Homebirth and Dr. Amy in the LA Times

On the heels of the AP’s completely one sided piece about homebirth comes a piece in the LA Times that explicitly tries for balance. The effort to present both sides starts with the title, At-home birth has pros and cons.

I am quoted in the article:

“All the existing scientific evidence, as well as state and national statistics, make it ultra-clear that home birth increases the risk of death,” says Dr. Amy Tuteur, a Boston-based physician and former clinical instructor in obstetrics at Harvard Medical School who opposes home births. “What I had seen of it during my years of practice were only disasters.”


The problem with home birth, Tuteur adds, is that the distance to the nearest emergency room can sometimes mean the difference between life and death. “Saying, ‘trust birth’ is like saying ‘trust the weather,'” she says, referring to a slogan occasionally used in natural-birth groups.

The article also notes that:

Much of the opposition to home births is directed at certified professional midwives, not nurse midwives. Critics say the certification for such professional midwives is inadequate for those without a prior nursing background. (Certified professional midwives counter that their training is as rigorous as that of nurse midwives and that their programs are specifically geared toward low-risk home delivery.)

It would have been helpful if it explained that certified professional midwives (CPMs) have less education and training that ANY midwives in the first world, and would be ineligible for licensure in the UK, the Netherlands, Canada, Australia or ANY industrialized country.

And they didn’t include the quote from me that I consider most compelling:

The Midwives Alliance of North America (MANA), the organization that represents homebirth midwives refuses to release the death rate of the 23,000 planned homebirths in their database. If their data showed homebirth to be safe, they’d be shouting it from the rooftops. The fact that they won’t reveal how many of those 23,000 babies died at the hands of homebirth midwives indicates that even MANA knows that homebirth is unacceptably dangerous.

The piece includes the usual suspects extolling the putative virtues of homebirth and repeats some of the usual mistruths favored by homebirth advocates, including the claim the Johnson and Daviss BMJ 2005 showed that homebirth is as safe as hospital birth, without mentioning that Johnson and Daviss didn’t compared homebirth to hospital birth in the same year. That data (available publicly years before the BMJ paper was written) wasn’t used because it showed that homebirth had a mortality rate nearly triple that of hospital birth in he SAME year.

The power of the article is to be found in the brave testimony of Liz Paparella, a frequent commenter on this blog:

In 2009, Austin, Texas, mom Liz Paparella’s fourth child was stillborn on her living room couch because her midwife failed to take Paparella to the hospital when she began bleeding during labor.

“I never thought it was more dangerous to have a baby at home than at the hospital,” says Paparella, who had given birth successfully at home two times previously. “In birth, the risk can change from low to high in a matter of minutes.”

Homebirth kills babies … babies who didn’t have to die. All the scientific evidence, and state and national statistics are clear on this point. Most importantly, MANA, the organization that represents homebirth midwives refuses the release the death rates for the 23,000 planned homebirths in their database.

The leaders of homebirth midwifery KNOW that homebirth has an unacceptably high rate of perinatal death. Unless and until they release that information, it is impossible for any American women to make an educated decision about homebirth.