Back in March, testifying before the Oregon legislature, Judith Rooks, CNM presented data that demonstrated that planned homebirth with a licensed midwife in 2012 had a death rate 800% higher than comparable risk hospital birth.

Oregon midwives have remained publicly silent on the issue, but now the Oregon Midwifery Council (OMC) has advised its members that things must change.

[gview file=”http://www.skepticalob.com/wp-content/uploads/2013/10/OMC_letter_Sept._2013.pdf”]

In a letter sent to members, President Silke Akerson wrote:

I am writing on behalf of the Oregon Midwifery Council to suggest specific rule changes to address the apparent increase in perinatal mortality with Licensed Direct-Entry Midwives in Oregon in recent years. While we know that Oregon Midwives generally provide excellent care, we also have been receiving reports of more deaths than usual in 2012 and 2013 and were deeply troubled by the vital records data for 2012 which showed a perinatal mortality rate significantly higher than what we would expect.

Higher than what she would expect? How would she know what to expect when she never bothered to check the perinatal mortality of Oregon DEMs at all, and when Melissa Cheyney, the Head of the Board of Direct Entry Midwifery, categorically refused to released the death rates Oregon homebirth collected by the Midwives Alliance of North America?

In response, the OMC recommends common sense measures that they have hitherto opposed, including:

1. Require LDMs to participate in peer review per Oregon Midwifery Council guidelines …

2. Require continuing education in risk assessment…

3. In recognition of their greater risk and the need for deeper informed choice, we recommend that you separate breech and twin births from the non-absolute risk criteria and put them in their own category with their own rules for consult and informed choice…. We recommend that the LDM be required to recommend that the client consult with a hospital based physician or CNM in order to hear risk and benefit information from a hospital based provider as well as from her midwife as part of the informed choice process. We also recommend that the LDM be required to give the client detailed and specific information about her hospital birthing options related to breech or twin births, including any options for vaginal breech or twin delivery in hospital.

Oops, it turns out breech and twins aren’t variations of normal, something that everyone else has known all along. Indeed, the legislature insisted on separate consent as of June 2011, but Melissa Cheyney and the Board repeatedly applied for extensions, at least up to July of 2012. It is not clear to me whether they ever produced a consent form in compliance with the requirements.

It appears that these common sense provisions, that should have been instituted years ago, are merely “recommendations,” not requirements. It remains to be seen whether Oregon DEMs will comply and whether the Oregon legislature will turn these recommendations into mandates.

I’m glad for the recommendations (woefully late and woefully inadequate as they are), but I find it particularly ominous that Akerson reveals that the hideous death rate of 2012 has apparently continued in 2013.

In all other circumstances, when we find that a product is particularly dangerous, we recall it and ban its use temporarily until the problems can be fixed. It is truly amazing to me that knowing what she does about the ongoing high death rate, Akerson does not recommend physician consultation for all homebirth patients until proper regulations are in place.

I never doubted for a moment that the hideous death rate of homebirth would catch up with CPMs and DEMs, and slowly but surely it is beginning to do so. What I cannot fathom is the extreme coldbloodedness that allows midwives like Akerson and Cheyney to ignore the babies that are inevitably going to die in between now and the time that rigorous standards are instituted.

I learned yesterday of yet another Oregon homebirth death, although I don’t yet have all the details. We cannot bring back the babies who have already died at the hands of Oregon homebirth midwives, but shouldn’t everyone be doing everything in their power to make sure that no additional babies die preventable deaths at homebirth?

I’d be happy to give Silke Akerson a chance to respond in a guest post if she so desires, as long as she is willing to address the fundamental question: why are homebirth midwives still practicing if they are so very dangerous?

MANA knows the death rate for Oregon and for every other state in previous years. Please sign the petition to force them to release their own death rates, which they have been hiding for years.

I could write a post every day for a hundred years and never run out of material. That’s because there’s an endless supply of sanctimommies, so impressed by their own “achievements” that they can’t see that they are making fools of themselves … or, in this case, assholes.

