I've been asked during interviews with prospective clients, and also by complete strangers who just learned I'm a midwife about the risks of having a home birth.  It's a good question that needs a straight answer.  However to understand the risks of home birth, you need to understand that birth in and of itself has an element of risk.  There are "low risk"  births but there is no such thing as a "zero risk" birth.  

What are the risks of birth?  There is a risk of baby being breech.  There is a risk of Mom tearing.  There is a risk Mom may have a hemorrhage.  There is a risk of shoulder dystocia. There is a risk baby may be in a posterior or other less than optimal position.  There is a risk baby may pass meconium before or during labor.  My list of risks is not complete, I decided to list the ones I have seen. These risks can be factors regardless of where birth happens.  I've seen shoulder dystocias in the hospital and in home births.  I've seen hemorrhages at the hospital and at home.  Births are not risk free.  Risks can be minimized or managed and for the majority of births, the risks are minimal.

Sometimes birth can be high risk.  For instance, a mother with a placenta covering all or part of the cervix is certainly dealing with more risk than a mother who does not have that issue.  A mother with high blood pressure has higher risks than someone who doesn't.  As a home birth midwife, I recognize I am not equipped or prepared to handle higher risk birth, so I monitor carefully to make sure pregnancy and birth remains normal to keep risk low.  I am particular about taking clients have low risk, healthy pregnancies.

The risks of home birth are exactly the same as at the hospital.  The biggest difference is that if there's a problem, care may be delayed due to needing to travel to the hospital.  In my midwifery practice, we discuss the risks and also have a plan if there is a need to get more help than I can provide.  During the birth I am constantly monitoring to ensure baby and mother are navigating labor well and that everything stays within the range of normal. Situations requiring immediate emergency care are thankfully uncommon. Usually we have time to arrange for a calm, orderly transfer of care.  I keep my training in emergency skills current and I practice them with my assistant on a regular basis so if there is ever a need to use them, we are ready.  I can't promise a risk free birth. I can promise that I will use my intuition, knowledge, and skills to the best of my ability to provide the best possible care and outcomes for my clients.