Saturday, July 12, 2008

An open letter to Geradine Simkins, President of the Midwives Alliance of North America

Geradine Simkins, President
Midwives Alliance of North America
611 Pennsylvania Avenue SE # 1700
Washington, DC

Dear Ms. Simkins:

Your public claim that "doctors ignore evidence" on homebirth safety is shocking (President’s Editorial, July 11, 2008). As you know, your organization, the Midwives Alliance of North America, is currently HIDING your OWN safety statistics on homebirth. YOUR OWN evidence almost certainly shows that homebirth with a midwife increases the risk of neonatal death compared to hospital birth for low risk women.

MANA collaborated with Johnson and Daviss on the CPM 2000 project published as a paper in the British Medical Journal in 2005; Ken Johnson is the former Director of Research for MANA and the study was funded by money from a homebirth advocacy foundation. That paper ACTUALLY showed that homebirth in 2000 had almost TRIPLE the neonatal death rate of low risk hospital birth in 2000. Using the same data collection techniques, MANA has continued to collect safety data from 2001 up to the present.

The data has been processed and analyzed and MANA has publicly offered the data to midwifery organizations who can demonstrate that they will use it for the "advancement of midwifery". The data is evidently so sensitive that MANA has protected it with a legal non-disclosure agreement. According to the Summer 2006 bulletin ( of your sister organization NARM (North American Registry of Midwives):
How can you get access to the MANA data on homebirth from the years 2001-2006?

The association then needs to contact the Director of Research on association letterhead, with the following:

a. A statement that the decision has been made by the group
b. A list of participating members
c. The name of a contact person who has been chosen to manage the account
d. The name of the association official authorized to sign the contract for the account

4) The DOR will then send a contract which contains two parts:
a. The agreement between the association and the Midwives Alliance for the account
b. A Non-disclosure Agreement which prohibits inappropriate use of the data...
Ms. Simkins, MANA has an ethical obligation to release the safety data it has collected. American women are entitled to a complete, public presentation of MANA's safety data. There should be no requirement for vetting and there should be no requirement for a legal non-disclosure agreement.

Contrary to your claim, and as the AMA is certainly aware, virtually all the existing evidence shows that homebirth increases the risk of neonatal death. Your own safety statistics almost certainly confirm this is detail. Hiding the data is unethical. Please release the MANA safety statistics to the public immediately.

Amy B. Tuteur, MD

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