Homebirth Hooey and Hokum

Blogging Mothers Magazine ^ | July 11th, 2010 | Jenny Hatch

[Jenny Hatch]

The American College of Obstetricians and Gynecologists are dealing with an increasingly incredulous birthing population who are rejecting their style of "knock em' out drag em' out" childbirth.  The young female birthing population is increasingly turning to new media for sources of information regarding childbirth, vaccinations, and psychiatric care, and the Medicos do NOT like having their monopoly broken up.

So a new "homebirth study" in the form of a blatently politicized piece of propaganda has now been published attempting to PROVE that homebirthed babies have a three fold increase of death over hospital born children.

[Jenny Hatch]

Video Podcast at One True Media

Pod Cast of this article: Homebirth Hooey and Hokum

HOOEY: def - silly or worthless talk, writing, ideas, nonsense; bunk: syn: nonsense, BS, bunk, rubbish, drivel, bull, pish, tosh, horse hockey, tommyrot, balderdash, malarky, foolishness, bunkum, huey, hogwash, poppycock, bilge, absurdity, babble, baloney, bananas, blather, bombast, bunk, claptrap, fatuity, flightiness, folly, garbage, gibberish, giddiness, hot air, imprudence, inanity, irrationality.

HOKUM: def - misleading, being dishonest syn: beguilement, betrayal, blarney, boondoggle, cheat, circumvention, craftiness, cunning, deceit, deceitfulness, deceptiveness, defraudation, dirt, disinformation, dissimulation, double-dealing, dupery, duplicity, equivocation, falsehood, fast one, flimflam, fraud, fraudulence, guile, hokum, hypocrisy, imposition, insincerity, juggling, lying, mendacity, pretense, prevarication, snow job, sophism, treachery, treason, trickery, trickiness, trumpery, untruth

The American College of Obstetricians and Gynecologists are dealing with an increasingly incredulous birthing population who are rejecting their style of "knock em' out drag em' out" childbirth.  The young female birthing population is increasingly turning to new media for sources of information regarding childbirth, vaccinations, and psychiatric care, and the Medicos do NOT like having their monopoly broken up.

So a new "homebirth study" in the form of a blatently politicized piece of propaganda has now been published attempting to PROVE that homebirthed babies have a three fold increase of death over hospital born children.

The Globe and Mail reports:

U.S. analysis on home birth risks seen as deeply flawed

"The new study suggests more babies die during deliveries at home than in hospital, but doctor who produced some of the data calls the conclusion ‘sensationalist’

A new study by U.S. researchers questions the safety of giving birth at home, suggesting that more babies die during home births than during hospital deliveries. But Canadian researchers, whose data were extracted and used in the study, say that conclusion is deeply flawed.

The meta-analysis of 15 studies, led by Joseph Wax of the Maine Medical Center’s department of obstetrics and gynecology, found that giving birth at home tripled the risk of neonatal death.

Patricia Janssen, an associate professor at the University of British Columbia’s school of population and public health, says that conclusion is “sensationalist” and based on data that are in some cases decades old, on very small samples and in some cases incomplete."

Canadian Midwife Gloria Lemay wrote on her Facebook page:

"I was called by the press today to give a comment on this "breaking story". Why do these people get press and we can't get press to expose the horrific induction rate?"

Midwife Wendy Gordon wrote on Glorias Facebook wall:

"I just took a look at the meta-analysis, and the authors cherry-picked studies from all over the globe to give them the results they wanted. The only studies included from the US were Wax's own meta-analysis of morbidities published earlier this year (he didn't analyze deaths at all in that study), the infamous Pang study that is notorious for including unplanned home birth and preterm births, and some random study of a homebirth practice in rural Sonoma county published in 1984.

The excellent Johnson & Daviss homebirth study from 2005 was not included. The other studies were from Canada (6 studies), Australia (4), Netherlands (4), UK (2), Sweden (2), Scotland and Switzerland (1 each). Wax's conclusions really don't say anything about the safety of homebirth in the US, and frankly, the results aren't generalizable anywhere on the planet since the healthcare systems and midwifery care are vastly different amongst the countries analyzed.

What a ridiculous analysis."

The Big Push for Midwives group sent out a press release in response to the study, it is linked below.

