States continually swing like a pendulum, changing their momentum from home birth, to institutionalized births. Prior to the twentieth century, most births occurred in the home setting and were viewed as a normal process. Today, home births only account for 1 % of the births in North America (Wong & Perry, 1998). With the increased dependency on medical professionals in this century, childbirth has become a medical process rather than a natural event. As healthcare consumers strive for greater control of their care, many women are choosing to give birth at home or in birthing centers, in environments in which they have control. The greatest concern that women face is the safety of their choice for both themselves and their unborn child. The purpose of this study was to compare maternal and perinatal outcomes of selected birthing methods. The methodology utilized was a literature review and synthesis, which includes publications from nursing, medical and related fields from 1990-2002. Birthing methods are defined, compared and contrasted based on outcome measures, and the safety and efficacy of each examined. This information will be used as a basis for recommendations for current practice, nursing education, and further research.