[Moderator note: This thread is a spin-off of a topic originally brought up in the Home Birth Forum. Because it deals with both topics of risk during vaginal birth and the merits of elective cesarean, I split the thread and am hosting this portion here in the Birth and Beyond Forum.]
For me it all comes down to knowing what to expect and trying to stay in control when things don't go as expected.
I had a very supportive midwife and somewhat pro-natural birth hospital with my first birth. It still ended up very medicalized, despite being vaginal. You need to prepare for this, no matter what. If I could start over I would have scheduled a c-section. I don't know of anyone who regrets scheduling one electively after fully informing themselves and as long as I carry to 39 weeks it's such a relief to know what to expect.
Now that I know the risks of vaginal birth (people talk all day about the risks of medicalized births but never of the vaginal traumas) and how my mother and I handle birth, I have decided to schedule an elective c-section for my next birth. It is quite different from an emergency c-section. The idea of going through a vaginal birth in a hospital scares me because there is such a high chance I would not be in control. The vast majority of women in hospital do not end up having a truly natural birth. If the c-section option was not available, I would be very tempted to do a home birth (if it weren't for the experience I had with my first birth). But I personally can't face that level of pain and further damage to my body again. But maybe you can; lots of women do it. But I am not a
Whatever your choice is, I strongly feel you should have a midwife or Ob with privileges to the nearest decent hospital and continue your prenatal care as if you were going to birth in a hospital; meanwhile you can keep a separate support team to help you stay informed about your home birth arrangement/attempt, should you determine that's what is best. I think home births can be much more satisfying and safe than attempting a low risk vaginal birth in hospital.