Several of my ObGyn friends posted this but I wanted some midwifery/doula perspectives on this. From what I learned this seems like a terrible end to a home birth indeed, but one that looks like medical incompetency on the part of the midwife/wives as opposed to a home-birth issue (e.g., ambulance was not called soon enough, all shoulder freeing techniques were not used, etc.). My understanding is that shoulder dystocia is NOT known before the baby is already in the birth canal and head is out, in which case pre-emptive Caesarian surgery would circumvent this unless done on all births. Any thoughts out there by other professionals well versed in home birth practices? Michelle Stroud, Robyn Berman, Katina Garduno-Roberts?