…if your study follows five hundred oranges and ten apples.
There’s yet another bang-up job of scientific/medical reporting in the Guardian today, entitled ‘Home Births are Good for Mother, Riskier for Babies, Study Says’. The article reports that a US study of home birth mortality/morbidity statistics shows that home births lessen the likelihood of interventions that are detrimental to the health of the mother, but triple the risk of death for the baby.
The researchers pulled together data from studies in the US and in Europe, including two from the UK. They considered a total of 342,056 planned home births and 207,551 planned hospital births.
So, what’s my problem with this? Well it’s simple: UK midwives are university trained and nationally certified. They are hospital affiliated and most NHS trusts have thorough, detailed home birth plans in place that, among other things, bring women/babies rapidly into specialist care in case of complication.
In the US, certification differs state-by-state, with some states allowing anyone at all, regardless of training (or lack of) to call themselves ‘midwives’; and midwives, as a general rule, have no affiliation with any hospital or obstetric team, which means that, if an emergency arises, american home birth women dial 911 and wait for an all-purpose ambulance to take them to a medical team with no prior knowledge of their circumstances, prenatal history, etc.
In short, the lot of home birth women in these two countries are practically as different as they could possibly be. Safety and efficacy conclusions based on averages across the two systems are *totally meaningless*–especially when we don’t even know how many studies came from each. (thank you, Guardian! Bang-up reporting!)