Place of Birth: Ethics and Evidence

In the US and UK Births in obstetric units vastly outnumber births that take place outside of an obstetric unit. Still non-obstetric births are increasing in both countries. Is it professionally responsible to support a non-obstetric birth? It is morally responsible to choose to give birth at home? This debate has become heated with those on both sides finding empirical support for their positions. Indeed this moral debate is often carried out in terms of empirical evidence. While to some this debate over the evidence is a distraction from what is genuinely at stake, namely different non-epistemic values, I will argue in this paper that the way forward is to take a closer and more fine grained look at the evidence. This closer look will first require that we distinguish between evidence of risk acceptability and evidence of safety (relative risk) and then focus carefully on evidence of the safety of non-obstetric births compared to obstetric births.