The home setting not only provides a special environment for birth and the practice of midwifery, but also has an impact on the processes used in clinical decision making. This article focuses on collaboration between the midwife and the birthing woman and also discusses the collaborative relationship between midwives and obstetric consultants. A home birth case study illustrates the interactions among the midwife, the woman, and the medical system. These critical relationships provide structure for safe, effective clinical practice in planned home birth when practice boundaries are not defined by institutional walls.

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