Anecdotal “Perils of Home Births”

Alison Cole

2009 has seen the release of two studies, one from the Netherlands and one from Canada, which support the safety of birthing at home with trained midwives who are integrated into the health-care delivery system.

Emailed to TODAY@nbcuni.com:

To Whom It May Concern:

In a segment aired on the Today Show 9/11/09, your station purported to delve into "The Perils of Home Births."  A large portion of the segment
was devoted to interviews with a grieving family who had lost their
baby.  My heart aches for this family, but their experience does not
shed light on the safety of birthing at home, just as the story of one
family mourning the loss of a hospital-born baby is not evidence that
all births should be removed from the hospital.

Biomedicine
purports to be evidence-based, eschewing emotion-based "anecdotal
evidence" for the stark light of fact.  However, no scientific evidence
was presented in your segment to support the contention that planned
home birth with a Certified Professional Midwife is more dangerous for
mom or baby that going to a hospital.  As the segment itself points
out, more babies die in hospitals (per 1000 babies born there) than at
home.  I am surprised, however, that the growing body of evidence which
supports the safety of out-of-hospital birth was ignored.  2009 has
seen the release of two studies, one from the Netherlands and one from Canada,
which support the safety of birthing at home with trained midwives who
are integrated into the health-care delivery system.  While the impact
of birth experience on an individual family is too important to allow
for random assignment of families to home or hospital birth  (as
advocates of evdience-based care prefer), the Canadian study especially
controls for variables remarkably well by comparing women in similar
states of health who were cared for by the same practice.  One
important of scientific conclusions is that they must be replicable,
and the studies mentioned above replicate the results of a 2005 study of out-of-hospital births with Certified Professional Midwives in North America.  The best available evidence
shows that out-of-hospial birth is nor more dangers for mother or
baby.  However, out-of-hospital birth has been shown to reduce rates of
expensive medical insterventions including surgical birth. 

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Finally,
it is important to remember that, far from being an advocate for
evidence-based practices, the American College of Obstetricians and
Gynocologists (ACOG) is an organization designed to advocate for the
interestes of OB/GYNs.  Rather than responding to the scientific
literature cited above, ACOG has recently been soliciting anecdotal evidence
on bad outcomes of out-of-hospital birth.  When the professional
organization of hospital birth providers tells us that the only safe
place for birth is in the hospital, we must approach this with the same
healthy skepticism with which we would approach claims from
oil-industry executives on the dangers of wind energy. 

I
encourage the Today Show to further the health of childbearing women by
featuring a segment on evidence-based maternity care rather than
resorting to sensationalized scare-tactics which obscure the facts of
this issue. 

Sincerley,

Alison Duren-Sutherland
Homebirth Mom

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