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& Homebirth midwives reveal death rate 450% higher than hospital birth, announce that it shows homebirth is safe
True to form, the Midwives Alliance of North America continues its deceptions about the risk of death at homebirth.
For the past 5 years, I have been relentlessly publicizing the fact that the Midwives Alliance of North America (MANA) has refused to release their own death rates. It doesn’t take a rocket scientist to realize that the death rates must be hideous, AND recognized as hideous by MANA executives.
After 5 years, and mounting pressure, MANA finally decided how to spin their hideous death rate: pretend that the hideous death rates aren’t hideous!
Isn’t that clever?
They are hoping that journalists will print their bogus conclusion, instead of the actual numbers.
The papers themselves are due to be released later today (at which point I will analyze them in depth), but the press releases include some of the numbers so we can take a look at them now.
According to :
The overall death rate from labor through six weeks was 2.06 per 1000 when higher risk women (i.e., those with breech babies or twins, those attempting VBAC, or those with preeclampsia or gestational diabetes) are included in the sample, and 1.61 per 1000 when only low risk women are included. This rate is consistent with some published reports of both hospital and home birth outcomes, but is slightly higher than others.
No, it isn’t “slightly” higher. It is MASSIVELY higher.
According to the , the neonatal death rate for low risk white women at term from the years
is 0.38/1000. As Judith Rooks, CNM MPH noted in her , intrapartum death among low risk babies is essentially non-existent in the hospital, so the neonatal + intrapartum death rate for the hospital is still 0.38
As the chart above demonstrates, the MANA death rate for the same years was 5.5X HIGHER. In other words, the MANA death rate was 450% higher than the hospital death rate.
On what planet is a death rate 450% higher than expected a safe outcome? Not on this planet.
MANA and homebirth midwives have been lobbying extensively for a scope of practice that includes breech, twins, VBAC, etc. Now they want to exclude those same births from their statistics. Even then, the MANA death rate is 4.2X higher than hospital birth. So even when homebirth midwives stick to low risk patients, homebirth has a death rate 320% higher than comparable risk hospital birth.
That’s hardly a safe outcome, either.
The results for various risk factors are even more appalling.
Of 222 babies presenting in breech position, 5 died either during labor or the neonatal period.
So the homebirth death rate for breech was 20/1000 compared to approximately 0.8/1000 in the hospital. That’s a breech death rate 25X higher (2400%) than the hospital.
To summarize, the MANA statistics show that homebirth as practiced in the US has a death rate 450% higher than hospital birth.
No wonder MANA has been hiding these numbers for years.
More on this study:
Author:Amy Tuteur, MD
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& No, you are not entitled to your own opinion about the safety of homebirth … or vaccines … or detoxes, etc. etc. etc.
Here at The Skeptical OB, we are treated to a steady stream of natural childbirth, homebirth and breastfeeding advocates parachuting in to “educate” everyone else. Sadly for them, they usually end by flouncing off after only a day or two. It’s almost as if they read Skeptico’s
and are putting its principles into practice [with my comments in brackets]:
Start by telling skeptics you want to “educate them on the facts”…
When the skeptic comes back with demands for “evidence” (they love that word) for your claims, you should say the skeptic is being “defensive”. Alternatively you could try a passive aggressive approach and say the skeptic is “attacking”…
Remember, your personal experience is always more valid than their scientific studies (or your lack of them). Anecdotes will convince more people you’re right than any number of “studies” …
Question the skeptic’s experience or qualifications… [i.e. point out that Dr. Amy is retired as if this is a big secret that isn’t featured in the sidebar of the blog] …
Question the motives of everyone [except for the people who agree with you] …
After the debate has been going for a while you should say you’ve provided studies to support your position, even though you haven’t. [Or, alternatively, insist that you “don’t have time” to provide citations for the “many” studies that support your position]
… [W]hen you’ve used up all the above tactics, say you’re not going to waste any more time with the skeptics you’ve been debating because they’re too sad, stupid, closed-minded, ______ (insert other flaw the skeptic has) to understand your brilliant arguments…
Finally, when all else fails, insist that you are entitled to your own opinion.
Except that you are not. As Philosophy Professor Patrick Stokes :
You are not entitled to your opinion. You are only entitled to what you can argue for.
The problem with “I’m entitled to my opinion” is that, all too often, it’s used to shelter beliefs that should have been abandoned. It becomes shorthand for “I can say or think whatever I like” – and by extension, continuing to argue is somehow disrespectful. And this attitude feeds, I suggest, into the false equivalence between experts and non-experts that is an increasingly pernicious feature of our public discourse.
What’s an opinion?
Plato distinguished between opinion or common belief (doxa) and certain knowledge, and that’s still a workable distinction today: unlike “1+1=2” or “there are no square circles,” an opinion has a degree of subjectivity and uncertainty to it. But “opinion” ranges from tastes or preferences, through views about questions that concern most people such as prudence or politics, to views grounded in technical expertise, such as legal or scientific opinions.
You can’t really argue about the first kind of opinion. I’d be silly to insist that you’re wrong to think strawberry ice cream is better than chocolate. The problem is that sometimes we implicitly seem to take opinions of the second and even the third sort to be unarguable in the way questions of taste are. Perhaps that’s one reason (no doubt there are others) why enthusiastic amateurs think they’re entitled to disagree with climate scientists and immunologists and have their views “respected.”
Here’s the money quote:
If “Everyone’s entitled to their opinion” just means no-one has the right to stop people thinking and saying whatever they want, then the statement is true, but fairly trivial. No one can stop you saying that vaccines cause autism, no matter how many times that claim has been disproven.
But if ‘entitled to an opinion’ means ‘entitled to have your views treated as serious candidates for the truth’ then it’s pretty clearly false. And this too is a distinction that tends to get blurred.
What does that mean for those who parachute in to “educate” us about homebirth, or any other aspect of pseudoscience?
It means that while you are entitled to have whatever beliefs you wish about these subjects, but you aren’t entitled to have your beliefs taken as serious candidates for discussion unless you can defend them logically and with citations to appropriate scientific papers (papers that you have actually read and understood).
Otherwise, you might as well skip directly to Skeptico’s last principle:
Announce that you’re not going to waste any more time with the commentors on The Skeptical OB because they’re too sad, stupid, closed-minded, ______ (insert other flaw the skeptic has) to understand your brilliant arguments
Be sure to stick the flounce and don’t be tempted to come back within the hour to keep making the same absurd “arguments” again.
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Author:Amy Tuteur, MD
Subscribe to our e-mail newsletter to receive updates.
Related Posts:
Visual Archives
Visual Archives allows you to browse every post in the blog in a unique way.
Thinking about homebirth? Watch this video!
For Fathers
If homebirth is safe …
Homebirth Bingo
Twelve things you shouldn’t say to Dr. Amy …
Dr. Amy in the News
2013 in review
Recent Comments
Dr. Amy Interviews
Feminist Current podcast,
Teen Skepchick interviews .
The Podcast Beyond Belief hour-long interview of Dr. Amy. Download it
, or directly from the podcast section of iTunes (episode 22).
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