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Like it or not, he said, some women will go to almost any length to avoid interventions they fear may harm them and their babies.
The Listening to Mothers survey found that a quarter of women who had given birth in a hospital would consider a home birth. Most women in the survey (2/3) said a woman should be able to have a home birth if she wanted, and 11% said they would definitely want a home birth.
"If you look at the profile of home-birthers, it’s not like they are some crazy fringe group," Dr. DeClercq said. "These are very well-educated women, 75% of whom have already had a hospital birth. They are researching and weighing the pros and cons. They’re not just making some random decision."
His data also suggest that women who transfer to a hospital from a home birth fear judgment and even recrimination. "The consequences of that can be a delay in transfer when it’s necessary, and can lead to problems," even poor infant outcomes.
On this point at least, the two sides find common ground.
"Most of us will never attend a home birth," Dr. Grunebaum said. "But we will encounter patients asking us about home births and seeking hospital transfer for successful or complicated home births, and babies transferred after a home birth. And for these we need to provide compassionate, nonjudgmental care."
None of the sources interviewed for this story reported any financial disclosures.
*Correction, 3/4/2014: An earlier version of this story misstated Mr. Bushman's name.