Safety of Homebirth contested in American Journal of Obs&Gyn

[Bournefree]

Contrary to all other data and recent studies The Lancet comments in an inflammatory way to a Meta-study (pulling stats from numerous other historic studies and bringing it together), reported in the AJO. It concludes:

"American Journal of Obstetrics & Gynaecology provides the strongest evidence so far that home birth can, after all, be harmful to newborn babies. The research incorporated 12 studies and 500 000 births from several industrialised nations (USA, Canada, Australia, Sweden, the Netherlands, and Switzerland). The data show that planned home births to healthy and low-risk mothers compared with planned hospital births in the same group of women doubled the risk of neonatal deaths (0·2% vs 0·09%). And when infants with congenital defects were excluded, the risk of neonatal mortality tripled"
Full article (https://www.thelancet.com/journals/lancet/article/PIIS0140673610611658/fulltext?rss=yes)

There is some very disconcerting language used in this article, and the study has now been taken up and banded around the media under the heading "tripling of infant mortality rates" and the lancet further fans the flames by commenting "Women have the right to choose how and where to give birth, but they do not have the right to put their baby at risk"

This has also been reported this morning by BBC breakfast, though the BBC has reported on this study before in July (https://www.bbc.co.uk/news/10465473)

The statistics do however show that any risk is extremely low; less than 0.2% and it is always this that should be remembered when looking at any risks of giving birth - the horror stories are always in the minority (even though, at times it might not seem like it!)

In my own experience it is the risks that are talked about the most both with Midwives, and Drs - so at times you are left feeling more than a little deflated about even planning your Homebirth.

My opinion is this headline is going to do some serious harm to women wanting a homebirth, in an environment where it is becoming increasingly difficult to get some doctors, and even some peers to listen to a women’s right to choose where to give birth.

All thoughts please ladies.. How does this study make you feel or are you affected by it?

xXx

 

[noileena]

I saw this on BBC news this morning, after saying to DH "it's just as safe for me to have LO at home"...I just know my MIL will listen to this kind of study rather than my own wishes

 

[Rmar]

The problem with most of these studies is they really don't look into how the homebirth took place. You would really have to look right into each individual case. Was it a planned homebirth or unplanned? (I know that this study notes only planned homebirths but other studies do not distinguish between the two) Was there a midwife attending the birth? Was there any kind of conditions that should have prevented the birth from taking place at home? Another point is that the study may include planned homebirths that were transfered either during or before labour began.

People don't realise that you really have to break down the statistics to get an idea of what is going on and take it on without bothering to look into it. Really look into the reasons for each death and how they could have been prevented. Could this prevention have taken place at home or did it require a hospital? If it requires a hospital, could you guarentee that it wouldn't have gone undetected in a hospital until it was too late, just like a trained midwife could detect at home? How far away were they from a hospital if it was a case of required medical care not happening soon enough? How were 500 000 births chosen; was it at random?

So many questions that are unanswered and horrible wording.

Women have the right to choose how and where to give birth, but they do not have the right to put their baby at risk.

The language used is persuasive language and just a tad biased rather than informing. I guess you would find many articled like that but, because it is published in a medical journal, it is most likely going to be taken as a fact that homebirth puts babies at risk rather than an opinion.

 

[snagglepat]

This kind of thing drives me potty. For a start, by combining studies from so many different places (I notice the UK isn't one of them) you lose the individual differences between those countries and the way the sometimes very different health care systems can have an influence. In the Netherlands the home birth rate is around 30%, whereas it's less than 1% in the US. This means that the maternity systems in these two countries must differ dramatically and the care that is available where they are, not anywhere esle has to be factored in to any decision an expectant parent makes.

I have done and continue to research extensively into the maternity care I am entitled to, and what additional support I can get for my home birth. In my local area, home births are extremely safe because they're relatively common and as a result, managing them safely is something all my local midwives have plenty of experience in. Where I used to live and where I birthed my daughter this wasn't the case so I made different choices about my care providers. A blanket figure like the one above is inaccurate, designed purely to scaremonger, sell newspapers and air time and to exercise control over the masses rather than facilitate informed choice.

It didn't even include the UK! Why on earth should we in the UK use it to base our decisions on?

Gina.

