Wednesday, August 18, 2010

Midwives...

Morning all

For your daily dose of insanity, have a look here...

It would appear that the medical establishment has published a report that says that a home birth has three times the risk of the baby dying.

It came complete in the lancet with an editorial, which is quoted in the guardian as including the line... ""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"."

Now, I'm going to go as far as assuming that no one in the article has lied or is materially wrong in what they say. Which, for me, is rather generous.

The response from someone who could be described as the head of a midwife trades union was...
She said midwives now "feel there is a concerted and calculated global attack and backlash against home birth which is being unfairly pilloried by some sectors of the global medical maternity establishment.

"There is a danger that risk during childbirth is presented in a way which is leading women to believe that hospital birth equals a safe birth. It does not. There is no hard and fast guarantee that a woman will have a safer birth in a hospital than at home".


She's wrong. And for a couple of reasons. Let us list them?

1) They aren't comparing the same thing. The medical journal reported on infant death; she's talking about maternal death.

2) "Global" is not a dirty word. The "Global medical establishment" has eradicated smallpox. What she's saying is that "One of the most educated professions in the world disagrees with me"

3) "attack and backlash" Hmmm. Either it's an attack on "home births" or it's a backlash against something midwives are doing. You can't have an attack and backlash at the same time. They describe different things.

4) That last paragraph is a little confusing. If I was to paraphrase the entire thing, what would it say? "There is a chance women could be misinformed about risk". Ok, fair enough. Which is why studies like this are important, because slightly flawed though it probably is, it remains better then no evidence.

She just doesn't like it.

5) Comparing cars to tractors. I haven't had anything to do with maternity hospitals, home births or the risks of child birth. However, I do know a few things.

One of the critical things is that doctors will strongly advise anyone who hasn't had a perfectly ordinary pregnancy to give birth in a hospital. Be it high blood pressure, diabetes or infection by zombie bite - they all advise a hospital is safer.

This forms a self selecting group, those at home who are low risk, those in the hospital at higher (average) risk.

And yet, despite all this, three times as many babies survived in hospital.

Which sounds safer to you?

2 comments:

Jen said...

1) somewhat agree. She seems to think the two are the same, though it looks like they've cut and paste her comments kind of harshly.

2) "Global" is irrelevant. It's a single paper in the Lancet - maybe a percentage of doctors in the western world believe this - it's hardly the signs of a vendetta.

3) Agree (*firmly closes lid on language nazi tendencies*)

4) yep this study may be misleading or presented in a misleading fashion, but this is probably more to do with the media than the article itself. Moral - don't base risky decisions on what you read in the papers.

5) Surely no one can think that giving birth at home is safer than hospital? More comfy and relaxing maybe, but not safer. Which means they're just arguing about how much safer hospitals are...and the point of this is??

The quote cited about women not having the right to put the baby at risk is interesting though. My automatic reaction is "of course they do". No ones choices are removed simply because they get pregnant - it's the medical establishment's duty to present the risks and make sure the person understands but it's not their place to take total control.

People have the right to make bad decisions.

Rabbitpirate said...

Interesting and well put post. While I agree that women should have the right to choose where they have their baby the simple fact that your home probably doesn't have a fully equiped neonatal unit down the hall should be evidence enough that giving birth in a hospital is probably safer than doing so at home. With home births if there is any problem with the baby or complications with the mother what do they do? They take them to the hospital. To me it just seems logical to cut out the middleman here.