The Big Push for Midwives Press Release

On the ICAN Blog several quote from the press release are shared:

ICAN Blog: Increased risk of home birth is pure fiction

7 July 2010, 10:23 pm

"The Big Push for Midwives released a statement today in response to publicity surrounding a forthcoming article in the American Journal of Obstetrics and Gynecology that claims to show home birth is unsafe. From the press release:

"As New York and Massachusetts moved to pass pro-midwife bills in the final weeks of their legislative sessions, the American Journal of Obstetrics and Gynecology fast-tracked publicity surrounding the results of an anti-home birth study that is not scheduled for publication until September. Described as unscientific and politically motivated, the study draws conclusions about home birth that stand in direct contradiction to the large body of research establishing the safety of home birth for low-risk women whose babies are delivered by professional midwives."

The release further quotes Dr. Michael C. Klein:

“Many of the studies from which the author’s conclusions are drawn are poor quality, out-of-date, and based on discredited methodology. Garbage in, garbage out.” said Michael C. Klein, MD, a University of British Columbia emeritus professor and senior scientist at The Child and Family Research Institute. “The conclusion that this study somehow confirms an increased risk for home birth is pure fiction. In fact, the study is so deeply flawed that the only real conclusion to draw is that the motive behind its publication has more to do with politics than with science.”

Several days ago, Amy Romano at Science and Sensibility expressed her own doubts about the study, highlighting these points:

1. The meta-analysis is compromised by the inclusion of a deeply flawed study that relies on birth certificates and includes preterm births, unplanned home births, and home births attended by unqualified providers. In the only analysis in which the researchers excluded this study, the significant excess of neonatal mortality disappeared.

2. The meta-analysis also includes studies that report on births that took place as early as 1976.

The Big Push notes that the timing of publicity initiated by AJOG is questionable, at best:

“Given the fact that New York just passed a bill providing autonomous practice for all licensed midwives working in all settings, while Massachusetts is poised to do the same, the timing of this study could not be better for the physician groups that have been fighting so hard to defeat pro-midwife bills there and in other states,” said Susan M. Jenkins, Legal Counsel for The Big Push for Midwives Campaign. “Clearly the intent is to fuel fear-based myths about the safety of professional midwifery care in out-of-hospital settings. Their ultimate goal is obviously to defeat legislation that would both increase access to out-of-hospital maternity care for women and their families and increase competition for obstetricians.”

The Globe and Mail ended its analysis of the study with these words:

U.S. analysis on home birth risks seen as deeply flawed

"Michael Klein, emeritus professor of family practice and pediatrics at the University of British Columbia, says the analysis and its conclusion has to do with the climate in the United States around midwifery. It is less accepted by the medical profession there than it is in Canada, he said.

“We’re dealing with a politically motivated study,” said Dr. Klein, who was a co-author with Dr. Janssen on the B.C. study.

Dr. Wax could not be reached for comment. His study was published Thursday in the American Journal of Obstetrics and Gynecology."

Dr. Waxs study is being ballyhooed around the Media as if it was the Gospel truth.

Informed parents would do well to reject such junk science as the little bit of propaganda that it is.

Jenny Hatch

Editor in Chief of Blog Mom Magazine

PS

I am a LOUD promoter of Husband and Wife Home Childbirth.  My personal Blog, The Natural Family Blog is DEDICATED to the promotion of Family Centered Homebirth.  If you would like to learn more about this style of childbirth, please review the Videos I have prepared on this topic.  I also organized our second conference that was held in 2001 in Louisville Colorado.

Laura Kaplan Shanley and Jeannine Parvati and Rico  Baker were the keynote speakers, if you would like to watch the Conference Videos, they are hosted on my blog here.

[Titus Quinctius Cincinnatus]

At least with homebirthing, you don't have to worry about staph infection caught from the hospital!

Actually, for our child, my wife and I were using midwives through a birthing centre near us. We actually ended up having to do to the hospital and have a C-section because our son was on his side, halfway between anterior and posterior, and his head was sort of bent down and he just wasn't coming out, period, even after 41 hours of labour (my wife is a trooper!). In this case, I am glad for hospitals, as back in "the old days," we'd have definitely lost our son, and probably my wife as well.

Still, we weren't thrilled at all about having to go to the hospital.

