Over the years the safety of home birth has been questioned and designing [[randomized controlled trials]] to test the safety of home birth compared to hospital birth has significant ethical problems. Studies of safety have generally found home birth (for healthy women with normal pregnancies) to be at least as safe as hospital birth. A recent study in the ''[[British Medical Journal]]'' ''Outcomes of planned home births with certified professional midwives: large prospective study in North America'' (Johnson & DavisDaviss, June 2005), concluded that outcomes were just as good and "medical intervention rates (such as [[epidural]], [[episiotomy]], [[forceps]], [[ventouse]], and [[caesarean section]]) were substantially lower than for low risk US women having hospital births.'" For example, amongst the home birth women, 3.7% ended up having a caesarean section compared to 19% for the US as a whole (for a similar risk profile) [2000 data].
According to Enkin et Alal in the work ''A Guide To Effective Care in Pregnancy and Childbirth''; "Women with low risk pregnancies considering out of hospital birth should not be discouraged."
According to the World Health Organization, the primary causes of maternal death throughout the world are [[obstetrical hemorrhage]] (25%), [[infection]] (13%), [[eclampsia]] (12%), obstructed labor (8%), complications of abortion (13%), other direct causes (8%), and indirect causes (20%). Infections"Indirect arecauses" almostinclude totallycommon eliminateddiseases, throughsuch simpleas cleanliness;malaria theyand arediabetes, alsothat greatlyare reducedoften treatable in the privateprenatal settingperiod. oftheMany home.of these "Indirectproblems causes"occur includesin commoncountries diseases,where suchthere asis malariano andprenatal diabetes,care thator area treatabletrained throughbirth generalattendant heatlhavailable careduring labor, withoutbirth aand hospitalthe first few hours after the birth when the mother (and the baby) is at greatest risk. A trained midwife can most often identify signs of hemorrhaging, eclampsia, fetal distress and obstructed labor in time to transport the woman to a hospital or call an ambulance. Thus basic prenatal healthcare, proximity to a hospital, and a trained midwife can provide nearly all the safeguards offered by a hospital birth.
