Wednesday, January 23, 2008

The toll of homebirth deaths mounts

The appalling rate of homebirth death on MDC continues. There have been at least 8 neonatal deaths in the last 2 years. Since there appear to be less than 300 homebirths reported on MDC each year, that means the neonatal death rate is at least 12 per thousand, TEN TIMES HIGHER than in hospital neonatal death rates for low risk women. That does not even include late stillbirths, of which there have been several. In a small group like the MDC homebirth group, you would expect approximately one neonatal death every 2 years. Instead, there is one neonatal death every other month.

The most recent death is a late stillbirth. The mother experienced decreased fetal movment over several days and the midwife did nothing more than listen once to the baby's heartbeat (which she found only with difficulty). When the midwife next listened, several days later, in the midst of active labor, the baby was dead. As in so many of the neonatal deaths and stillbirths on MDC, there was evidence that a problem might be developing, but that evidence was dismissed because "birth is natural" and the baby "knows when to be born".

It's difficult to know whether the women on MDC who choose homebirth are representative of the majority of women who choose homebirth or are a particularly reckless group. Nonetheless, MDC should be required reading for those who think that homebirth is as safe as hospital birth. Over and over and over again otherwise healthy babies die of easily preventable causes. Based on what I have read there over the last 2 years, I suspect that in the real world (as opposed to studies carefully crafted by homebirth advocates to promote homebirth) homebirth has a perinatal death rate 10-20 times higher than hospital birth for low risk women.

This is why it is absolutely imperative for MANA (the Midwives Alliance of North America) to release their safety statistics. No matter what they show, it is unethical to withhold them. However, it would be absolutely unconscionable to withhold them specifically because they show definitively that homebirth has a neonatal death rate dramatically higher than hospital birth.

Ultimately the campaign to legalize direct entry midwives is about MONEY, pure and simple. Legalization is recognized as absolutely essential to gaining access to insurance reimbursement, and that is the goal. Homebirth is not illegal and attending a homebirth is not illegal. However, holding yourself out as a medical professional and receiving money in exchange is illegal in many states. This is not about choice, this is not about women's rights, this is only about money.

MANA continues to state that homebirth with a direct entry midwife is as safe as hospital birth. Withholding their own safety data suggests that they may know this to be a false claim. In other words, they may be letting women unknowingly risk their babies' lives just so that midwives can make more money.


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