I don't think medical staff like midwives and nurses set out to control AT ALL, i just think that the system in which they are forced to work is so rigid that unless they do as the hopsital says they are basically on their own - like when my 1st midwife came to check me and i was 2-3cm after 11 hours of labour i know she was worried about getting home because she thought it'd be midnight before she delivered and she had to use public transport to get home (a good distance away) which stopped at 11pm. The relief when i delivered at 6.20pm was tangible from her! At hospital her shift ends when it ends so she can make provision to get home knowing when she can go, whereas on homebirth shifts she gets to go home when the birth is finished or 12 hours after she arrives - that is a RIDICULOUSLY long shift! 12 HOURS and that is from when she was called to me - she might have been near the end of an 8 hour hospital shift when i called her! I feel strongly that Midwives should be supported in their roles much better so they are ABLE to help women achieve the births they want.

Epacris, i think i get what you were trying to say, that because you have really looked at your options and know what you want your birth will be less simple to hi-jack? Sadly there are educated and determined women (i know a few) who were basically lied to during labour - i know 2 women who had induced labours and then c-sections because bubs was distressed. In one case the efm trace shows NO distress at all, and in the other the sintocin drip wasn't turned down to see if it eased the late decels before moving to section even though mum was in transition when they were happening. If an Ob tells you "i need to do a section or your baby will die" and you only later find out it wasn't true - education and determination aren't going to make any difference.

One of the reasons i wanted a homebirth is because i KNEW i wouldn't be able to fight off intervention in labour. I was too focused on the sensations in my body, too vulnerable. I chose to minimise the chance of intervention by staying at home rather than having to try to stave it off in hospital. I cannot imagine how hard it would be not to have even that option.

I fully agree Dach that midwives and doulas should be as fully renumerated as obs and there should not be an expectation that just because catching the baby is a privilege their time and skill shouldn't be paid for properly BUT i do not think the individual should have to meet the costs in some circumstances but not others. Either public healthcare pays for all of it, or none of it and everyone has insurance. Money shouldn't be a factor for the individual, the poor deserve good births as much as the rich do.

a bit O/T but one of the things which struck me so hard about the Dutch maternity care article is the statement that there is no culture of litigation in the Netherlands because the government DOES help those who have suffered malpractice or injury at the hands of medical professionals, they don't need to sue to get money to help with care.

Bx