Wednesday, October 29, 2008

No, Arwyn, homebirth is not statistically the safest

The folks at MDC appear to be concerned. Someone has posted a respectful, non-inflammatory post about the many homebirth deaths among her friends. The moderator, Arwyn ("Birth Goddess") has interrupted to state the position of MDC. I'm not sure whether MDC is primarily concerned with blunting the impact of the original post, or responding to the role that MDC has in promoting practices that apparently lead to neonatal death fairly routinely.
Birth is safe, but it is not, and never can be, risk free. Every woman should birth wherever they feel safest, but we (Mothering magazine and MDC) support and promote natural birth as the default option because, statistically, it is safest. It is the "best" option overall. It is not best for every motherbaby, for every birth, for every situation, but the truth is that our maternal and neonatal mortality and morbidity rates would be lower if the majority of births were intervention-free rather than highly medicalized. Thank G-d/dess we live in a time and place where we have access to medical technology, to medications, to surgical birth, because sometimes they are needed. But they are, on the whole, overused.
Here's a newflash, Mothering magazine and MDC, homebirth is not , statistically, the safest. In fact, homebirth with a direct entry midwife is the most dangerous form of planned homebirth in the US. Let me refresh your memory in case you have not seen the data from the most recent US dataset (Linked Birth Infant Deaths 2003-2004).

As this chart shows, the neonatal mortality rate for DEM assisted homebirth is almost double the neonatal mortality rate for hospital birth with an MD. This is all the more remarkable when you consider that the hospital group contains women of all risk levels, with all possible pregnancy complications, and all pre-existing medical conditions. An even better comparison would be with the neonatal mortality rates for CNM assisted hospital birth. The risk profile of CNM hospital patients is slightly higher than that of DEM patients, but CNMs do not care for high risk patients. Compared to CNM assisted hospital birth, DEM assisted homebirth has TRIPLE the neonatal mortality rate.

Neonatal mortality would not be lower if births were "intervention-free," it would be much higher. If 10% of American babies were delivered by homebirth, homebirth deaths would vault to the 3rd or 4th leading cause of neonatal death!

Arwyn, if you want confirmation of the national data, just check your own website. There have been at least 13 preventable neonatal deaths and 2 cases of severe anoxic brain damage among MDC members in the past 10 months! Homebirth increases the risk of neonatal death. How much data, and much tragedy aided and abetted by your own site, do you people at Mothering and MDC need to see before they acknowledge the truth?


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