Anecdotal "Perils of Home Births"

Reader diary posted by Alison Cole

September 13, 2009 - 4:48pm

Alison Cole's picture
Emailed to TODAY@nbcuni.com:

To Whom It May Concern:

In a segment aired on the Today Show 9/11/09, your station purported to delve into "The Perils of Home Births."  A large portion of the segment was devoted to interviews with a grieving family who had lost their baby.  My heart aches for this family, but their experience does not shed light on the safety of birthing at home, just as the story of one family mourning the loss of a hospital-born baby is not evidence that all births should be removed from the hospital.

Biomedicine purports to be evidence-based, eschewing emotion-based "anecdotal evidence" for the stark light of fact.  However, no scientific evidence was presented in your segment to support the contention that planned home birth with a Certified Professional Midwife is more dangerous for mom or baby that going to a hospital.  As the segment itself points out, more babies die in hospitals (per 1000 babies born there) than at home.  I am surprised, however, that the growing body of evidence which supports the safety of out-of-hospital birth was ignored.  2009 has seen the release of two studies, one from the Netherlands and one from Canada, which support the safety of birthing at home with trained midwives who are integrated into the health-care delivery system.  While the impact of birth experience on an individual family is too important to allow for random assignment of families to home or hospital birth  (as advocates of evdience-based care prefer), the Canadian study especially controls for variables remarkably well by comparing women in similar states of health who were cared for by the same practice.  One important of scientific conclusions is that they must be replicable, and the studies mentioned above replicate the results of a 2005 study of out-of-hospital births with Certified Professional Midwives in North America.  The best available evidence shows that out-of-hospial birth is nor more dangers for mother or baby.  However, out-of-hospital birth has been shown to reduce rates of expensive medical insterventions including surgical birth. 

Finally, it is important to remember that, far from being an advocate for evidence-based practices, the American College of Obstetricians and Gynocologists (ACOG) is an organization designed to advocate for the interestes of OB/GYNs.  Rather than responding to the scientific literature cited above, ACOG has recently been soliciting anecdotal evidence on bad outcomes of out-of-hospital birth.  When the professional organization of hospital birth providers tells us that the only safe place for birth is in the hospital, we must approach this with the same healthy skepticism with which we would approach claims from oil-industry executives on the dangers of wind energy. 

I encourage the Today Show to further the health of childbearing women by featuring a segment on evidence-based maternity care rather than resorting to sensationalized scare-tactics which obscure the facts of this issue. 

Sincerley,

Alison Duren-Sutherland
Homebirth Mom

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1 comment

Very well written. As a mother that has had two babies, one in a hospital setting and one in an out-of-hospital setting, I completely agree with this letter. A planned out of hospital birth, with a midwife (LM, CPM or CNM)is just as safe (or even more safe) than a hospital birth. I have worked in a hospital for years, and truely believe that hospitals are for sick people, not the average low risk laboring mother and newborn baby. There are times when medical intervention is truely needed, but for most of the time a planned home birth or birthing center birth is a great choice.

Submitted by HOLTMANJEN on September 19, 2009 - 4:51pm.