Marsden Wagner , MD, MSPH Pediatrician, neonatologist and perinatal epidemiologist Director of Women's and Children's Welfare for the World Health Organization for 15 years. The reason the maternal mortality fell in the US this century was because of the advent of antibiotics and blood transfusion more than anything else. There is simply no scientific evidence to prove the falling mortality was because birth was moved into the hospital.
Maternal mortality is quite different from perinatal mortality and infant mortality.
The latter two are much influenced by socioeconomic factors while maternal mortality is much more directly a function of the quality of the health care available. But at the site of the place where the woman is transported, there is need for a doctor who has surgical skills and, ideally, obstetrical skills, to manage the complications. There are at least two reasons why the US is 16th in the world in maternal mortality and both reasons have to do with access to quality care. First, the large numbers of women without health insurance in the US have to jump through so many hoops to get care that there is likely to be delays in receiving the care and this can be a disaster. The delays and crowding and lack of skill of doctors all can lead to maternal mortality.