My wife and my first baby was delivered at home just last week. We had an exceptionally experienced and well regarded Midwife who had delivered more than 1,500 babies at home. We met several dozen people who had their babies with our Midwife, including many repeat clients. For us, the direct evidence available to us about our specific Midwife, and from people in situations similar to ours, weighed much more heavily than arguments about national averages.
I couldn't say definitively going into the birth whether homebirth was safer or less safe. But the statistics I saw were close enough, and the risks low enough, that safety wasn't our primary decision factor. We made our choice based on quality of care. The depth of the preparation, the quality of the attention, the feeling of teamwork and shared responsibility, the respect, endemic to the midwifery model of care–in our situation–made it a clear winner.
I get your point about demographic self-selection skewing statistics. But to be honest, this statement reads to me like: "there are some big issues with the fact that people who choose to use Ibuprofen are generally in demographic groups that are less likely to have brain tumors to begin with". Why is it a "big issue" that people make choices appropriate to their circumstances? Or do you mean that it's merely an issue for the data?
I generally agree with this sentiment. Though I would like to comment that well-trained Midwifes are quite capable of handling emergencies. Our daughter was born with an extremely short cord. The delivery went smoothly without any intervention. But about a minute after our Baby was born, the cord detached from the placenta–a very serious emergency. The placenta needed to come out immediately. The Baby had already latched on–which wouldn't have been the case in a Hospital–and the Oxytocin helps the Uterus contract to deliver the placenta. Within 30 seconds of the cord breaking, the Midwife gave my wife a shot of Pitocin, and was ready to "go in and get it" (the placenta), if needed. Thankfully, the placenta shot out about 10 seconds later, and the bleeding quickly subsided.
In a hospital, an OBGYN may have still gone in and "explored" the Uterus to look for tears after the placenta was delivered, causing much more trauma. And I would have supported the OBGYN in doing so too, because I wouldn't have had as long and as trusting a relationship with a Dr. I barely knew as I did with our Midwife, who we had spent 40 hours with over the course of the previous 9 months.
Home birth is not for everybody. You take on a lot of responsibility giving birth to a baby at home. You have to be prepared. But it's truly a wonderful thing to spend the first seconds, minutes, and hours with your new baby in the comfort of your own home. To have privacy, and peace. To deal with the pain by retreating into oneself, as my Wife did, rather than through the brute force of drugs. My Wife doesn't even describe the experience as painful, just laborious.
In my opinion, for better or worse, pregnancy is more akin to weather than climate. If you make decisions based on the "climate" of home vs. hospital birth, you're liable to end up wearing a wetsuit in the desert. You need to understand the climate as broad framing for your decision. But climate is a terrible predictor for your local conditions, so don't forget to look out your window and reason about your own circumstances.