Saturday, June 21, 2008


I suspect that the ultimate irony of the campaign to promote homebirth and license direct entry midwives will be to bring about the demise of direct entry midwifery.

Direct entry midwives and their supporters have successfully tried to confuse American women on two critical points:

1. Homebirth is KNOWN to increase the neonatal death rate
2. American DEMs are grossly undereducated and undertrained compared to ANY other midwives in the industrialized world.

The effort to license DEMs has already let to the national government's collecting statistics on homebirth with a DEM. The first large data set already shows that homebirth with a DEM triples the rate of neonatal death compared to low risk hospital birth. This is consistent with all the existing scientific evidence on homebirth. Homebirth advocates will no longer be able to pretend to themselves or others that homebirth is safe.

MANA, the trade union for DEMs, has been successful up until now at confusing people about the education and training of DEMs. They created their own certification ("CPM") which is so close to CNM (certified nurse midwife) as to create confusion. Homebirth advocates routinely cite the practice of midwifery in European countries like the Netherlands, without bothering to explain the American DEMs are nothing like Dutch midwives and would never be considered qualified in the Netherlands. Dutch midwives, like ALL other midwives in the industrialized world are hospital trained with extensive experience in managing complications. In contrast American DEMs never have any hospital training and receive degrees from correspondence courses.

Homebirth advocates are shrilly and falsely decrying the AMA's attempt to "outlaw" homebirth when the AMA is simply asking for acknowledgement of the facts. Homebirth is not as safe as hospital birth and American DEMs do not meet the standards for midwives anywhere else in the industrialized world.

MANA, the DEM trade organization, may continue to withhold the 7 years of safety statistics it has collected, but soon it won't matter. The government is now involved and the truth can no longer be suppressed.


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