Monday, January 15, 2007

Why is MANA hiding its data?

Johnson and Daviss should be commended for instituting a system to record the number and outcomes of homebirths. The study that they published included data from the year 2000 only, but MANA (Midwives Alliance of North America) has continued the collections of statistics. This could be a valuable resource for women wondering about the safety of homebirth. There's a problem, though. No one is allowed to see those statistics. Well, that's not quite right. You can have access to the statistics only if you "use the data for the advancement of midwifery".

The following information comes direction from the NARM (North American Registry of Midwives) Summer 2006 Bulletin.

What information is available?
... aggregate statistics describing births contained in the Midwives Alliance (MANA) database ... These items include number of births, numbers of transfers, cesarean sections, etc.
This information would undoubtedly be of value to women considering homebirth, yet they cannot get access to it.

MANA is very protective of the information in its database and has created elaborate procedures to limit who can and who cannot see it. In fact, the only way you can see the data is if you are a midwifery organization whose members have contributed personal statistics to the database. Even then, the procedure is complicated.

How can you get access to the MANA data on homebirth from the years 2001-2006?
The association then needs to contact the Director of Research on association letterhead, with the following:
a. A statement that the decision has been made by the group
b. A list of participating members
c. The name of a contact person who has been chosen to manage the account
d. The name of the association official authorized to sign the contract for the account
4) The DOR will then send a contract which contains two parts:
a. The agreement between the association and the Midwives Alliance for the account
b. A Non-disclosure Agreement which prohibits inappropriate use of the data...

The data made available from the Midwives Alliance Statistics Project can be very useful for lobbying or regulatory purposes. It puts the control of the data in the hands of the midwives. Having state level data can be useful when trying to get a bill passed, but it can also be useful to show that midwives are involved in self-assessment and accountability. In other words, it shows your numbers but also that you are on top of things and will be in the future. It is much stronger than just a flash of numbers at bill-passing time, and might boost your chances of avoiding your regulatory board feeling the need to monitor you in some other way ...
What does MANA have to hide? Why can't women see the homebirth statistics for the years 2001-2006? Don't women contemplating homebirth deserve to have the same information that the midwives have?

I cannot help but wonder why the only people allowed to see the data must sign a non-disclosure agreement. It suggests to me that the data show that homebirth is not safe. Why else would MANA need to take elaborate precautions to hide it and to be sure that it does not find its way to people who are not committed to "the advancement of midwifery"?

Labels: ,

0 Old Comments: