whoops, was not finished with that other post.
2nd flaw: The cost of 1 years malpractice is more than I make in 5 yrs, so there is no way I, & many homebirth midwives can afford malpractice! However, if malpractice were truly only used for damage caused by providers negligence, it might be affordable, but that is not the way it works in real life.
3rd flaw: many homebirth midwives cannot get malpractice, even if they could afford it.
Besides the inherent flaws in the logic of every HCP having malpractice, it may be true that docs should have malpractice, because both parties (the doc & the pregnant woman) don't get to know each other very well, making the birth riskier for both parties. On the other hand, when one gets authentic traditional homebirth midwifery care, there are many long chatty, home visits. If you are not completely comfortable w each other by the time of birth, you change arrangements & don't birth together. I feel like if anyone felt like they needed to be protected from my care, they would hire someone they were more comfortable with, not stay with a provider they didn't have confidence in.
As for a reasonable transfer rate, that depends on the experience, skills & legal restrictions of the HCP & the risk factors of clientele she is working with, as well as what other alternatives are available. For instance, in Haiti, I found the hospitals to be very under-equipped to deal with emergencies, therefore, there are many times might choose to handle a problem at home there, where if I was here in the US, I would transport. Even here, in the poor rural areas, I might choose to stay home for something that I would transport for, if I had any confidence that the hospital could handle it better than I could do at home.