The brief answer is that birth is as safe as life gets. No provider, whether in hospital, birth center, or home can offer guarantee of safety. We can know what outcomes show.

Care is safest with medical system integration. This means that consultation and transfers of care must be established to ensure timely and complete response to the any elevated risks of pregnancy, labor, and postpartum/neonatal time periods. The American College of Nurse-Midwives, American College of Obstetricians and Gynecologists, as well as the American Academy of Pediatricians all recommend consultative access and plan for handling transfers of care.

Birthing people have fewer interventions and suboptimal outcomes at home. This includes not only those common to hospital-based birth (epidural, induction of labor, etc.) but also interventions and outcomes which can occur in any setting (episiotomy, 4th degree laceration, infection, etc.). (Hutton et al., 2020)

Newborns are as safe when born at home as born in hospital. Researchers who published their systematic review in the internationally-prominent Lancet have found that outcomes support this assertion. Findings are based on review of twenty-one studies from eight countries, including the U.S. and Canada, and include over 500,000 intended home births. (Hutton et al., 2019)