Saturday, August 23, 2008

Homebirth midwifery: missing the point

I have written about Homebirth: A Midwife Mutiny, Lisa Barrett's website, before (A homebirth midwife has a problem). Every time I think I cannot read anything more ridiculous from a homebirth midwife, I am proven wrong. Consider this gem in response to a news story about the tragic death of a premature baby born during an airplane flight:
I hope the baby was stillborn at 34 weeks and they didn't cut the cord creating the problem. If the baby was still born why would they try to cut the cord even if they felt it was the right thing for a live born? You'd think they would all be too upset to worry about that.

I hope that they post explaining what really happened. It goes to show the lack of knowledge surrounding the third stage in general and the ridiculous belief that after the baby is born you MUST get that cord cut. How we have forgotten about physiological birth in the rush to try and get rid of risk and control it.
Barrett appears to be suggesting that death from prematurity can be prevented by delayed cord clamping. This is absolutely mind boggling.

First of all, to the extent that there is any benefit to delayed cord clamping, it is in preventing anemia of prematurity. To my knowledge, there is no scientific evidence showing that delayed cord clamping is a treatment for hypoxia, let alone prolonged hypoxia.

Second, even if delayed cord clamping were to decrease hypoxia, the placenta stops functioning and is expelled in a matter of minutes.

Third, if delayed cord clamping is a treatment for prematurity, why did the overwhelming majority of premature babies die before the advent of modern medicine?

Talk about willful ignorance. If the baby did die from prematurity, it died because there was no equipment or personnel available to perform an expert resuscitation. In fact, the baby died in exactly the same way that a homebirth baby needing an expert resuscitation would die. This is the part that homebirth midwives cannot seem to absorb. Their techniques and fetishes (like delayed cord clamping) DON'T improve neonatal mortality. Homebirth INCREASES neonatal mortality; it doesn't lower it.

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