There is little incentive for obstetricians to back up home-birth midwives, because of the potential for malpractice suits

“Some midwives choose to forgo malpractice insurance, saying that their close relationship with clients makes it less likely that they will be sued.”

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Anonymous
The malpractice issue was not the thrust of the article, of course, but since you brought it up…..Would you want to back up a home midwife?
Especially when that home midwife has no malpractice insurance of her own?
By definition, you have a high-risk obstetrics case. Sounds like a malpractice suit waiting to happen.
Of course the midwife has relatively low malpractice rates. The “close relationship” surely helps, but far greater……if the case is high-risk, what does she do? Dump to someone else. By definition, all she is insuring against is low-risk obstetrics.
Anonymous
I agree with the comment above.
Why would a doctor want to backup a midwife? By definition, the doc wont be involved until something serious goes wrong. As a doc I would hate to be in that position where I have to rush in at the last minute to avert disaster. I am taking all the risk and its not worth it.
As a doc, if I have the potential of dealing with emergencies, I want to be involved wtih the pregnant mother from the very beginning, not rushing in at the last minute with no real clue whats going on.
Anonymous
Depends on the midwife, of course, but so many of them have this “anti-doctor, anti-hospital” mentality that is synergistic with the pregnant woman with the same attitude.
So when something goes wrong and they end up in the hospital, they are there but at the same time refuse interventions that by this point even the midwife agrees needs to be done.
The patient has the feeling we’re “intruding”. The chance something will go wrong, by definition, is now high. Sounds like a setup for a lawsuit.

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