The problem I see is that direct entry midwives in the United States will often attend home births that do not fit these criteria; while insisting that home birth is at least as
safe as hospital birth, many will attend twin births, breech births, births after 41 weeks, births of women who have pre-existing or pregnancy - induced disease, births after two or more previous caesarean sections, and births of women whose labor has been jump - started
rather than begun spontaneously (whether by herbs, prolonged nipple stimulation, the breaking of her water, or illicit use of
medications).