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Where women give birth is a contentious issue across the rich world
A RISKY and self-indulgent eccentricity, or a return to natural obstetrics? A medical and political row rages between supporters of home birth, many of them midwives and expectant parents, and its detractors, many of them doctors. Start telling women where they may or may not give birth, with hints that the choice may endanger their child's life, and the gloves come off. A court in Hungary has just sentenced the country's leading proponent of home births, a midwife and obstetrician called Agnes Gereb, to two years in jail for medical negligence in a case concerning two births, in one of which the baby died. She has also been banned from practising for five years.
Stereotypes and simplifications are in rich supply. Many doctors think they are trying to curb a bunch of lentil-munching fanatics who ignore the dangers of something going suddenly, and badly, wrong in childbirth, when even a few minutes' delay can be fatal. The home-birthers decry grasping, bossy doctors who turn a natural experience into a near-emergency needing medical intervention. Hospital births are more likely to end in Caesarean sections, and to involve episiotomies (cutting the vulva) and epidurals (which increase the odds that the labour will require forceps, which can tear the perineum).
Two kinds of risk are at issue. Giving birth at home may be safe most of the time, but when things do go wrong, they are more serious. In hospital more things go wrong because...