[netmilsmom]

If I had tried a homebirth with my first daughter, both of us would be dead.

With my second, she would have totally lacked oxygen and my intelligent 10 year old who is working two years ahead of her grade would be a vegetable.

Home births are not for everyone.

[netmilsmom]

>>(my wife is a trooper!).<<

Your wife is AMAZING!
I liked my painkillers. A lot. I did 23 1/2 hours with my first one. It was not fun.

[Jenny Hatch]

“Still, we weren’t thrilled at all about having to go to the hospital.”

I had my first three in the hospital, so I know what you mean, my second was a section after twenty hours of labor, your wife is a trooper!

I just wish the researchers were honest about the studies they are conducting. This was is so over the top fraudulent, it is right up there with Climate Gate junk science.

Jen

[Jenny Hatch]

“Home births are not for everyone.”

I know. I almost died after my first home birth and we could not resuscitate our son, so we transferred to the hospital for help.

I just wish the researchers didn’t try so hard to make it look more dangerous than it is. Most children born at home will do just fine.

jen

[Yaelle]

The biggest problem with childbirth is that it is dangerous and fraught with the most emotion of any condition or treatment. Thus are OBs sued more than any other kind of doctor. Emotions are running high, and there is so much that can go wrong with childbirth. At home OR in the hospital.

I know of someone in my town who went in after a healthy pregnancy to have her baby, big city hospital, and she ended up with permanent brain damage. There is a LOT of change going on in a woman’s body: hormones going WILD, loss of blood, blood pressure wildly changing, fluids going nuts. My best friend had severe high blood pressure POST delivery. This woman with brain damage came very close to dying, and now she is relearning how to walk and talk. Thank G-d her baby is fine, but I don’t know if she can even hold her yet. Birth is MAJOR, and it’s a miracle so many of us had healthy, uneventful deliveries.

I always wanted to do a home birth. I think it’s beautiful, and with the right professionals there who’ve seen it all, it’s safe (caveat: if something goes very wrong, it’s nice to be close to a hospital).

My first had a head much bigger than my pelvis was going to allow, so all of mine have been C-sections. I have come to love my Ziplock Births too, because I still get the baby at the end of it, and I recover well. :) But I support intelligent home birthing 100%.

[Excellence]

This is not directed at you personally, but at an unfeeling and impersonal organization.
And here I thought the hospital would respect my privacy but, no, they sent my name and address to ICAN, who sent me a newsletter with the headline (okay, I’m paraphrasing) “Okay, so you failed as a woman miserably, you can still gain salvation by having a VBAC.” How I gave birth matters not one whit compared to how I gave life. I’m still waiting for those self-righteous bitches to send me a card congratulating me on the birth of my twins. It’s been 19 years, should I give up?

[vpintheak]

At the hostpital you are already at a place where you can go into immediate surgery if something goes wrong. Which happens. More power to you, but I would be so completely full of guilt if my child or wife died because they weren’t at the hospital. Not worth the risk.

[ddk632]

I fully agree, and would hold myself responsible. I would never forgive myself.

I notice the trend of posters who support the home birth idea all had a negative experience with it, but “support it 100%”. Kind of, “it’s not for me, but if you do it and succeed, more power to you.”.

That is my attitude as well... more power to you if you succeed. But that is a risk I cannot take. I can’t even bear the thought of forcing my wife to be in labor any longer than absolutely necessary, just to satisfy some ideological convictions.

We are 34 weeks pregant with our first child at the moment and will be in a hospital equipped with state of the art NICU and the best, trusted doctor who came recommended... and an epidural (maybe valium for me, hehehe... just kidding).

There will be no horror stories from us to tell our children in the future. And if anything goes wrong, we did the utmost to be prepared and not complicate things further than they might get by themselves.

[ddk632]

I fully agree, and would hold myself responsible. I would never forgive myself.

I notice the trend of posters who support the home birth idea all had a negative experience with it, but “support it 100%”. Kind of, “it’s not for me, but if you do it and succeed, more power to you.”.

That is my attitude as well... more power to you if you succeed. But that is a risk I cannot take. I can’t even bear the thought of forcing my wife to be in labor any longer than absolutely necessary, just to satisfy some ideological convictions.

