This is an article about an analysis of births in Oregon, where homebirthing (and to a lesser extent use of birth centers) is extremely popular at rates above the national average, and where the women are mostly of more “slim” BMI and other conventional health markers. The takeaway is that infant mortality is rare homebirthing or birthing at a center, but occurs at a greater relative frequency than in hospitals. There was also a higher risk of neonatal seizures, needs for infant ventilators and blood transfusion need for mothers in out of hospital births. Minor complications like tears were lower, however.
This analysis excluded all the actual high-risk to OBs women (breech, twins, etc.), and that’s a big flaw, because women with “weird” (breech) or genuinely high-risk conditions are a big chunk of the homebirthing pool (not the birth center pool, since they are excluded from nearly all American birth centers) and that is one of the reasons there is so much antipathy towards homebirthing (even though those women doing so is itself a response to obstetric mismanagement with hospital birthing).
The basic takeaway is that if you’re a low risk, healthy woman, homebirthing or using a birth center is not unreasonable and probably will be easier overall in terms of recovery, but yes, your baby is more likely to die if you birth away from high-tech emergency equipment. By excluding the high-risk women who choose to homebirth, though, the discussion of how to improve obstetric management for those women remains left off the table.