".....and you can do all of this and still have everything go wrong. Or you can stumble upon the worst midwife in the history of birth....and have a perfect outcome. But you should try, at least, to find out everything you can about the person you are counting on to act swiftly, instinctively and in your best interest should things take a turn for the worst."
I think you also need to acknowledge the extremes of some of the rhetoric out there -- the "trust birth", "birth is normal", "breech is a variation of normal", "twins are a variation of normal", "I am obese, hypertensive and of advanced material age but high risk is just something doctors make up to scare you out of homebirth" type stuff. I see a lot of normalizing of high risk scenarios in homebirth discussions -- after all its just the "cascade of interventions" that's the problem, right? After all, doctors just like to "play the dead baby card". And I see a lot of "if I just think happy thoughts everything will be okay" -- so I think there are people that have stepped away from the idea that you need a caregiver who really knows what she's doing because, after all, isn't that just a "medwife" and aren't you just demonstrating that you don't "trust birth" after all?
Twins are not inherently high risk. Breech birth IS a variation of normal. I would feel comfortable giving birth to a breech baby at home. I've witnessed breech birth, I've read extensively about breech birth(no, not just birth stories)....breech is not inherently dangerous unless you are unprepared and start freaking the hell out.
An obese, hypertensive mother of advanced age COULD be at higher risk in a hospital setting where her "condition" is pigeon holed, instead of actually evaluated on an individual basis to see what her labs, body and baby are ACTUALLY saying about her risk factor. <---that statement doesn't mean anything more than the fact that in a hospital scenario, that women would be a prime candidate for the ole "you know you HAVE to have a c/s, right?" - when it COULD BE that she would be just fine delivering vaginally and that proper nutrition, birth preparation and support during pregnancy/labor could mean that the risks associated with doing major abdominal surgery could be higher than those of letting her deliver naturally. That doesn't say anything about WHERE she has that natural birth....because that's not my business and this hypothetical woman is a bit too hypothetical to be able to say.....but the point is, that each woman, each baby, each set of circumstances needs to properly evaluated and that it can't be "homebirth no matter what" OR "hospital birth no matter what" - there is a perfect place for each birth....and a mother and her gut/research/provider/whatever need to evaluate the specific factors involved in each scenario to decide where that perfect place is.
For me, that perfect place was out of hospital with both of my kids. With this third baby...well, three months in, that seems still to be that case. But any number of things could come up which may possibly change my mind. Information, self honesty and being partnered with competent caregivers will all come into play in the final decision.
Partnering with midwife you KNOW makes risky decisions, even sitting in on a hearing involving one of her cases gone wrong due to actual malpractice...and then choosing her as a provider and being shocked when things go terribly wrong, is disregarding information, lying to yourself and seeking out known incompetence to partner with. It's just stupidity. Sorry, but it is. Ignorance is just that. Intentionally disregarding facts is not ignorance...it's recklessness.