Is the most effective way to prevent perineal damage to avoid episiotomy?
In 2009, while 99.3% of US women delivered in hospital, 0.7% delivered at home. In response to this slight rise in homebirths, The American Journal of Obstetricians and Gynecologists issued a warning to all doctors and midwives to refuse to attend homebirth under all circumstances. In the absence of respected medical research showing planned homebirth to be unsafe, their recommendation is based on a single maternal death reported in the Daily Mail.
Today research wrongly considers hospital birth as the gold standard. Bias towards hospital births causes the majority of researchers to ignore the fact that women could achieve even better outcomes than hospital birth, at planned attended homebirth.