Monday, December 15, 2008

New Wisconsin statistics continue to show high homebirth death rate

At the beginning of the year, I wrote about the neonatal mortality statistics in the state of Wisconsin, which showed that homebirth with a direct entry midwife had a neonatal death rate triple that of low risk hospital birth (at any gestational age) for the years 2000-2006. The state recently updated the its mortality module query with the statistics from 2007. In addition, it is possible to limit the data to term births and exclude premature births. The new data shows an even greater gap. Homebirth with a DEM in Wisconsin in 2007 had a neonatal mortality rate 8 times that of low risk hospital birth (with a CNM)!

This is yet more hard data confirming the increased risk of neonatal death at homebirth attended by a DEM. The real increase in risk is almost certainly greater than that depicted in the table. That's because the true CNM neonatal mortality rate for low risk women is probably lower than the data shows, and the true DEM neonatal mortality rate is almost certainly higher. The CNM neonatal mortality rate is probably lower than the rate depicted because it includes women who are not low risk, since CNMs care for all women anticipating a vaginal delivery. The DEM neonatal mortality rate is almost certainly higher because it does not include emergency transfers of the mother during labor. The attendant recorded on the birth certificate is the attendant who actually delivered the baby, not the attendant who supervised the labor, so all DEM intrapartum transfers are recorded in the MD group, not the DEM group.

So here it is: the latest hard evidence that DEM attended homebirth has a rate of neonatal death triple that of hospital birth for low risk women. Is it any wonder that MANA (Midwives Alliance of North America) is concealing their data? It is not surprising, but it is immoral.

0 Old Comments: