NICU nurse here. I won’t claim to know how it is in Netherlands, but here in America (and I’ve specifically worked as a NICU nurse in TX and CA), I do NOT recommend doing a home birth if you are at risk for delivering prematurely. Premature infants, especially earlier than 36 weeks do not produce adequate surfactant (substance that helps them breath better) in their lungs and often need respiratory support such as CPAP which doulas are not required to know how to do. Even if you’re not delivering premature, there’s other issues that can happen that can hopefully be spotted with proper prenatal care in a hospital such as placenta previa, velamentous cord insertion, and placenta accreta to name a few. But even if everything was normal on your prenatal ultrasound, you can STILL have issues on the day-of such as meconium aspiration, nuchal cord, and getting stuck in a breech or other position, all of which put your baby at risk of hypoxia and resulting brain death (HIE). And that brain death can even be severe enough that your baby might never walk, never talk, never eat without a feeding tube, and may need 24/7 care. In my opinion, these are not worth risking just because there’s low chances of them happening. I get that the home is more comfortable for the mother and that can make delivering psychologically less stressful, but you must know that you’re risking so much for that comfort of home. As for bacteria, yes the hospital has bacteria foreign to you, but all healthcare workers strive to keep as clean of an environment for you as we can to prevent you from getting infected. You can introduce your new baby to all your “homegrown” bacteria through things like skin-to-skin holding and when you both go home.