I think some of it is access to care too; some women in the US do this simply because of the cost of a midwife or doctor, it seems.

But also in Canada we have WAY higher standards for who can call themselves a midwife than they do in the US, and the midwives here have university degrees. Also, I think people here and other countries who have public health care seek help faster than Americans simply because cost isn’t a barrier, even if they do get sucked into this nonsense.