Tuesday, June 24, 2008

For their next trick, Johnson and Daviss will ...

They must be really desperate, and it's easy to see why. Their own research shows homebirth increases the risk of neonatal death. The latest US statistics shows homebirth increases the risk of neonatal death. The MANA statistics show homebirth increases the risk of neonatal death.

In response, Johnson and Daviss are planning to resurrect the incredibly out of date, unpublished SOCIOLOGY dissertation of Peter Schlenzka. I'm not kidding. On Oct. 27, 2008, at an American Public Health Association conference (where else?), they plan to present Safety of planned out-of-hospital birth similar to low-risk hospital birth in California: A large retrospective cohort study.

Before we address the fact that the study doesn't even show what they claim (of course!), let's look at a few fundamental facts.

1. The study is unpublished. It has never been subjected to peer review. Presumably it has been submitted to many journals and rejected.

2. The study is totally outdated. It refers to California data from almost 20 years ago.

3. It is a SOCIOLOGY dissertation. It has not been read or evaluated by anyone with expertise in obstetrics or public health. We don't even know what the sociology department examiners thought of it.

4. Peter Schlenzka has never published any research of any kind.

5. Peter Schlenzka appears to be unemployed. He describes himself as a private consultant, but I cannot find any evidence of that.

6. As he usually does, Johnson fails to mention his close ties to MANA (Midwives Alliance of North America) including the fact that he is the former of Director of Research of MANA.

Johnson and Daviss must be really desperate to even think of presenting this as if it were scientific information.

Now let's look at the dissertation itself. You can download it here. I read the whole thing. It perfectly epitomizes that old saying: "If you can't dazzle them with brilliance, baffle them with BS." It is an absolute horror, using every trick in the book to confuse and obfuscate. The bottom line is that it does NOT show homebirth to be as safe as hospital birth. Despite lots of pious declarations about comparing like with like, Schlenzka NEVER compares homebirth in 1989-1990 with low risk hospital birth in the same years.

I did, though; you knew I would. I took Schlenzka's raw data and calculated mortality rates. Taking the most charitable view, the data shows that homebirth increases the risk of perinatal death from 1.5/1000 to 2.2/1000. In reality, the gap is probably much wider. I can't get a better estimate because, although Schlenzka acknowledges that 48.5% of the hospital group is African American compared to only 1.4% of the homebirth group, he does not tell us how many deaths come from the African American group.

Peter Schlenzka could not get his claims published by any peer reviewed scientific journal. His data has never even been reviewed by anyone with expertise in obstetrics or public health. Johnson and Daviss don't really care about that, since they know no scientist would take them seriously. This is part of a public relations effort to dress up an outdated, unpublished sociology dissertation in the mantle of respsectability for the gullible homebirth advocates. They plan to change the designation of this paper ("unpublished dissertation") to something that sounds impressive to those who don't know better ("presented at the APHA").

This is part of an ongoing campaign by professional homebirth advocates to keep the truth from American women. All the existing scientific evidence shows that homebirth increases the risk of neonatal death. The MANA safety data is so damaging to the cause that it must be hidden. The only thing left to do is to try to rehabilitate an out of date piece of junk and pass it off as legitimate to those who can be tricked.


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