Homebirthing risk of neonatal death up to triple that of hospital

http://www.sciencebasedmedicine.org/?p=2392#more-2392

The CDC released a bunch of stats:

As this chart shows, the neonatal mortality rate for DEM (direct entry midwife, another name for homebirth midwife) assisted homebirth is almost double the neonatal mortality rate for hospital birth with an MD. This is all the more remarkable when you consider that the hospital group contains women of all risk levels, with all possible pregnancy complications, and all pre-existing medical conditions. An even better comparison would be with the neonatal mortality rates for CNM assisted hospital birth. The risk profile of CNM hospital patients is slightly higher than that of DEM patients, but CNMs do not care for high risk patients. Compared to CNM assisted hospital birth, DEM assisted homebirth has TRIPLE the neonatal mortality rate. The chart shows the data for 2003-2004, but the data for 2005 has recently become available. Homebirth death continues to be far higher than death in the hospital for comparable risk women. In 2005 the neonatal death rates were CNM in hospital 0.51/1000, MD in hospital 0.63/1000 and DEM attended homebirth 1.4/1000.

You know, I totally get why some women want a more homey, natural, comfortable place for giving birth. Hospitals can be so cold and clinical. But this data clearly shows that home-birthing has a much higher neonatal mortality rate. I wish more hospitals had options for women that want a more homey vibe...I don't know what that would entail, exactly, but there has to be things that can be done to entice home-birthing moms to give birth in a safer place.

I read this yesterday. I so seriously love that blog.

I would think that would be a duh moment...Of course having a baby in a hospital is safer for the baby than to have it at home....There's that common sense thing again

Originally Posted by melonhed I read this yesterday. I so seriously love that blog.

Mel, I'm addicted. I heart you long time for the link!

Amy Tuteur is notoriously guilty of swaying information to back her arguement. She will not debate head to head Homebirth supporters.

If you look on the CDC website, you can see the facts. There is a risk to all birth. No one is God and can promise you a perfect outcome. Homebirth is for normal healthy women, no diabetes, preeclampsia, placenta previa. http://wonder.cdc.gov/controller/datarequest/D31


Birthplace Medical Attendant- Deaths Births Death Rate Per 1,000

In Hospital Doctor of Medicine(MD) Total 25,678/ 3,589,407/ 7.15
In Hospital Certified Nurse Midwife(CNM) Total 853/ 296,023 /2.88
Not in Hospital Other Midwife Total 53 /13,793 /3.84

So happy CNM have a great birth rate. However they have tools that some homebirth midwifes are not allowed to carry. Iv's for instance. If you do not want a homebirth, you should hire a CNM. I think Obs should only be for high risk women and as consultants in case of pregnancy issues.

Originally Posted by lunarstar Amy Tuteur is notoriously guilty of swaying information to back her arguement.

I never heard of Amy Tuteur, so I googled and learned that she is a former physician. But I couldn't tell figure out what "her argument" is.

Care to tell me?

Originally Posted by ignoramoose http://www.sciencebasedmedicine.org/?p=2392#more-2392 The CDC released a bunch of stats: You know, I totally get why some women want a more homey, natural, comfortable place for giving birth. Hospitals can be so cold and clinical. But this data clearly shows that home-birthing has a much higher neonatal mortality rate. I wish more hospitals had options for women that want a more homey vibe...I don't know what that would entail, exactly, but there has to be things that can be done to entice home-birthing moms to give birth in a safer place.

I wish I could give birth at home but b/c of my particular health issues, I can not. I can tell you exactly why women dont like the hospital though. More often then not, they ignore your birth plan, "pit to distress" is common practice by impatient OBs, the staff works to talk you into interventions you are not interested in but will "speed up" your labor, unless you come across as crazy they will keep offering you pain meds even if youve made it clear that you are not interested, they require Hep Locks for even low risk women which gives them easy access to begin unnecessary interventions and augmentations, they want you in bed being monitored even though it is not the most conducive position to labor in, many hospitals do not offer water births.. I could go on.

