More on home birth risks

From the recent comments file:

While I abhor the tone taken by many comments on the blog I’m asking you to look at, this doctor has some disturbing statistics on neonatal mortality at homebirths. Could you please discuss your thoughts on this post?http://skepticalob.blogspot.com/2012/01/curious-silence-on-rising-rate-of.html
Thank you! Catherine Taylor

Catherine – thanks for your comment! I appreciate it.

Home birth neonatal mortality, by provider type

The chart (left) from the blog you referenced says more about the way home births are handled in the U.S. than it does about home birth itself. As I’ve mentioned before, the Birthplace in England study, as well safety data from Canada and Europe, show that in selected circumstances home birth can be as safe as hospital birth in terms of maternal or neonatal deaths–if home birth is integrated into the larger maternity care system, which in the U.S. it is most definitely not.

Here in America we have a patchwork of state laws that in many cases increase the risk of home birth for mother and child. We also lack the kind of nationally recognized licensure and regulation of home birth midwives that most other western countries have, which can lead to women being cared for by poorly qualified, “underground”  birth attendants and to the kind of tragic outomes that the chart highlights.

The first step in addressing these issues can be found in the Home Birth Consensus Summit’s Common Ground Statements:

“It is our goal that all health professionals who provide maternity care in home and birth center settings have a license that is based on national certification that includes defined competencies and standards for education and practice.

We believe that guidelines should:

  • allow for independent practice
  • facilitate communication between providers and across care settings
  • encourage professional responsibility and accountability, and
  • include mechanisms for risk assessment.”

With few exceptions the regulatory, institutional, and medical systems in the U.S. don’t support home birth. Yet women are increasingly seeking home births, and no matter what the blogging doctor Catherine cited might fervently prefer, they can’t be forced to do otherwise. Speaking as a physician, unless you’re part of the effort to make home birth a safer alternative for those women who want one (and their babies), you’re part of the reason for those bad statistics.

4 Comments

Filed under Home birth, Politics

4 responses to “More on home birth risks

  1. Like, double like, triple like!!
    Love your take on all of the home birth stuff – such a sensible response.

    Like this

  2. Thank you, Dr. Sloan! I have linked your blog to my fb business page.

    Like this

  3. Samantha

    I had a PLANNED home birth. I also PLAN to have my next child in a home birth setting. Mind you this was in Pa. I found it exceptionally hard to find a group that did home birth, doctor or likewise. I ended up with a FANTASTIC group of professional women who had years and years of experience. I was a lucky lady…I wish more people would be on board with helping these SAFE alternative birthing options be found. Remember when the alternative was the hospital?! I don’t think anyone disputes what modern medicine has given to us….but when we give birth, we are not sick…we are doing what our bodies were meant to do. I wish more people believed in the SAFE option for home birth. *I was about a 3 min car ride to the nearest hospital…what makes this anything dangerous are the people trying to be against it and making available resources scarce for those that are determined to have this as an option. My child excels beyond her age and I am still alive. I think you should have a medical facility as a back up close to a home birth…because this IS life and anything can happen but get over it already and let people decide what is BEST FOR THEM! Please…

    Like this

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