I thought about the situation. My grandmother was born at home at a time when there was no access to emergency care or hospitals. Sometimes a doctor could make it to the home in time to help "deliver" the baby, but the majority of the time a laboring mother was supported by whichever woman was closest to her and could be there to help. Many times this was her own mother, sister, neighbor, or even daughter. In true emergency situations there was nowhere to go for help, and even the local doctor had huge limitations in what he could do. Birth was a wonderful but potentially dangerous situation, but when there were hard outcomes it was accepted as a part of life.
By the time my grandmother was having babies birth had been moved from home to the hospital. Birth had become even more dangerous due to doctors unwittingly spreading deadly infections because they simply didn't know to wash their hands when going from treating very sick patients and performing surgeries to catching healthy newborn babies. Fear about the pain and dangers of childbirth became even more rampant as doctors and hospitals struggled to find ways of handling childbirth in a new setting. Women were seeking a way to escape the horror of it all, and their doctors were feverishly looking for ways to save the day.
Doctors learned to wash their hands and take safety precautions, and new medications were presented in an effort to "help" women with the process of childbirth. This involved such things as "Twilight Sleep" in which laboring women were medicated during labor, able to feel everything but having no memory of the experience later because of the drugs. Women were tied to their hospital beds and gagged to keep them from wandering the labor ward, thrashing, or screaming out. In other cases women were simply put under with ether or chloroform into a drug-induced sleep during labor, while doctors forcefully extracted their babies using forceps. The mother didn't remember the birth, and would wake alone because her baby had been taken to the nursery while she was still asleep. One can understand why loving partners were not allowed on the labor and delivery ward during this time.
In the years since, there have been huge strides made to improve hospital births. Expectant fathers are now encouraged to be present and supportive while the mother is laboring, and hospital rooms have been made to appear more like a home setting. Other changes include major medical interventions to control and manage the process of birth, such as medications to start labor or make it go faster, and pain medications which numb a woman to the physical experience of childbirth without knocking her out completely or preventing her from remembering the experience. Interventions that can save lives in true emergencies have been developed, but are now being overused to the point that the potential risks outweigh the benefits. It seems that in an effort to improve childbirth it has been taken to the medical extreme in which every step is managed and medicated, and 1 out of 3 newborns in the US is removed surgically.
Those who recognize the extreme medicalization of birth are left wanting for something better. They are returning to "old" ways of birthing without unnecessary interventions, the way my grandmother came into the world. Bringing birth back to the home is a conscious effort to allow women the experience of normal childbirth, as nature is so beautifully designed.
In pursuing a return to old ways women are not simply accepting greater risk than they would face in a hospital setting. Indeed, many feel they are reducing their risks by avoiding the interventions common in the hospital.
So, how is home birth better than it was 100 years ago? Because of the technological and medical advances over the years, we now have access to life-saving interventions which are needed in true birth emergencies. Those interventions which pose greater risk when overused are still valuable and needed in some cases. No woman plans a home birth intending to transfer, but she understands that it is a possibility. For me personally, this was a comfort when I planned my home birth. I knew I would be in a comfortable setting where I could labor and birth my baby in peace, and felt confident in my ability to do so. I felt that all would go smoothly, but I also knew that if for some reason it didn't I had options that my great-grandmother never did.