Wednesday, April 09, 2008

The high C-section rate at homebirth shows that birth is not "trustworthy"

Yes, you read that correctly. Homebirth advocates point proudly to the low rate of C-sections at homebirth, but those rates only appear low in comparison to hospital rates. In the hospital, C-section is not always a lifesaving procedure (in retrospect). However, at homebirth almost all C-sections save the life of the mother, the baby or both. Therefore, it is rather astounding that for a natural process that is supposed to be "trustworthy", women who are the lowest of low risk can anticipate that 1 in 25 will need surgery to save their lives or their babies' lives.

A 1 in 25 chance of death is utterly inconsistent with the notion that birth is inherently safe or that anyone should be "trusting" birth. Homebirth advocates like to pretend, and loudly trumpet, that childbirth is safe, despite massive amounts of contemporary and historical evidence to the contrary. Failing that, they like to pretend that high neonatal and maternal death rates are caused by iatrogenic infection. Of course, that's not true, either. The next fallback position is to pretend that lifethreatening complications of pregnancy, like eclampsia, hemorrhage or prematurity, are rare, but these complications are not rare, they are relatively common. Moreover, even AFTER these complications are excluded, even when there is no reason to expect anything other than an uncomplicated vaginal delivery, 4% of women still need lifesaving surgery.

I cannot think of anything in life that has a 1 in 25 death rate that would be called even remotely safe. If every time a mother and baby got into a car there was a 1 in 25 chance that one of them would not come back alive, driving would be considered horrifically dangerous. If a routine medical procedure was known to kill 1in 25 babies, the scandal would be immense.

So how, exactly, can childbirth be considered trustworthy when 1 in 25 homebirth mothers need to be rescued by obstetricians performing life saving surgery?


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