Your first point is spot-on. Home births are bound to be statistically more successful because they are (usually) only planned for low-risk pregnancies. Howev

Your first point is spot-on. Home births are bound to be statistically more successful because they are (usually) only planned for low-risk pregnancies. However, the increased death rate in the Oregon study is a) localized to that state, and b) attributed to an overabundance of uncertified midwives: > But out-of-hospital births are not as safe as births in hospitals in Oregon, where many of them are attended by birth attendants who have not completed an educational curriculum designed to provide all the knowledge, skills and judgment needed by midwives who practice in any setting. In other words, there are a lot of "birth attendants" practicing midwifery in Oregon who aren't necessarily CNMs (certified nurse-midwives) or CMs (certified midwives) -- which is perhaps closer to the barber acting as surgeon analogy. EDIT: Here's a rebuttal to the Wax study: http://www.midwiferytoday.com/articles/ajog_response.asp http://www.midwiferytoday.com/articles/ajog_response.asp