The Midwives Alliance of North America (MANA), the organization that represents homebirth midwives, is desperately lying about the death rate at homebirth.
No, they’re not lying about the rate of neonatal death at the hands of homebirth midwives, 2.06/1000. They are lying about what it means.
Specifically, they are attempting to conceal the dramatically increased risk of death at planned homebirth during the years 2004-2009 by comparing it to everything except the only valid metric. That metric is the death rate for comparable risk hospital birth during the same years, publicly available on the CDC Wonder website.
They know, as as I have written, that the death rate for babies of comparable risk women who delivered with a certified nurse midwife in the hospital 20004-2009 is only 0.38/1000. That means that the death rate at the hands of homebirth midwives was 450% higher than the death rate in the hospital.
I’m not the only person to use the CDC numbers. Researchers like Amos Grunebaum, MD use the same numbers to reach their own conclusions that homebirth dramatically increases the risk of death.
MANA can’t change its own hideous numbers, the same numbers it has refused to publish for the past 5 years. Instead, MANA, and executives Melissa Cheyney CPM and Wendy Gordon, CPM have attempted to discredit the the CDC’s mortality data. In a recent piece on its blog, MANA says:
Why doesn’t the Cheyney study compare home birth to hospital birth mortality rates?
It makes sense to want to draw these comparisons. However, hospital rates in the U.S. are derived from vital statistics data (birth certificates and/or death certificates). A number of organizations, including the American College of Nurse Midwives and Citizens for Midwifery have spelled out the limitations, which include a failure to capture the intended place of birth and inaccurate reporting of some outcomes. (my emphasis)
This is a lie.
MANA has received aid in propagating this lie from an unusual source, CDC statistician Marian MacDorman, a long time ally of the homebirth movement, previously a member of the Editorial Board and now the Editor-in-Chief of the Lamaze sponsored journal Birth:Issues in Perinatal Care. Indeed, MacDorman was interviewed for in a recent article about homebirth in The Daily Beast:
Most of the alarmist studies come from data pulled from vital-statistics data, from birth certificates and infant death certificates that are linked together. These administrative records “aren’t designed for research,” says Marian MacDorman, a statistician at the CDC who studies birth trends. “There are quite a few limitations in using that data for that kind of analysis.”
First, the researchers aren’t able to follow women who intend to deliver at home but later transfer to the hospital, which removes trauma patients from home-birth statistics. Then home-birth data fail to account for planned vs. unplanned births. (my emphasis)
That’s two separate lies about the data.
Indeed, the researcher who performed the first published study using the data, United States Home Births Increase 20 Percent from 2004 to 2008, noted:
Almost all the home births attended by certified nurse-midwives⁄certified midwives (98%) or “other” midwives (99%) were planned …
Who performed that study? None other than Marian MacDorman, that’s who.
This is not the only study that MacDorman has published using the CDC data. Far from it.
So the only question that remains is:
Marian MacDorman, were you lying about the validity of birth certificates in your own published papers or are you lying about it now?