The top 5 reasons to ignore homebirth deaths

Dead babies are difficult to sweep under the rug. Everybody notices.

The standard strategy of homebirth advocates is to claim that homebirth is as safe as hospital birth. They point to poorly done studies published by those with a vested interest in promoting homebirth. They compare mortality rates at homebirth with high risk hospital birth. They point to international comparisons of infant mortality (which is a measure of pediatric care, not obstetric care). You can fool lots of laypeople with that misinformation, but it’s not particularly persuasive when there are repeated reports of homebirth deaths.

On Mothering dot com there is approximately 1 homebirth death per month and has been for years. National mortality statistics for homebirth midwives are dismal and individual states like Colorado have truly appalling death rates at homebirth. Perhaps most difficult to sweep under the rug are the individual stories of homebirth deaths such as those recounted in The Daily Beast or on personal blogs. As much as homebirth advocates would like to pretend that these deaths don’t happen, they can’t pretend that these stories are not real. At that point, the fallback strategy is to insist that these homebirth deaths don’t count.

Although homebirth advocates have many reasons for ignoring homebirth deaths, some reasons are more popular than others. What follows is a list of the “Top 5 Reasons to Ignore Homebirth Deaths.” Feel free to suggest others that should be added to the list.

Number 5: It was the mother’s fault.

This is always the first reason. We should blame the mother because …

… the baby was breech; there were twins; it was a VBAC. Never mind that homebirth midwives in states like Oregon insist that these women are not high risk. If the baby dies, suddenly risk becomes important.

… the mother ignored the midwife. The story typically does not mention that, but homebirth advocates love to pretend that is what happened and then rhapsodize on the midwife’s professional obligation to attend the patient anyway.

… the mother dared to complain that her baby died. This isn’t the cause of death, but it shows that the mother is a bad person and we don’t need to be upset that her baby died.

Number 4: It was the midwife’s fault.

Surely the midwife must have handled the situation improperly. A “good” homebirth midwife never has a perinatal death, so the fact that the baby died “proves” that a bad midwife was attending in this case. All the other homebirth midwives in the world, with the exception of this midwife, are safe practitioners.

Number 3: This baby would have died in the hospital.

This excuse is almost always rendered in the following fashion: “We don’t really know the details in this case; it’s just as likely that this baby would have died in the hospital.” In other words, it’s basically the baby’s fault and no one could have saved it. There’s never any explanation as to why the hospital would not have been able to save this particular baby. No real explanation is ever needed in order to counsel others to ignore the death.

Number 2: Some babies died in hospitals.

Okay, maybe this baby could have been saved at the hospital, but so what? Some babies die in the hospital, right? Therefore, that proves that giving birth in the hospital is just as dangerous as giving birth at home.

Umm, no it doesn’t. Yes, some babies die in the hospital, but those babies are almost always premature or have congenital anomalies incompatible with life. The issue is not whether some babies die in hospitals, but whether babies die of preventable causes in the hospital.

This also ignores the fact that MORE babies die at home than in the hospital. More dead babies means homebirth is more dangerous. The fact that some babies die in hospitals tells us nothing about the relative safety of homebirth and hospital birth.

And the Number 1 reason why we should ignore homebirth deaths: Babies die.

Homebirth advocates express a surprising amount of fatalism about homebirth deaths. The following comment is representative of this viewpoint:

First of all, Amy, babies (and mothers) die. It’s a fact of life. You will never have 100% survival rate. So what’s acceptable? Knowing that there was nothing that could have been done or that if you had have done something, you may well have ended up with a baby that was so damaged, it would have been better off dead. For others, it’s knowing that it’s God’s Will. You are arguing against religious and personal freedom by saying that we should treat all women the same.

Weitz and Sullivan quote a homebirth midwife in Licensed Lay Midwifery and the Medical Model of Childbirth:

Basically one of the things I object to about the medical profession is their one hundred per cent rule, their unwillingness to accept the fact that sometimes people are just supposed to die or babies are just supposed to die or that there is a place for less than perfect and less than one hundred per cent.

So there you have it, folks. No need to worry about those dead homebirth babies. It was the mother’s fault. Or maybe it was the midwife’s fault. Or maybe it was the baby’s fault. If all else fails, just declare that “babies die.” It’s sad, but “shit happens.” Sure a lot of “shit happens” at homebirths, but that doesn’t mean that homebirth isn’t safe, does it? Does it? Nah … it’s just an unfortunate coincidence.