital deliveries, both pro and con. Normally I'm a big fan of evidence based medicine and making decisions using data, but this might be one time where the literature is not that helpful. The problem is that disasterous deliveries, whether at home or in the hospital, are very low frequency events, so a study would have to be almost prohibitively huge to give a fair comparison of home versus hospital outcomes. I'm simply not convinced that any of the studies cited were big enough.
I still think that the best solution is for hospital based deliveries to get better, to ditch the impersonal and degrading garbage associated with them. I think deliveries done in a dedicated birthing center, perhaps in a separate building on a hospital campus, with nice rooms and quiet delivery personnel, yet connected to the hospital in case rapid action is needed before, during, or after delivery, is the way to go.
Come on folks. Both sides have to give a little in this debate. Pro home-birthers need to acknowledge that it's about the baby, not the experience, and that homes are simply not as well equipped to handle bad babies as hospitals are. Anti home-birthers, though, need to acknowledge that too many hospital deliveries have too many unnecessary impersonal and obtrusive things, ranging from yelling obstetricians to lousy, stirruped posture, to normal babies being whisked away from their mothers right after delivery. It's too bad; it shouldn't be that hard to give a good birthing experience in a hospital - but apparently it is.