We are 34 weeks pregant with our first child at the moment and will be in a hospital equipped with state of the art NICU and the best, trusted doctor who came recommended... and an epidural (maybe valium for me, hehehe... just kidding).

There will be no horror stories from us to tell our children in the future.

[ddk632]

Sorry for the double post. I removed one line at the end which I thought would address some other posts in this thread, but decided against it since I don’t want to even think of the possibility of something going wrong... do not want to put it out there. So this is officially my removal of the last sentence from my first post from the universe.

[elc]

I can’t even bear the thought of forcing my wife to be in labor any longer than absolutely necessary, just to satisfy some ideological convictions.

But what about doctors who place arbitrary deadlines on pregnancies; who push for inductions and rush labor ("Pit to distress") to accomodate their schedule; or push for c-sections if you have not delivered before they leave for the day? It happens all the time in the US. The C-section rate in this country is horrendous (and yes, I know there will be people who chime in and say if it wasn't for a section they or their baby would be dead). People seem to ignore that it's major surgery. It's no wonder people are turning more to homebirth. Too many doctors are getting in the way of a birthing.

I had a great homebirth with my 2nd (a VBAC) with well qualified midwives. What pissed me off is that they did not have oxygen on hand. But that's not their fault. The state of VA ties their hands in many ways.

[netmilsmom]

>>I just wish the researchers didn’t try so hard to make it look more dangerous than it is. Most children born at home will do just fine.<<

I agree with you. But I would say “many” and not “most”.
Especially with women starting later having babies. I was in poor shape because of my age. I ended up with PIH totally out of control. I had two code teams in the room when she was born.

First baby, I wouldn’t risk it. I’d go for the birthing center and a midwife. They know what to look for. After that, with good prenatal care, go for it. I hate hospitals anyway.

[KosmicKitty]

I’m sure home-birth works well for those with out complications. (And sometimes those complications sneak in when you don’t expect them)

But I would have died with my oldest child if the emergency c-section was not available.

That being said, those who wish to take their chances should have the opportunity - just make sure to get someone to sign something about not suing the midwife if something goes wrong.

[Jenny Hatch]

“There will be no horror stories from us to tell our children in the future.”

You seem pretty confident that nothing bad ever happens in the hospital. When I said that we had to transfer after my first home birth, I have no regrets about making that decision to birth at home.

My son gestated for 45 weeks and weighed eleven pounds at birth. I was able to have a spontaneous, painless birth in my bedroom.

If I had been working with a doctor or a midwife, I would have been induced three weeks before and only god knows what may have happened while artificially trying to get that huge baby out before he was ready to be born.

I was able to give birth standing up and it only took four pushes to get him born.

Sometimes big babes are slow to breathe and we could not get him going. The EMT’s really helped and he was in the NICU for three days of observation and tests. I also bled quite a bit and had to have a bag of blood.

Our fifth childs birth was awesome - at home - and I did my own prenatal care. No Problems. It was very empowering to finally have everything go right. My biggest complaint about our four previous births was the fact that I could not keep my babies with me right after the birth. For one reason or another each of them was taken away.

At home, no one is able to “steal” the baby away for tests and observation. And my husband and I just reveled in being able to hold our son without anyone bugging us.

Here is my unassisted childbirth video: http://www.youtube.com/watch?v=xXuZs1PvkB0

Good luck with your birth, any way the baby is born, it is always a happy time when a new child joins a Family.

For me, I just prefer to be at home. (And would appreciate the researchers NOT fudging the data)

Jen

[GunRunner]

I agree.

I just watched "The Business of Being Born" documentary, and it was over the top in its anti-hospital sensationalism.

Most of the gobbledygook spouted by the pro-home birth folks seems more about quasi-philosophical girl-power feminism than any realistic benefits to the mother.

The ironic part about the documentary was that one of the women they followed around for her whole pregnancy who was wanting to do a home birth had to go to the hospital and have an emergency C-section anyway.

Most of the women who did have the home births had them in an inflatable swimming pool or the bathtub of their house.

No thanks. My wife is due in March and has had the most perfect pregnancy ever so far. But if she starts hemorrhaging after delivery and starts losing blood rapidly, or if the baby stops breathing after birth, I want her somewhere other than our bathtub or a kiddie pool in our living room with a midwife next to her.