Friday, April 11, 2008

Why can't homebirth advocates tell the truth?

I just came across the latest whopper from Betty-Ann Daviss, of Johnson and Daviss (authors of the BMJ study that claims to show that homebirth is as safe as hospital birth, but actually shows homebirth to have a mortality rate triple that of hospital birth). Do homebirth advocates ever tell the truth about anything?

A post published today on the website of the Midwives' Alliance of Pennsylvania provides an update of the case of Diane Goslin, a direct entry midwife who has appealed her to the Pennsylvania Supreme Court over the cease and desist order issued by the Pennsylvania Board of Medicine.

According to the article:
"The judges had some very important questions," said Betty-Anne Daviss, co-author of the largest study ever conducted to assess the safety of homebirth. "Namely, they wanted to know if a woman has a Constitutional right to birth her baby at home with whom she wants." Daviss pointed out that governments in both Canada and Great Britain are working to expand public access to midwives like Diane and, by so doing, are seeing a decrease in maternal and infant mortality rates in those countries.
There's just one serious problem. That claim is flat out false. That didn't stop Daviss from making it. In the most recent year for which there are complete statistics, 2005, the perinatal mortality rates for both Canada and Great Britain ROSE compared to the previous year. The infant mortality rate rose in Canada and remained constant in Great Britain.

So there is no basis for claiming that expanding public access leads to lower perinatal mortality since neither country experienced lower perinatal mortality. Moreover, any one who has taken Statistics 101 knows that correlation does not equal causation. Even if the perinatal mortality rate had dropped, there would be no reason to ascibe it to increasing rates of homebirth. Finally, because the proportion of homebirths in both countries is tiny, even massive increases or decreases in homebirth deaths would have no impact on the national perinatal mortality rates.

Why do homebirth advocates have such a problem telling the truth? The perinatal mortality rates of these countries are rising not falling, and the perinatal mortality rates of these countries tell us absolutely nothing about the safety or dangers of homebirth. Statements like these serve only to misinform laypeople and perhaps that is the intention.

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