With regard to the statement "all that matters is a healthy baby", I have one additional thought. If that is true, and all that matters is a healthy baby, then why is it that mom's who are the most emotionally dissatisfied with their birth experiences have had bad ones, but maintained long term good outcomes? In fact, a bad birth experience can lead to post partum depression. You can't convince me that the long term health of the baby is the only thing that matters.

As a mom and a nurse attending deliveries I've heard that expression a lot with regard to birth experiences. So it occurred to me that there is some variation on the definition of a healthy baby, or a good outcome of a labour and delivery. So the question is, what is a "good outcome" to you? Is the definition of a good outcome simply bringing the baby home, ultimately healthy? Or do you want to optimize that outcome?

Here are some examples:

Is it a good enough outcome to have the baby require separation from you, have deep suctioning immediately after birth, and possibly oxygen, including bagged breaths, and stimulation (typically fairly rough back rubbing along the spine, as that's what the national standard for rescucitation teaches all docs and nurses to do for stimulation), but ultimately room in with you? Is that a good outcome?

Is it a good enough outcome to have the baby start out with respiratory distress and have to transition in the NICU? Maybe it has to stay a day or two for a sepsis workup, because of the risk of pneumonia - this would require a spinal tap - but it comes home with you after a few days? Is that a good outcome?

How about real pneumonia? Then the baby is in the NICU for a week minimum getting antibiotics and oxygen therapy... but it'll come home at some point down the road, just not with you. It IS ultimately healthy, though. Is THAT a good outcome?

How about persistant pulmonary hypertension? In this scenario because of the lack of cues indicating birth, baby doesn't transition well and ends up with high pressure in the lungs and low pressure in the body, and blood continues to bypass the lungs and not oxygenate, and baby requires intubation, vasopressors, antibiotics, and may be critical for some many days (even so far as to go on ECMO - basically lung bypass, like in surgery), but ultimately gets better and goes home. Is THAT a good outcome?

See, to me, the goal isn't about the lesser of the evils (oh, I'll take the transient respiratory issues and rough early moments after birth rather than the potential for meconium, or stuck baby, in the case of electing for a C-section), it's about optimizing the outcomes so that NONE of those are high risk. Homebirth, or non-interventive birth, does that... I want my baby on my chest, I want her to get there gently, with no tugging on her head, I want her to nurse as soon as she's ready (not have to wait for hospital policies on bringing her back OUT to me, for example), and I want her to never leave my side.

THAT, to me, is a good outcome... and very little less will leave me completely satisfied, unless I know that the interventions we have are required medically.

And yes, I've seen all the above mentioned secenarios.