Surprise! Jennifer Block refuses to debate

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Jennifer Block refuses to debate the scientific evidence on the safety of homebirth. Amazingly enough she claims that as a non-scientist she isn’t really qualified to do so.

This is her complete statement:

In response to Amy Tuteur: It is my role as a journalist to report on the evidence base–that is, published, peer-reviewed research, and published, peer-reviewed critique of that research. I encourage you to publish your findings in a peer-reviewed journal. Non-scientists “debating” the science does a disservice to both the science and the women caught in the middle. (See brilliant comment above: “Who IS ‘winning’ the homebirth debate? Probably not women or babies, since they’ve become contested spaces rather than people.”)

Pulling numbers from the CDC Wonder web site to compare the outcomes of place of birth and birth attendant is not appropriate for a number of reasons, first because there’s been no analysis to control for confounding variables, and also because there’s no mechanism to separate births that were intended to happen out-of-hospital from those that were unattended accidents. Your statement about birth certificates doesn’t check out. This from Melissa Cheney:

“Oregon did not start collecting data on planned homebirth until 2008, and that data is not available to researchers yet. I know because I am first on the list to receive it. The US standard birth certificate is not used in all states and even with it, there is no way to distinguish between assisted and unassisted home deliveries. No one in the research world thinks vital records is adequate for tracking homebirth outcomes. It is simply not designed for that.”

In response to the accusation that the Midwives Alliance of North America is “hiding statistics,” it is my understanding that there are close to 18,000 records on planned, CPM-attended home births that the organization is working to make available to researchers, so that statistics can be gleaned. But like many databases, it will not be available in its raw form to the general public. Researchers will have to apply for access by submitting protocols, which is common in the research world.

My reply:

I’m disappointed in your unwillingness to debate, Ms. Block, but I’m hardly surprised; I predicted it.

“Non-scientists “debating” the science does a disservice to both the science and the women caught in the middle.”

I’m a little confused. You obviously think you know enough science to write a book promoting the safety of homebirth, run a website promoting the safety of homebirth, write articles in magazines and across web promoting the safety of homebirth, but you don’t think you know enough to debate the scientific evidence about the safety of homebirth? If you don’t know enough to debate me, how do you know homebirth is safe?

“It is my role as a journalist to report on the evidence base–that is, published, peer-reviewed research, and published, peer-reviewed critique of that research.”

Then why do you consistently ignore the overwhelming majority of papers published in peer review scientific journals that show that homebirth increases the risk of neonatal death?

“Pulling numbers from the CDC Wonder web site to compare the outcomes of place of birth and birth attendant is not appropriate for a number of reasons”

Then you’d better call Johnson and Daviss and tell them to retract the BMJ 2005 paper since they used the CDC data for 2000 in their paper.

“it is my understanding that there are close to 18,000 records on planned, CPM-attended home births that the organization is working to make available to researchers, so that statistics can be gleaned. But like many databases, it will not be available in its raw form to the general public.”

That’s flat out false, as you are almost certainly aware. MANA has ALREADY offered the raw data publicly back in 2006. According to an announcement placed in the NARM (North American Registry of Midwives) Summer 2006 Bulletin.

‘… aggregate statistics describing births contained in the Midwives Alliance (MANA) database … These items include number of births, numbers of transfers, cesarean sections, etc…

The data made available from the Midwives Alliance Statistics Project can be very useful for lobbying or regulatory purposes. It puts the control of the data in the hands of the midwives. Having state level data can be useful when trying to get a bill passed, but it can also be useful to show that midwives are involved in self-assessment and accountability. In other words, it shows your numbers but also that you are on top of things and will be in the future. It is much stronger than just a flash of numbers at bill-passing time, and might boost your chances of avoiding your regulatory board feeling the need to monitor you in some other way …’

So the numbers are freely available to anyone who wants to use them to lobby on behalf of homebirth, but they remain hidden from the general public.

Finally, Ms. Block, this is not about the right to have a homebirth. Any woman can have a homebirth if she chooses. This is about the right to have accurate information so women can make informed decisions. Your 3 page Babble article is typical of homebirth advocacy information: it is filled with mistruths, half truths and outright deceptions. And it is notable for the dramatic omissions such as the failure to mention that CPMs (certified professional midwives) do not meet the educational and training standards for midwives in ANY first world country (unlike CNMs who meet and exceed those standards).

Women are ethically entitled to accurate information. If you are willing to publicly proclaim that homebirth is safe, you ought to be prepared to defend that claim publicly. Your unwillingness to do so, indeed your claim that as a non-scientist you are not qualified to do so, speaks volumes.

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