The US has the highest rate of obstetric interventions, yet one of the poorest records regarding outcomes amongst industrialized countries. Countries where midwives are the keepers of normal birth, whether in the home or hospital settings, have lower rates of interventions and better outcomes. It's really quite simple. There's no need for a pathologist (an OB, a subspecialty of surgery) until there's something pathological to treat. The prevailing idea here that "normal birth is a retrospective diagnosis" is harming our mothers and babies.
Many of the "complications" that healthcare providers see in the L&D wards are directly caused by the healthcare environment: lack of 1:1 support, immobility, forced dependence, and dependence on machines rather than physical assessment skills. Shoulder dystocia is most commonly a problem of positioning rather than cephalopelvic disorder and neonatal breathing issues are often a problem of aggressive hydration of the mother (fluid overload) for the ever-present epidural. Time and time again, studies prove that the single greatest intervention in labor is continual support for the laboring mom, yet nurses spend very little time at the bedside *in contact with the mother,* with the attention going to the "machine that goes ping."
I would suggest that anyone considering a career in obstetrics (or considering having a baby) should read two books: Henci Goer's The Thinking Woman's Guide to a Better Birth
and Rima Apple's Perfect Motherhood: Science and Childrearing in America
. You did (will) not learn everything you need to know about birth in nursing school
or in OTJ training.
*I've had two hospital births. The first was a typical induction for post-dates (three weeks post EDD) and the second was a cesarean after 80 hours of labor at home, in water. Not all transfers from homebirths are for "complications" or emergencies. In fact, very few are true emergencies.