NYTimes asks: Homebirth is never safest, but can it be safe enough?

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I knew that it was only a matter of time, but sometimes it seemed as if it would take forever for the mainstream media to absorb the scientific evidence that has been around for decades: homebirth results in the deaths of babies who didn’t have to die.

The NYTimes, in its Room for Debate feature, acknowledges this increased risk in today’s featured question: Is Home Birth Ever a Safe Choice? The participants in the debate include Drs. Amos Grunebaum, Frank Chervenak and Aaron Caughey, as well ACOG representative Dr. John Jennings, Tekoa King, CNM and Marinah Valenzuela Farrell, CPM.

The pull quotes say it all.

Drs. Grunebaum and Chervenak: “In the United States, those who support home birth as safe are propagating junk science.”

Dr. Caughey: “Even in Europe, the fetal and neonatal risks are higher with home birth.”

Dr. Jennings: “The ability of a physician to rapidly provide care can be the difference between life or death for both mother and baby.”

In other words, homebirth leads to the preventable death of babies.

How do King and Farrell respond?

Tekoa King, CNM: “In Britain, women are actually advised to have children at home or in a birth center, rather than a hospital, when the pregnancy is low-risk.”

Marinah Valenzuela Farrell, CPM: “Certified professional midwives and certified nurse midwives should be licensed to practice independently in all 50 states.”

The contrast is striking. The obstetricians are concerned with babies’ lives; the midwives are concerned with money.

Here’s how I’d answer the question “is homebirth ever a safe choice?

Homebirth is NEVER the safest choice, so women contemplating homebirth need to ask themselves what risk to the baby’s life is acceptable to them.

The risk of death of a baby at homebirth is far higher than the risk of death of a baby in a car accident, so an appropriate analogy would be to ask “Is failing to buckle your infant into a carseat ever a safe choice?” The answer, of course is that it is never the safest choice, but apparently some parents believe that it is safe enough.

For me, personally the risk of not buckling a baby into a carseat, though tiny, it still too high. The risk of death of a baby at homebirth, which is much higher, is obviously completely unacceptable to me, but other women may feel differently.

Women have a right to make that choice for themselves provided that the choice is an INFORMED choice. That means understanding what homebirth midwives like King and Farrell were forced to acknowledge: homebirth increases the risk of death. Midwives who tell you otherwise are repeating the lies propagated by celebrity homebirth advocates and purveyors of junk science like the Midwives Alliance of North America (MANA), the organization that represents homebirth midwives. Their own data shows that homebirth increases the risk of death by 450%.

Most obstetricians believe that no increased risk to the baby is ever justified.

Most homebirth midwives believe that increasing THEIR income is an acceptable reason to risk the life of YOUR baby.

The obstetricians follow the Hippocratic injunction, Primum non nocere, first do no harm.

The midwives follow their own injunction, the experience of homebirth justifies putting babies at risk of death.

It may be ugly, but at least it’s honest.