I can’t comment on your SIL’s situation, but I can absolutely say that the data shows that most c/s are not ’emergent’ rather they are ‘urgent’ and most mothers and/or babies are not in imminent danger of death. Of course, sometimes they are and an emergency c/s does save lives.
Second, you are not always safer in a hospital. Most hospitals, especially in smaller centres, are not staffed 24h a day with OB and anaesthesia. That means that even IN the hospital an emergency procedure requiring those services may be delayed for transit time. Also, even if the hospital does have 24h OB and/or anaesthsia service, they may be occupied with other procedures elsewhere and unavailable. I’ve had patients wait HOURS for an epidural or a c/s because there was no one available to do it. At a home birth (at least where I live), a midwife calls ahead to the hospital to warn them to prepare for arrival so that transit time is minimized and as seamless as possible.
Third, hospitals are in fact breeding grounds for several types of bacteria that are not common in the community, some of which are antibiotic resistant. These bacteria are often less common on Birthing Units, but not always. And YES, infections do cause some women to choose homebirth….H1N1 and Sars are the most known of these, and I can attest to C. diff being a factor in my community. Additionally, birthing rooms are not sterile, birth itself isn’t sterile. It’s a process that involves poop, blood, amniotic fluid, sometimes urine, sometimes vomit….definitely not sterile. Yes, health care providers do wear sterile gloves, in large part to protect THEM as well as the baby. But don’t kid yourself that birth is anywhere close to clean or germ-free.
And last, and perhaps most importantly….birth can be dangerous, but it’s not “extremely dangerous”. Did you drive a car today? That’s several times more dangerous than childbirth. Don’t be a fear monger.
As for ACOG….they are a professional, self-serving association. They can say whatever they want, it’s an opinion statement. And their journal publishes shoddy studies which are generally torn apart by the rest of the scientific and medical community (eg. Wax et al on homebirth). so, take what they say as the promotional literature it is, not as evidence based medicine.
Contrary to what you say, there is actual a large amount of good, scientifically sound data on homebirth and it overwhelmingly shows that homebirth is AS SAFE for mothers and babies as hospital birth. Not SAFER, not LESS SAFE. It also shows that homebirth reduces the incidence of unnecessary medical interventions that cause further iatrogenic interventions.
You are entitled to your opinion, and it’s not an uncommon one. However, women in general are better served by solid factual information to help them make educated decisions around birth.
ETA: yes, as Junip3r pointed out in a lower post, the data shows homebirth is as safe as hospital in healthy, low risk populations with a trained care provider in attendance.