One thing you have to say for homebirth midwives. They have chutzpah. They are grossly undereducated, grossly undertrained, and ineligible for licensure in any first world country, but when it comes to hypocrisy and mendacity, they are second to none.
Consider the following press release sent out to news outlets by The Big Push for Midwives, a national campaign to license homebirth midwives so they can collect insurance reimbursement.
Here’s the first paragraph:
A study published this month in Obstetrics & Gynecology, the journal of the American College of Obstetricians and Gynecologists, found that barely one-third of the organization’s clinical guidelines for OB/GYN practice meet the Level A standard of “good and consistent scientific evidence.” The authors of the study found instead that the majority of ACOG recommendations for patient care rank at Levels B and C, based on research that relies on “limited or inconsistent evidence” and on “expert opinion,” both of which are known to be inadequate predictors of safety or efficacy.
That sounds bad (and it is meant to) until you understand that the rating system for clinical guidelines: A (good and consistent evidence), B (limited or inconsistent evidence), or C (consensus and opinion). In other words, there IS scientific evidence for ACOG recommendations, but not all of it is of the same quality.
What’s hypocritical and mendacious about the press release from The Big Push for Midwives?
When it comes to the practices exclusive to homebirth midwifery, 0% meet Level A guidelines!
… and 0% meetLevel B guidelines; and even 0% meet the lowest level, Level C guidelines. That’s because there is NO evidence of any kind to support the practices exclusive to homebirth midwifery.
Homebirth in the US- no evidence of efficacy or safety
Refusing postdates induction- no evidence of efficacy or safety
The Brewer diet- no evidence of efficacy or safety
Home VBAC- no evidence of efficacy or safety
Herbs – no evidence of efficacy or safety
Chiropractic in pregnancy – no evidence of efficacy or safety
I could go on and on, but you get the idea. It is both hypocritical and mendacious to send out a press release accusing ACOG of having less than perfect evidence when homebirth midwifery has no evidence at all.
The ultimate irony? The Level of Evidence for the actual paper that The Big Push is quoting, Level III, is the lowest possible level!
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