Exhibit A: Tracy Cassels of Evolutionary Parenting.

I’ve written about Tracy before. Like most sanctimommies, she suffers from ostentatious sadness:

To the mother who felt like a bystander during the birth of her child, I’m sorry. We failed to make sure you knew that this was your birth, not theirs …

To the mother whose baby was taken away after birth and kept in a hospital nursery, I’m sorry. We failed to make sure all hospitals have in-room boarding which is best for mother, baby, and family…

To the parents who left their baby to cry to sleep because they wanted to teach their child to self-soothe, I’m sorry. We failed to make it better known doing this actually disrupts the process by which your baby learns to regulate emotions and that your little one is still highly stressed even when he or she is no longer crying…

Surely there ought to be an award for someone who manages to squeeze so much self-congratulatory sanctimony into so few words. Tracy’s latest post, entitled Why Ending the “Mommy Wars” is Misguided and Dangerous is an exquisite example of self-parody that could easily be retitled “We aren’t ending the mommy wars until I win.”

Doesn’t it sound so lovely to say that we have to support each other as moms no matter what we do? After all, they’re just choices and isn’t each choice as valid and wonderful as the rest? If we all just accepted this, the world would be… well, what would it be? …

It would be shit.

Why? Because in very few cases are these parenting “choices” actually choices and when we try to take these acts and turn them into 100% voluntary acts by every family, we ignore the problems that lead parents to make some of the so-called choices they do…

Apparently Tracy thinks that anyone who is not copying her is being prevented from doing so. It apparently never occurs to Tracy that people aren’t copying her because she isn’t worth copying.

Some of you may be ready to jump in about how you have been bombarded by a stranger at the store while buying formula, claiming you’re poisoning your child, or something like that. Folks – that’s not a mommy wars problem, that’s an asshole problem. And sadly there are assholes everywhere and all the rhetoric about supporting each other isn’t going to change those people. But it’s also indicative of the larger problem too – by framing the issue into “choice”, this person believes you are making a true choice without knowing your individual circumstance. Maybe it is a true choice and you’ve done all your research and come to this conclusion about what’s best for you and your family taken as a whole, and that’s why the person still remains an asshole, but for many it’s not, yet that’s exactly what “ending the mommy wars” is pushing for it to be seen as.

One thing you have to give sanctimommies credit for is their utter blindness to their own hypocrisy.

Oh, Tracy, Tracy, save us from our own false consciousness! Fortunately you have seen the light!

Only now those of us who aren’t towing [sic] the line and continue to share information are viewed as the “bad guys”. Those of us who want to change things so that families are supported and given real options are accused of just trying to make people feel “guilty” or say it’s “our way or nothing”. We are heading down a path where families will have fewer and fewer true choices if we allow it. We can’t. We have to do something if we want families to really feel supported and cared for, not just given lip service to.

Earth to Tracy! Earth to Tracy! I have an bulletin for you:

We aren’t copying you because we think you are an ignorant, self absorbed fool!

We aren’t copying you because you have no idea what you are talking about.

We aren’t copying you, because we think you are wrong, in your assessment of what OUR children need, in your assessment of what WE need, and in your pathetic attempts to aggrandize your faux “achievements.”

True, you are a master of self-parody, but when it comes to mothering choices, we’ll wait and ask your children what they thought of your performance, not settle for your own dazzingly self review.

And the asshole problem? Well, Tracy, if the shoe fits …

After my talk at ACOG’s Maui conference, I was approached by quite a few obstetricians who wanted to share their stories of homebirth transfers that they couldn’t save. It seemed that even years after the fact, many doctors were haunted by what might have been: if only the homebirth midwife had understood that the baby was breech; if only she had recognized fetal distress; if only the patient had transferred to the hospital sooner. And it struck me quite forcibly that these supposedly heartless obstetricians mourn the deaths of homebirth babies far more than the midwives who presided over their deaths.

