My wife had to have an emergency C-section the first time around when they lost the heartbeat on our first baby, so we've stuck with planned C-sections - so yes, we are somewhat constrained in terms of our choices there.
Maybe we're living in a failed society if we cannot provide the basic, bare minimum of pregnancy care for women. Like I assume you're the same kind of person that would be equally baffled as to why the fertility rate has been going down and can't connect the two dots. As well as the child mortality rate in the US skyrocketing.
Father of 3 here, first two were home births, the third had complications and ended up being a hospital birth. I was initially skeptical for the same reasons but the first meeting with the midwife convinced me that they were taking every precaution and had the training to deal with whatever might come up.
The majority of births are simple if you let them be and the midwives go to great lengths to make sure the conditions are right for a successful event. In the case of our third we hit some conditions leading up to the delivery date that disqualified us for a home birth so we seamlessly transitioned into the hospital system (where the midwife still delivered the baby)
Home birth is absolutely a rational choice in many cases. The author had a very strong reason to require hospital birth but in scenarios with lower risk it is safer in some respects to avoid the hospital.
It will still cost you 5 - 10k for a good midwife and you'll still want to be insured in case you need to transfer. So it only knocks off 5-10k from the total.
Pain relief is a major reason to go to a hospital. There is no safe way to get pain relief in a home birth. It is obviously a very personal choice.
> if anything goes even a tiny bit sideways you just throw your hands up and expect to lose both the mother and child
Of course not. This wrong in two important ways. Midwives are medical professionals. They can administer medicine. Most notably they can administer Pitocin to stop hemorrhage after the placenta is delivered. This is the most common cause of maternal death during labor.
The other way this is wrong is it ignores the option of transferring to a hospital in an emergency. Midwives assess medical risk and can make the call to transfer. Delivering mothers who are overwhelmed can also make the call.
> And you actually pay for this?
The midwife model of care has many advantages over common OBGYN practices. As one example midwives are often delivering 2-3 babies a month instead of many every day. As another example the person delivering your baby is someone you have actually met before and have built a rapport with. Some hospitals try to make this happen with doctors but it is commonly not the case.
Overall the tradeoff is worth it to many people -- it's about 1% of births in the US.