One problem with collecting national statistics is that state laws for lay midwifery vary greatly. Some states do not "allow" midwifery, which means women choosing home births must be attended by midwives who cannot legally intervene when complications arise. Other states do allow midwives a scope of practice allowing minor emergencies to be handled at home. It's very uneven.Also, some studies do not distinguish between midwife-assisted deliveries vs planned unassisted births vs planned hospital births where the mother simply didn't make it on time.
It doesn't make sense to compare modern homebirths to homebirths 100 yrs ago. First, in 1900 almost *all* births were at home, including high-risk ones. Hospitals weren't much better back then in quality either.Today, midwives in states where it's legal may carry pitocin, IV normal saline, Doppler or fetoscope for monitoring, oxygen for both mom and baby, etc. There is also licensing throught the state Department of Health which regulates the training and scope of practice for midwives.I live in AZ where hospital transfers from homebirths still count under homebirth statistics. At least here, nothing is being skewed. But in states where midwives are illegal, hospital transfers probably count under hospital births since the midwife technically does not "exist".