Nowhere is that more evident than in the shocking indifference of the Midwives Alliance of North America (MANA) to the deaths at the hands of their members. To say they couldn’t care less is an understatement. They don’t even bother to pretend for public relations purposes. Imagine that real medical providers such as hospitals, physician organizations or state medical societies were presented with evidence that a higher proportion of patients than expected died under their care. Whether they truly intended to do anything or not, we would expect expressions of concern, promises to investigate, committees to study the problem, etc.

MANA can’t even muster false concern. Instead, every new report of the dramatically increased death rate at homebirth attended by non-nurse midwives is met by a wall of defiance. MANA lies about what the study shows; MANA lies about previous research, MANA adjusts the comment policy on it’s blog to create a “safe space” (i.e. a truth-free zone) where supporters of homebirth can discuss it without the pesky interference of tiny dead bodies.

MANA doesn’t promise to investigate reports of the increased risk of perinatal death at homebirth. Why would they? They know from their own data that homebirth increases the risk of perinatal death.

MANA doesn’t promise to create committees to study the problem. They have no interest in solving the problem, so why would they study it?

MANA never claims to reassess the scope of practice of homebirth midwives. They are publicly on record as supporting each midwife setting her own (!) standards as if standards were personal opinions and not professional guidelines.

MANA no longer even bothers to deny the increased risk of death at homebirth. Their new approach could be summed up as “Sure more babies die at homebirth, but the absolute risk is low” as if that excuses those preventable deaths.

MANA’s indifference to these dead babies is more than shocking to me. It is downright chilling. I haven’t practiced obstetrics for many years, but I still remember the deaths of babies who we expected to live. In most cases we had already applied every piece of technology at our disposal and every bit of obstetric knowledge we had to save them, so there were no personal recriminations about not doing more. Nonetheless, I and the other physicians were profoundly moved, questioned everything we had done, and publicly presented the case to the other obstetricians and midwives in the department to be sure we had done everything we could.

No doctor or certified nurse midwife ever dared suggest that some babies aren’t meant to live, or tried to console us by pointing out that our absolute death rates were small. Had they done so, I suspect the head of the department would have fired them on the spot. Every baby counted for us and, honestly, I cannot fathom why every baby does not count for the women of MANA.

I suppose I could be grateful for MANA’s chilling indifference to the increased risk of perinatal death at homebirth. It certainly makes my job of pointing out the deficiencies of homebirth midwifery even easier than it already is. Sure, I can tell people that homebirth midwives are just laypeople masquerading as midwives, that they lack the education and training of all other midwives in the first world, that they are ineligible for licensure in any other industrialized country. But, at bottom, the most powerful demonstration that homebirth midwives aren’t healthcare providers is their casual indifference to homebirth deaths.

Actually, their reaction is worse than casual. Instead of calling for an investigation, instead of waiting for peer review of the midwife’s actions, instead of withholding judgment until all the facts are in, homebirth midwives call for a rally, raise money and wail that any attempt to hold homebirth midwives accountable for homebirth deaths is persecution and a violation of human rights.

By their actions and their words, homebirth midwives in general and MANA in particular, demonstrate their shocking indifference to the preventable deaths of babies at homebirth. I suspect that their reaction elicits a more powerful response of distrust and disgust than anything I could ever write about homebirth.

So thank you, MANA, I guess, for making my task easier. While you are cheerfully hiding the deaths of babies at homebirth, the public is recoiling in horror.

Apparently Melissa Cheyney, CPM, head of the Oregon Board of Direct Entry Midwifery and and Wendy Gordon, CPM (and placenta encapsulation specialist!) are feeling pressured by my “attacks.”

Hallelujah!

I didn’t think that either my exposure of Gordon’s lies, or my exposure of MANA’s attempt to hide their own death rate could exert any pressure on them since they don’t seem to be the least bit pressured by dead babies. From my perspective (naive, I know), there could be no greater pressure than the fact that babies are dying preventable deaths for no better reason than preserving the ability of lay people to get paid for pretending to be midwives. Every REAL health care provider that I know (physician, house officer, medical student, CNM, student CNM) would be utterly devastated by even a single preventable death, let alone dozens of them.

