Homebirth hater? No, but here’s what I do hate …


I’m often accused of being a homebirth hater, as if that means that what I write about homebirth should be discounted. Apparently homebirth advocates believe only those who love it should be allowed to write about it.

The truth is, though, that I don’t hate homebirth. Homebirth is a choice that every women is entitled to make and I would never ban the choice even if I could.

I don’t hate homebirth, but here’s what I do hate:

1. I hate preventable deaths of babies.

I freely admit that I have a soft spot for babies and I absolutely abhor the idea that some babies are dying because their mothers have been convinced that homebirth is safe when it is not.

How many babies are dying?

If you look at the data from Oregon on planned homebirth with licensed midwives (the most comprehensive data ever collected on American homebirth), we find that the death rate at homebirth is 800% high than comparable risk hospital birth. While 0.6 babies/1000 die at hospital birth, fully 5.6/1000 die at homebirth. That means for every 1000 babies whose mothers choose homebirth, 5 will die preventable deaths. Even though homebirth is a fringe practice, that means that more than 100 babies die each year simply because their mothers chose to deliver them far from the expert personnel and emergency services that would have saved their lives. I hate that.

2. I hate preventable brain injuries.

While death is, of course, the worst thing that can happen to babies whose mothers choose homebirth, it’s not the only disaster to befall them. A poster to be presented at next month’s meeting of the Society of Maternal-Fetal Medicine demonstrates that the risk of brain damage due to lack of oxygen is 18 times higher at homebirth than in the hospital.

Yes, babies born in the hospital do suffer brain damage, too. But for every 100 babies who suffer brain damage in the hospital, 1800 suffer brain damage at home. I hate that!

3. I hate that the Midwives Alliance of North America (MANA), the organization that represents homebirth midwives, has been hiding their own death rates for the past 5 years.

(MANA) has assembled a database of over 27,000 homebirths attended by their members. They publicly boasted about a low C-section rate, low intervention rate and a low prematurity rate. How many babies have died to achieve that low C-section rate? For the past 5 years, MANA has REFUSED to release the death rate. You don’t have to be a rocket scientist to suspect that those death rates are hideous.

Even MANA knows that homebirth kills. They just don’t want American women to find out.

I hate that.

4. I hate that homebirth midwives (CPMs, LMs) aren’t real midwives, just lay people who couldn’t be bothered getting a real midwifery education.

The CPM and LM designations were made up by laypeople and awarded to themselves, despite the fact that they lack the education and training of all other midwives in the industrialized world. In the UK, the Netherlands, Canada, Australia, etc., you need a university level degree to practice midwifery. In the US, you need a master’s degree in midwifery. In contrast, the requirements of the CPM were “strengthened” in September 2012 to require a high school diploma.

Most women have no idea of the vast difference between real midwives (certified nurse midwives) and self-proclaimed “midwives.” I hate that.

5. I hate the fact homebirth advocates lie about the safety of homebirth in other countries.

Homebirth advocates are forever proclaiming that homebirth and midwifery in other countries leads to lower mortality rates. They point to the Netherlands, but the Netherlands has one of the highest mortality rates in Western Europe, and the perinatal mortality rate for Dutch midwives attending low risk births (home or hospital) is HIGHER than the mortality rate for Dutch obstetricians caring for high risk women.

They point to the UK where the system is led by midwives, but that system is experiencing a terrible crisis. A recent government report was scathing in its assessment that UK midwives put the lives of mothers and babies at risk.

They point to Australia where midwives published a study claiming to show that homebirth is safe even though their study found that homebirth had a death rate 5X HIGHER than comparable risk hospital birth.

I hate those lies.

I could go on and on, but I suspect that I have made my point.

I don’t hate homebirth, but I do hate that babies die preventable death and sustain preventable brain damage all because their mothers were fed lies about the safety of American homebirth, the safety of international homebirth, and the vast differences between American homebirth midwives and midwives everywhere else in the first world.

The only thing that surprises me is that homebirth advocates don’t hate those things, too.