We read with great interest the article by Chervenak et al and are very supportive, corroborating with their arguments and challenges, especially sharing our apprehension of recent statements by professional associations and the European Court regarding the acceptability of home births.

We would like to emphasize and share a couple of points briefly.

First, we would like to argue against the use of the term, prospective uncomplicated delivery, because the existence of such a delivery can be confirmed only retrospectively, and in our experience, the majority of clinicians do not accept this term.

Second, we are worried by the reported elevation of a network of private midwifes to status symbols. As with other types of status symbols in today’s societies, we believe that such attitudes are built on anecdotal substantiation and are primarily the result of fashion trends instigated and propagated by circles with specific profiles and characteristics, probably professionally misguided and possibly having previously experienced unpleasant (even unprofessional) incidences in maternity institutions. We strongly believe that any tendencies to idolize the lack of clinical professionalism and experience during delivery are reprehensible attitudes that leave the future mother and her baby exposed to increased dangers.

Third, we share the implied alarm by the notion that a 15/20/30 minute rule of from decision to incision is feasible in the context of home labor; this is clearly unachievable. Intrapartum asphyxia cannot be prevented, whereas its long-term consequences for the newborn are still under investigation. In our country, most of the centers offering nearly home birth experiences are situated next to obstetric units; hence, clinicians are available within moments if necessary.

Finally, we are in total agreement with the concluding statement of the paper and would like to applaud the authors for the sensible advice they provide. We concur that an ethical use of ideology should be considered here, and we are additionally advocates of the quotation from the editorial in the journal Lancet .

As a parting thought, although attempting to play devil’s advocate regarding an appropriate response when women request a clinical presence during a home birth, the professional, after opposing the idea, can add emphasis by bouncing back the request by mentioning the fear of jeopardizing one’s clinical career and livelihood in case of, God forbid, anything going wrong.

We believe that professionalism “demands adherence to evidence-based standards of care” because this would ultimately lead to better and wanted patient satisfaction.