I think they can work... I had one which I discussed with my hubby so he could advocate for me if I was too out of it to say what I wanted/didnt want... Most went to "plan" except for a couple of things (one being that I didnt want to give birth on my back, but that happened because Claire was stuck and we needed monitoring and for the Ob to stick his hand up me and guide her out). I sort of also think it is more likely to work if you have some kind of continuity of care throughout pregnancy and labour.