The Doctor that was set to deliver my last missed her b/c he was in the OR doing a csection. He, from what I understand (and have experienced) is a "pit to distress" kind of doctor. His personal Csection rate is over 50% and he is not a high risk doctor. The hospital I use is very busy and they like to keep things trucking along but from what I understand, even the most intervention happy nurses thinks he takes things to far. He, unfortunately, is not an uncommon sort of OB. I agonized my entire pregnancy trying to figure out what I could do to find a new office just so I could avoid HIM. Insurance issues kept me from being able to follow my old OB to her new practice

Originally Posted by annulla I never heard of Amy Tuteur, so I googled and learned that she is a former physician. But I couldn't tell figure out what "her argument" is. Care to tell me?

Here's her background, annulla:

http://www.sciencebasedmedicine.org/?p=2486

For those of you who don’t know Dr. Tuteur, she is an obstetrician-gynecologist. She received her undergraduate degree from Harvard College and her medical degree from Boston University School of Medicine. Dr. Tuteur is a former clinical instructor at Harvard Medical School. Her book, How Your Baby Is Born, an illustrated guide to pregnancy, labor and delivery was published by Ziff-Davis Press in 1994. She runs the website AskDrAmy.com and has her own iPhone app, the Ask Dr. Amy Am I Pregnant Quiz. Dr. Tuteur blogs at The Skeptical OB.

Originally Posted by annulla I never heard of Amy Tuteur, so I googled and learned that she is a former physician. But I couldn't tell figure out what "her argument" is. Care to tell me?

If you can find what state she held a medical license that would be great. No one has found where she was a registered physician. Her argument is that she is against homebirth, she has had multiply blogs against it.

Statistic from where. Worldwide or the US. It is an important factor. What kind of study? How were the # of home births determined.

I have a cousin (far removed) who has 4 kids, no ss #, they don't go to school not on radar. And I am sure in amongst home birthers there alot are under radar. Even in the US census, under the radar, is a problem. (what about all the cult communes are they counted) And the US government spends tons of money to try and get that as close to accurate as possible. I don't thing the CDC goes the extemes to get the data accurate.

Statistic can say anything they want.

Every person that ate an apple in 1857 died. Don't eat apples.

This is not pro or con home birth. Just con on statistic.

I had my last three at home with a CNM. The last two were water births. My first was born in a hospital, and I really did not have much "negative" experiences there, but it just did not "feel" right for me.
I chose a CNM for a homebirth with my second child, as I got pregnant while me and my (now ex) DH were between health insurance plans.
After experiencing that home birth, I did not even consider a hospital setting for my third and fourth.
There are risks associated with just about everything. I do agree that the statitics for this, as with most everything else, can be skewed to suit ones needs/agenda.
This is a personal decision, IMO. And it is a decision that I have never once regretted.

I believe in home birth. My friend is a midwife. Healthy women have been delivering healthy babies in the privacy of their home since time began, I see no reason they should drop 60grand on the last hours of her 9 months of hard work. Medical birthing is essential as well for women not able to go through home births.

Unfortunately my nephew died days after his hospital birth due to an infection he got during delivery. I will never ever forget holding him before they took him off life support. I had never in my life had any association with infant death before that, I was a bit messed up for a bit. I don't know how my BIL & SIL got through it.

Apparently, in the Netherlands, homebirth is quite common BUT their midwives have extensive medical training:

http://www.sciencebasedmedicine.org/?p=2392#more-2392

Originally Posted by Amy Tuteur, MD The mantra of American homebirth midwives is “trust birth.” The studies of homebirth in The Netherlands make it clear that Dutch midwives don’t follow that philosophy. In fact, the fundamental premise is exactly opposite: birth is inherently dangerous and great care must be taken to prevent, diagnose and manage complications. The Netherlands mandates rigorous education and training of midwives; the eligibility criteria for homebirth are strict; and a dedicated transport system is in place.

Maybe this is the sort of system we should look to here in the U.S. Have much more stringent training in place for midwives, stricter eligibility for homebirth, etc....I mean, we do have CNMs (certified nurse midwife) who are great! The problem is with DEM (direct entry midwife) and that is where the homebirthing danger lies.

Like I said, I *totally get* why homebirth is attractive. I just wish it was safer!

I would have loved to have had home birth but unfortunately, I have several conditions including being a group strep B carrier so I couldn't.

I have nothing against home births. I am just glad I had the better safe than sorry with both of my pregnancies. I had to have c-sections. My 1st went into distress and they had to get her out fast. My 2nd was too big and would not come down. If I hadn't been at a hospital, I could have lost them both.

I am glad that some women can experience the at home births. It must be more relaxing and peaceful.