 

[JenStar1976]

I watched the BBC interview this morning. I really felt that the homebirth lady really didn't get to put her point across as the anti-home birth lady just butted in the whole time! It also upset me when they read out one of the comments afterwards: "home birthing mothers are selfish".

 

[Bournefree]

The problem with most of these studies is they really don't look into how the homebirth took place.

Totally! There are pregnant women out there now, who are going to face armchair critics who haven't read the article and drilled down into the facts, and they will be telling them (if they are brave enough to tell these people they are planning a homebirth), "oh you know you are putting your baby a risk, and you might die, and don't you think that is selfish!" The study was of only 15,000 homebirths in a variety of countries, compared to 485,000 hospital births the data is hard to tally. of the 15k homebirths, a majority transferred when problems arose - no fatalities occurred at home!! Some of these subject live in countries without dedicated midwives! Which the reason for wide success in the Netherlands, as Gina points out.

In the Netherlands the home birth rate is around 30%, whereas it's less than 1% in the US. This means that the maternity systems in these two countries must differ dramatically

It didn't even include the UK! Why on earth should we in the UK use it to base our decisions on?
Gina.

I couldn't agree more!!!

I watched the BBC interview this morning. I really felt that the homebirth lady really didn't get to put her point across as the anti-home birth lady just butted in the whole time! It also upset me when they read out one of the comments afterwards: "home birthing mothers are selfish".

I had the same feeling!! The person responding was an idiot (that wasn't the exact wording I used at the TV this morning, as it was more a barrage of abuse of the 4 letter kind!), I was also angry with the BBC; they reported this a month ago quietly.. but low and behold a slow news day and they're on the scaremongering-band-wagon!



...it all makes me very sad , as it will like it or not, have an accumulative effect in the subconscious of the population, and their attitudes towards homebirth.

Let hope not too many people were watching¬! Or at the very least they bother to read the detail!

 

[Sophist]

The problem with most of these studies is they really don't look into how the homebirth took place. You would really have to look right into each individual case. Was it a planned homebirth or unplanned? (I know that this study notes only planned homebirths but other studies do not distinguish between the two) Was there a midwife attending the birth? Was there any kind of conditions that should have prevented the birth from taking place at home? Another point is that the study may include planned homebirths that were transfered either during or before labour began.

.

This. In fact, for this very reason there is a huge home birth study being conducted in the US right now. I've agreed to be a participant. It's much more well controlled than previous studies which included all sorts of things.

 

[cupcake23]

I put this up for discussion a few weeks back

https://www.babyandbump.com/home-natural-birthing/384436-home-birth-choice-puts-babies-risk.html

Well I'm a midwife..... I had a home birth. I did not put my baby at risk.

I agree with the other ladies. Poorly construced 'research' amongst other things.

 

[Bournefree]

I put this up for discussion a few weeks back

https://www.babyandbump.com/home-natural-birthing/384436-home-birth-choice-puts-babies-risk.html

Well I'm a midwife..... I had a home birth. I did not put my baby at risk.

I agree with the other ladies. Poorly construced 'research' amongst other things.

I didn't realise you had posted this before. I was looking for comments since the breakfast broadcast, and couldn't find any. Thank you for linking the posts and congratulations on your homebirth!
xx

 

[cupcake23]

I put this up for discussion a few weeks back

https://www.babyandbump.com/home-natural-birthing/384436-home-birth-choice-puts-babies-risk.html

Well I'm a midwife..... I had a home birth. I did not put my baby at risk.

I agree with the other ladies. Poorly construced 'research' amongst other things.

I didn't realise you had posted this before. I was looking for comments since the breakfast broadcast, and couldn't find any. Thank you for linking the posts and congratulations on your homebirth!
xx

Thanks, I had a fab experience and more women should be open to home birth but when crap like this is put out to the media all you get is scaremongering.

Its a shame I missed the broadcast, Im just glad that the RCM have more sense then people in white coats.x.

 

[Rmar]

Another news article, today. Different language and an obvious different point of view.
https://www.telegraph.co.uk/health/healthnews/7948419/Britains-senior-midwife-criticises-misogynistic-attacks-on-home-births.html

 

[cupcake23]

I've got myself really upset after reading the dailymail article on this, I don't even want to put it up because it's a load of crap! It pisses me off that women are going to be scared to have homebirths, this will be thrown in their face by unsupportive Drs, midwives and family members and they will end up missing on what could be a fab experience.