Evidence from US suggests that trials will not alter obstetric behaviour

Home births are currently rare and controversial in the United States. The most recent national figures show that in 1992 only 0.6% of infants were born at home.1 The attendants for these 25923 births were certified nurse-midwives (11.5%), physicians (18.1%), other midwives (31.9%), and others (38.5%). In many areas it is difficult or impossible to find a trained attendant for a home delivery, and hospital back up is almost non-existent. Mother and birth attendant often encounter suspicion and hostility if an obstetric problem necessitates transfer to hospital. Physicians and nursemidwives who attend home births may be denied malpractice coverage or have hospital admitting privileges revoked. …