I worked for many years in a freestanding birthing center with a doc and a CNM.
I fully support a woman's right to birth in the environment she feels is best for her and her baby. Unassisted childbirth is not something I would choose for myself; neither is an epidural or a scheduled C-section. But I support another's right to choose these options.
I think it is a scary thought, to force medical care upon someone that doesn't want it.
As for holding them responsible if something would happen--I find that thought horrible. How can you determine that something would not have happened anyhow? How can you determine that the outcome would not have been the same, or worse, if the woman had been in the hospital?
What next? Mandating that every hospital have a level III NICU? Should a small hospital be held liable if a baby is born there that needs immediate, NICU level care and they are unable to provide it, and the baby dies as a consequence of this inability to provide care? Or maybe the mother should be held responsible, because she chose not to birth in a hospital with a NICU. Because isn't that what you are saying, when you say that a woman should be held responsible for her choice of birth environment?
So, by that logic, all out of hospital (out of tertiary care center hospital?) birth should be illegal, because it is not medically the safest?
I think it would be difficult enough to have a dead baby or dead mother, without some sort of legislation that would fine or imprison the mother and/or the father. What would the other children in the family do? Be placed in foster care? Would you only punish the parents if something went wrong, or in all situations of unassisted childbirth? What a horrible, cruel thing. All because a hospital with a NICU is safer? But safer isn't always the best choice for someone, and ideas of "safer" are different, depending upon one's previous experience and beliefs.
Every patient has the right to refuse medical care. Every patient. I think it is deeply disrespectful to think that we should legislate that women must birth a certain way, and those who do not should be held legally responsible.
Breastfeeding is much healthier (and therefore safer) for babies, too. Think of the babies that would be saved, think of the improved health and the lowered cost of care if we legislated that every mother must breastfeed, and that every mother who doesn't must be fined. Nope, that doesn't work, either.
What about smoking? Should we fine women who smoke, and harm their babies because of it? I dont' think so, either.
Do you see where I'm going with this? Does it make sense? While I understand the desire to have women birth in a safe environment--I think we ALL share that desire--I have a different definition of "safe" than you; I think all of us have slight variations on it. We can't force ourselves onto someone. We can't imprison women for planning to birth without an attendant, or for not birthing in an ideal medical environment. We still must respect the autonomy and dignity of the individual, and while you can disagree with their decisions, you can't force them to accept medical care they don't want.
As of yet, at least in my state, the fetus does not have any rights. Even if it did, I think we would have to balance that with parental rights. I feel pretty strongly that *I* know what is best for my child; not the legislature. I would react fairly negatively to anyone telling me that I could not birth in a certain manner or environment; that I couldn't raise my children to be a certain religion; that I had to feed them certain food, or educate them in a certain fashion.
I think that the evidence is that out of hospital birth is not overwhelmingly more likely to end in death or morbidity; some studies show there is an increase, but I think most feel those studies are flawed (the last one I read, I think it came out last year, combined attended and unattended planned out of hospital births with accidental out of hospital births, for example). If there is not overwhelming evidence that an action is going to almost certainly cause great harm (as with the JW, refusing a transfusion for a child who will certainly die without it), I don't see how a parent can be legally prevented from doing something like birthing alone.