Newspaper articles "home birth safety" - 
report on Canadian Medical Association Journal article on the Home Birth Demonstration Project with Direct-entry Midwives in British Columbia.

By Rod Mickleburgh

VANCOUVER, BC -- Far from being risky, hippy-dippy trips for Earth mothers, home births with a midwife present are just as safe as having babies in the hospital, according to a landmark study of more than 2,100 births in British Columbia.

They are also less likely to lead to infection or require pain-management drugs and Cesarean sections, says the study, to be published today in the Canadian Medical Association Journal.

"This is a thumbs-up for home births," said the study's author, Patricia Janssen of the department of family practice at the University of B.C. "While there is no guarantee of absolute safety anywhere, they do seem to be as safe as hospital births."

The study is the first major one of its kind in Canada since midwives were licensed to attend home births in many provinces during the 1990s. The CMAJ study examined 862 planned home births attended by midwives, 743 hospital births attended by physicians and 571 hospital births with midwives present.

Based on such neonatal outcomes as babies receiving oxygen, immediate post-birth health of the babies and signs of stress, there was no statistically significant difference among the three categories, Ms. Janssen concluded.

Ms. Janssen did add one note of caution. There were three perinatal deaths among the home births, compared to one in the hospital.

Although the numbers are too low to be statistically important and the death rate is well within the range of other studies, she said it deserves ongoing evaluation.

Medical doctors have generally resisted the introduction of midwives and home births, arguing that they are fine for normal deliveries but risky when things go wrong. Dr. Shelley Ross, a Vancouver family physician who has been delivering babies for 25 years, said the CMAJ study hasn't changed her mind.

"You can look at all the statistics you want, but if you lose one mother or one child who might have been saved in a hospital, is that worth the risk? "We don't feel it is safe. You can't predict the unpredictable.

Editor’s Note:  It is interesting that a generally positive newspaper article on a very positive and important midwifery study ends with a quote by a doctor dismissing its value and leading us right back to the same unscientific premise – the automatic superiority of hospital-based physician care – which has been uncritically accepted by both public and professional for the last 90 years.

Dr Ross remarks that the study hasn't changed her mind and that “You can look at all the statistics you want, but …..” and goes on to say if there is even one death it is too many. We are all in agreement that zero preventable death is the goal but it must be noted that it is not better to suffer from over-treatment than under-treatment. The study identifies that hospital birth under the care of a physician has a higher rate of cesarean surgeries. However, Dr Ross ignores all the complications that this surgery introduces into childbirth and future pregnancies, such as placenta previa or uteine rupture. The study also identifies that measures of newborn well-being, such as good apgars, were the same in both locations and for both categories of caregivers, another fact not acknowledged by Dr. Ross. 

 In regard the 2 statistically unexpected perinatal deaths, i suggest you read the details in the article accompanying the study entitled Is Home Birth Safe?  It discusses the finding of an extensive investigation for systemic explanations (they could find none) and their recommendations (continuing scrutiny of all problematic outcomes and hospital transfer for babies with significant meconium passed during first stage labor).