First. Yes, I was present. But I had never attended a birth before (in fact I specifically avoided watching any of the birth videos) and have no medical training beside some basic first-aid. I had done a fair amount of reading (as had my wife) but reading does not a doctor (or midwife) make.

Mostly what I did was see to my wifes comfort as much as possible. As it turned out, my wife was on the other side of the hot tub when our daughter crowned. Moments later the water went from clear to dirty green and there was our daughter doing the backstroke.

As to why my wife didn't want a doula or other female present, I can't answer that beyond a basic mistrust of strangers. I tried to get her to accept at least a doula (I would have been much happier with one present) but to no avail.

Finally, no I didn't know everything would turn out OK. But no one does with any birth, in any setting. Like everything else in life, it comes down to doing your research and then hoping for the best. We live 5 minutes from a major hospital and had worked out responses to different birth situations (most of which were to call 911). Standard medical guidance is to have no more then 30 minutes from 'decission to incission' when it comes to emergency c-sections. We were both comfortable that we could have met this criterion if it came to it.

One more thing, if anyone is interested in reading a very good analysis of medicalized birth, I would suggest "The Thinking Woman's Guide to a Better Birth" by Henci Goer.

As my wife went unassisted when she gave birth to our daughter, I thought I should chime in. Sidenote, our daughter was born without complications and is now a healthy, happy, 6 month old infant.

My wife gave birth in a large hot tub in our basement, with candles, incense and the music of her choice. The lights were dimmed or turned off and she was free to eat or drink whatever she wanted. She used hypnosis and breathing to help with the labor pain. Still, even with the best environment we could set up, she was (to say the least) in a fair amount of discomfort.

Was this the right choice? For her, it was. Not wanting submit to hospitals and the invasive (often ineffective) procedures they like to administer to laboring mothers was a no brainer. Fetal heart monitors, intervenous drips, episiotomies have all been shown to have a limited impact on healthy mothers with normal pregancies. Not to mention the scary rate of c-sections.

But why not a midwife? The problem is that many midwives have been drifting closer to becoming mini-doctors rather then true birth assistents. Like doctors, many midwives now substitute medical knowlege for personal warmth and caring. As a consequence, a woman who wants the freedom to make her own medical decissions has to look further a field then even a midwife. As for pre-natal care, a lot of providers won't even see a woman who isn't giving birth in a hospital.

Is there a perfect birthing solution? I doubt it. Ultimately it is up to the mother to be to decide what is best for her.