Home Truth Is Out There

November 28th, 2011

Data from a new study, published in the British Medical Journal, has been chewed up by the Fourth Estate and spat out to deliberately fear-monger against Home Birth.

See the Press Assoc., BBQ, Terriblybadfor examples of the most widely reported ‘angle’ on the study.

Babies born to first-time mothers who choose a home birth are almost three times more likely to die or suffer a medical complication, according to a report.

I have read the study, linked above. The overall risk for a ‘serious adverse outcome’ did not reach statistical significance in home birth vs other birthplace cohorts. Only when a specific subset of data were analysed was a significant result reached.

And just to clarify the inflammatory quote above, see table 8.4 in the Appendix to the study for the data which show that your child does not have ANY more likelihood of dying at home compared to a ‘medical’ setting. In fact, the highest proportion of neonatal deaths were found in freestanding midwifery units. For what it’s worth.

However, having read the study and having tried to understand the data, I would like to present an alternate interpretation.

CHOOSING TO GIVE BIRTH IN AN OBSTETRIC UNIT HARMSYOU, AND HARMS YOUR BABY, BEFORE YOU EVEN ARRIVE

It’s true, and this brilliant study proves it.

THEN THEY HARM YOU SOME MORE

It’s true, and this brilliant study proves it.

Let me elucidate on the data which supports my hypothesis.

So, you are ‘low risk’ (defined by this study), gestation has gone very well (defined by this study), labour starts… at home you get on with things. Eventually a midwife usually arrives and checks you over. At this stage only 5.4% of women at home had any kind of medical complication (meconium leaking, abnormal foetal heart rate and so on).

If, however, your labour starts and you have to leave home, get to hospital and do whatever they tell you to do before a midwife sees you… 19.5% of women showed 1 or more complications! 8x as many women in hospital had 2 or more complications than those women who stayed at home. That’s a bad start.

So, baby is coming and those Obstetricians just can’t keep their hands away. If you’ve chosen hospital you have 4x more chance of little Chelsy being sucked out with a plunger (ventouse), 3.5x more use of metal salad servers (forceps), 5x more chance of being slit open (caesarean), almost 2x more chance of serious perineal trauma, 2x more blood transfusions, 5x less chance of a normal placenta delivery, 3x less chance to use natural pain relief such as water birth – but 4x more chemical pain relief (epidurals etc.), and, finally, 4x more chance of having your fanny slashed by a scalpel-happy medic.

Also, home birth rates better than midwife-led units in all these aspects.

Obstetric Unit births were classified as ‘spontaneous vertex’ (normal head-first) births in only 74% of cases.

At home your chance of a completely normal birth was 93%. Again higher than midwife-led units.

All this data is freely available in the study manuscript online and it’s online appendices.


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