Abstract: The article focuses on the controversy surrounding place of birth for women considering having a vaginal birth after caesarean section (VBAC) out of hospital. It presents a summary of the research and arguments supporting choice of birthplace between midwifery-led and obstetric units. The impact of these opposing environments on birth experience and outcomes is reviewed. A combined VBAC rate in birth centres is between 73.5% and 91% (Harrington et al, 1997; Lieberman et al, 2004; David et al, 2009). There appears to be no difference in adverse neonatal or maternal outcomes and Apgar scores at 5 and 10 minutes in comparison to a control group. Factors affecting the risk of uterine rupture and contraindications for an out-of-hospital birth are reviewed. Professional and ethical issues highlighted are the duty of the midwife to support women making controversial birth choices and a restriction of women's and midwives' autonomy in the context of the medicalised management of birth.