True to form, the Midwives Alliance of North America continues its deceptions about the risk of death at homebirth.
For the past 5 years, I have been relentlessly publicizing the fact that the Midwives Alliance of North America (MANA) has refused to release their own death rates. It doesn’t take a rocket scientist to realize that the death rates must be hideous, AND recognized as hideous by MANA executives.
After 5 years, and mounting pressure, MANA finally decided how to spin their hideous death rate: pretend that the hideous death rates aren’t hideous!
Isn’t that clever?
They are hoping that journalists will print their bogus conclusion, instead of the actual numbers.
The papers themselves are due to be released later today (at which point I will analyze them in depth), but the press releases include some of the numbers so we can take a look at them now.
According to Citizens for Midwifery:
The overall death rate from labor through six weeks was 2.06 per 1000 when higher risk women (i.e., those with breech babies or twins, those attempting VBAC, or those with preeclampsia or gestational diabetes) are included in the sample, and 1.61 per 1000 when only low risk women are included. This rate is consistent with some published reports of both hospital and home birth outcomes, but is slightly higher than others.
No, it isn’t “slightly” higher. It is MASSIVELY higher.
According to the CDC Wonder database, the neonatal death rate for low risk white women at term from the years 2004-2009 is 0.38/1000. As Judith Rooks, CNM MPH noted in her review of Oregon homebirths, intrapartum death among low risk babies is essentially non-existent in the hospital, so the neonatal + intrapartum death rate for the hospital is still 0.38
As the chart above demonstrates, the MANA death rate for the same years was 5.5X HIGHER. In other words, the MANA death rate was 450% higher than the hospital death rate.
On what planet is a death rate 450% higher than expected a safe outcome? Not on this planet.
MANA and homebirth midwives have been lobbying extensively for a scope of practice that includes breech, twins, VBAC, etc. Now they want to exclude those same births from their statistics. Even then, the MANA death rate is 4.2X higher than hospital birth. So even when homebirth midwives stick to low risk patients, homebirth has a death rate 320% higher than comparable risk hospital birth.
That’s hardly a safe outcome, either.
The results for various risk factors are even more appalling.
Of 222 babies presenting in breech position, 5 died either during labor or the neonatal period.
So the homebirth death rate for breech was 20/1000 compared to approximately 0.8/1000 in the hospital. That’s a breech death rate 25X higher (2400%) than the hospital.
To summarize, the MANA statistics show that homebirth as practiced in the US has a death rate 450% higher than hospital birth.
No wonder MANA has been hiding these numbers for years.