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Does the journal Nature censors comments?

It may have censored my comment. It hardly seems consistent with the spirit of inquiry that is the heart of science. But then again, when it comes to homebirth, there are some who would rather not let anyone inquire too closely.

Here’s the e-mail I receive from Nature just about an hour ago, in regard to a comment I posted 3 days ago:

Dear Amy TuteurMD,

The following post you wrote on the Nature News website has been hidden by the moderator in accordance with our terms and conditions.

It is rather ironic that while homebirth midwives attempt to discredit the Wax study, they steadfastly refuse to publish the safety data that they have collected.

MANA (The Midwives Alliance of North America) the trade organization for homebirth midwives (certified professional midwives, CPMs) spent the years 2001-2008 collecting a tremendous amount of data. Over the years MANA repeatedly told its members that more extensive safety data was forthcoming, encompassing approximately 18,000 CPM attended planned homebirths. MANA has announced completion of the data collection and publicly offered the data to others.

So why haven’t we seen the death rates for CPM attended homebirths? MANA will only reveal the data to those who can prove they will use it “for the advancement of midwifery” and even these “friends” of midwifery must sign a legal non-disclosure agreement providing penalties for those who reveal the data to anyone else.

In other words, MANA’s own safety data shows that homebirth increases the risk of neonatal death, possibly quite dramatically.

Complaints about the Wax study are a red herring. The organization that represents American homebirth midwives KNOWS that homebirth increases the risk of neonatal death. Their own data is so compelling on this point that they don’t dare release it.

The Midwives Alliance of North American has an ethical duty to release its own neonatal death rates. There is absolutely no justification for keeping this information from the American public. Rather than questioning the Wax study, we should be asking what MANA is hiding and why.

Your comment has been reported and taken down.

-Nature News Editors

A further irony is that the I wrote the comment in response to a piece by Erika Check Hayden which describes the pressure being exerted on the American Journal of Obstetrics and Gynecology and its parent company Elsevier for publishing the Wax study last summer.

“The 25,000 US women who give birth at home each year received shocking news from the nation’s obstetricians early this year. Babies born at home die within their first month of life at two to three times the rate of children born in hospitals, the American Congress of Obstetricians and Gynecologists (ACOG) declared on the basis of a review1 published in July 2010.

But the study behind the warning is not as definitive as it seemed. Before the ACOG warning, the study generated so much criticism that the journal that published it, the American Journal of Obstetrics & Gynecology, was investigating it…”

From whom did the study generate criticism? The author of the piece doesn’t say. However, we do know that just about every organization that profits from homebirth issued furious press releases denouncing the Wax study and its findings.

I placed similar comments on two other websites, Scientific American, where the piece was rerun, also 3 days ago, and Check Hayden’s blog, where she posted a similar piece last night. My full comment remains on the Scientific American website and is still in moderation on Check’s blog.

Nature News, like many other websites has a “Report this comment” function that allows readers to flag spam or abusing comments. That’s perfect for anyone who prefers to suppress the information in the comment since, rather than leading to a comment review, the “Report this comment” automatically kicks out the comments without having anyone review the report.

Therefore, I have sent the following inquiry to Philip Campbell, the Editor of Nature:

Dear Dr. Campbell,

I am writing to you in your capacity as Editor in regard to a comment that I posted on the Nature News story entitled Home-birth study investigated.

I am concerned that my comment was flagged and removed in conjunction with an effort by the Midwives Alliance of North America (MANA), the organization that represents homebirth midwives, to hide the death rates of American homebirth. My comment appeared in response to a piece that detailed apparently extraordinary pressure brought to bear on the American Journal of Obstetrics & Gynecology and its publisher Elsevier in an effort to discredit a scientific study that showed that homebirth increases the neonatal death rate.

My comment detailed MANA’s attempt to hide its own safety data:

[Full text of the comment]

The software that allows readers to report comments is often set to automatically kick out any flagged comment without regard for content. Therefore, I am writing to ask that my comment be reviewed by a staff member to determine if it violated the Nature News terms and conditions or whether it was flagged by a reader who simply wanted the fact that MANA is hiding its death rates removed from public view.

Thank you for your consideration.

I’ll let you know if there is any response. In the meantime, readers of this blog may want to comment on the “controversy” regarding the safety of homebirth at Nature News, Scientific American or Erika Check Hayden’s blog.