"And those homebirths that are rushed into hospital for analgesia, foetal distress, etc that then become 'hospital statistics' for PPH, foetal hypoxic brain injury surely have probably clouded my judgement on normality."
straighttalker, can't comment about individual hospital statistics, but a couple of questions:
Do you feel that those women who book a homebirth are more likely to have a PPH than similar mothers birthing in hospital? And their babies are more likely to experience fetal distress? Because your post implies that you feel the inclusion of women transferring in from homebirths with these problems is inflating hospital figures.
Have you any evidence which you could share with us here which confirms that there are higher rates of serious complications for women birthing at home? And also poorer outcomes for babies?
Homebirths currently make up only about 2% of all births in the UK. Do you work in an area with a particularly high homebirth rate?
"In my current place of work, a birth which takes place in hospital (no matter the location of the majority of the labour) is classified a hospital birth."
My understanding is that current recommendations on place of birth are based on a number of studies none of which identified increased rates of mortality and morbidity associated with planned home birth. The largest of the studies was The National Birthday Trust study from 1994 which looked at the outcomes from 8000 births, based on place of booking, not place of birth. It found no evidence of poorer outcomes for either women or babies, and did find lower rates of fetal distress, instrumental delivery and emergency c/s.
Anyway, the findings of new and important research into outcomes associated with place of birth will be published this month I think and I'll be interested in what it says. I appreciate that there are methodological problems with all the current studies on homebirth because of the impossibility of randomising and that many are underpowered to identify rare poor outcomes. Never the less, there is clearly enough evidence for both the Royal College of Midwives and the RCOG to publish a recommendation that homebirth is 'safe' and 'has many benefits'.
You'd really have to ask yourself why two reputable bodies would make this recommendation if there was good evidence that home birth was clearly associated with poorer outcomes for either women or babies.
"However any professional in the know - obstetrician, anaesthetist, midwife, paediatrician - who exchanges a potentially uncomfortable traumatic 24-48 hours in the hospital for a homebirth is criminally misguided, and someone I'd like to meet to ask why on earth she would do that."
Quite a few midwives opt to have their babies at home. I assume for most, they've reviewed the evidence and made their decision as to what's best for themselves and their babies in light of it. The midwives I know are convinced that women birthing at home are less likely to need interventions in the birth, and no less likely to end up with a well baby.
Anyway, sorry I've yacked on a bit, but still would be interested in knowing about the homebirth rates in your area and whether you believe women having their babies at home are more at risk of a serious PPH.