Tuesday, July 03, 2007

Homebirth advocacy: it's always about misinformation

Recently I offered a challenge to find any homebirth advocacy website that did not rely on mistruths, half truths and deceptions. No one has yet been able to find a single one. That's not surprising since homebirth advocacy appears to be based on mistruths, half truths and deceptions. A recent article on Birthworks, a South African homebirth advocacy website is yet another example of how misinformation and deception are integral to homebirth advocacy. The article, Homebirth - A few words about safety, written by a lay midwife contains the classic erroneous assertions.

In only 8 paragraphs, the author makes quite a few erroneous comments, as well as comments that indicate a general lack of understanding about birth and about statistics. For example:

"Furthermore, we strongly feel that safety is not the issue (if it were there would be no argument: statistics repeatedly demonstrate that homebirth is safer than hospital)"

WRONG. There is no study that demonstrates homebirth to be as safe as hospital birth.

"Furthermore, we strongly feel that safety is not the issue( if it were there would be no argument: statistics repeatedly demonstrate that homebirth is safer than hospital"

WRONG. All the existing studies to date show that hospital birth has a LOWER rate of preventable neonatal mortality.

"the United States ranks 23rd - 24th internationally among industrialised nations in infant mortality."

A sure sign of lack of education and understanding. Infant mortality is neonatal deaths plus infant deaths from 1 month to 1 year. Therefore, it is the wrong statistic to assess obstetric care.

"Suppose physicians everywhere suddenly decided to focus on eliminating choking deaths resulting from the ingestion of food. The medical focus would become: avoid death by choking. To that end, public eating areas would be set up so that people could be observed by health professionals while dining. Standards of ‘’normal’’ eating would be established; perhaps times of the day, blood sugar levels, and chewing patterns would all be calculated in relation to the number of people who choked. Some who had choked before or who were especially at risk (the very young or very old) would be hospitalised during meals to be more carefully monitored..."

INANE. Let's look at the risks for children. There are approximately 160 choking deaths each year for a rate of 0.004/1000. Compare that to an excess rate of preventable neonatal mortality at homebirth of 1-2/1000 and we find that the risk of a death due to homebirth is 500 times higher than the risk of death from choking. Moreover, as small as that choking risk is, we don't ignore it; we try to lower it. We stress watchful behavior for parents; we teach the Heimlich maneuver; we have laws to prevent toys from becoming choking hazards. If we think it is worth protecting children against the possibility of choking, then it is certainly worth preventing them from dying at homebirth, which poses a much higher risk.

"Statistically, birth at home with skilled midwives provides the very safest care possible for most women."


So in 8 short paragraphs the author rests her support for homebirth on:

ignorance of the existing scientific research
ignorance statistics; infant mortality is not the relevant statistic
a faulty and inappropriate analogy.

As usual, ignorance of basic knowledge about birth, science and statistics is integral to homebirth advocacy.

0 Old Comments: