I had an unplanned unassisted home birth with my last child. We had planned a home birth, but she came so quickly the midwives did not get there in time. The paramedics were there very quickly - just as shoulders were being born. Then about 10 midwives descended (or that's how it seemed!).

I had a fairly serious postpartum bleed (1.5 litres), in part probably because of the speed of delivery. The midwives had syntometrine to make the uterus clamp and stop the bleeding and we had lots of time to transfer to the hospital where they could make an assessment of whether I needed a transfusion.

The bleeding was managed at home in exactly the same way it would have been in the hospital. The only difference is that they have blood products in hospital, but that takes time to administer even in the hospital because they don't have blood in your delivery room ordinarily.

As for shoulder dystocia, my research when I was planning for a homebirth convinced me that a shoulder dystocia is handled in the hospital in exactly the same brutal way the midwives are trained to deal with it at home, legs in the air and the attendant breaks the baby's collarbone.

You know, with birth we always tell these horror stories and then aggregate them to "prove" birth is dangerous. Life is full of freak accidents and horror stories, yet we take these calculated risks all the time. Why not in birth?