I find it truly mind boggling that both Cheyney and Gordon could engage in such utterly reprehensible, totally unethical efforts to keep critical information from American women. Don’t they care at all about the dead babies?

Evidently not. They have progressed from lying by omission, refusing to release the MANA death rate while simultaneously boasting about the low C-section rate that resulted in those babies’ deaths, to straightforward bald faced lies like Wendy’s whopper appearing in her MANA blog post:

This research, which claims to be the largest study of its kind, relies on data from birth certificates (known as “vital records”). What we know about using information drawn from birth certificates is that they are pretty good for capturing information about things like mother’s age and whether she is carrying twins. They are not very accurate when it comes to rare outcomes like very low Apgar scores, seizures, or deaths (Northam & Knapp, 2006).

What does the Northam & Knapp article actually say? The exact OPPOSITE.

Birthweight, Apgar score, and delivery method agreed 91.9% to 100%. The high-percent agreement supports the reliability of those variables …

Before MANA started blocking comments, I managed to ask:

So the heart of Gordon’s argument is completely untrue. And Gordon referenced the mistruth with a citation that showed the opposite of what she claimed it showed.

Do you plan to correct that misinformation?

No one denied that Gordon deliberately misrepresented the data on the reliability of Apgars and deliberately misrepresented the North & Knapp paper. How could they? Anyone who can read can see the lie for themselves. But they didn’t correct it, either, because the truth is the last thing MANA wants women to know.

Cheyney and Gordon are downright pathetic. They are far feeling far more “pressure” about being exposed as liars than they feel about behaving grossly unethical and letting the deaths of innocent babies count for naught.

I’d like to address Cheyney and Gordon directly, since they obviously read this blog:

Stop lying! Stop hiding! Stop trying to bury dead babies twice, once in the ground and the second time in our collective memories.

How dare you two lie to American women by omission or commission? I never had any doubt that you aren’t healthcare providers; I’ve always known you are lay people trying to get paid while you get your birth junkie fix, but really??!! Have you no decency at all?

Release the MANA death rates. Stop lying about existing research. Start acting like the healthcare providers you claim to be and not a bunch of selfish, self-absorbed women who casually step over the tiny bodies of babies who didn’t have to die on your way to picking up a check.

And, one more thing: If you think this is pressure, you ain’t seen nothing yet!

If the behavior of Cheyney and Gordon makes you angry, please sign the petition to force MANA to release its own death rate.

Thank you to the folks at ACOG for inviting me to address the district meeting in Maui.

It was a privilege and a pleasure to speak to nearly 300 obstetricians, medical students and CNMs, all of whom were eager to learn what they could do to prevent homebirth tragedies. As I told the group, I wish I could have taken a picture from the podium. I think many homebirth advocates would be surprised. They’d be surprised that the group was 50% women; they’d be surprised that the group was anxious to learn all they could; and they’d especially be surprised that the question I heard repeatedly, both during my talk and afterward was: “How can we convince homebirth midwives to transfer a higher proportion of their patients, earlier in labor, before it is too late to save the baby?”

Homebirth advocates also would have been surprised by the straightforward nature of my talk. All I did was tell the truth: the truth is ugly enough, and there was hardly a soul in the room who was not aware that homebirth leads to preventable deaths, because they had seen if for themselves.

The talk was not recorded, but I have posted my Powerpoint slides:

[gview file=”http://www.skepticalob.com/wp-content/uploads/2013/10/The-Homebirth-Midwife-said-What.pptx”]

You can read my notes for the talk (complete with typos) here:

Dr. Amy’s ACOG talk

The talk took over an hour plus time for questions from the audience.

My questions to the audience were these:

How many babies have to die preventable deaths before we address the misinformation spread homebirth advocates and homebirth midwives? How many babies have to die before we abolish the pathetically inadequate CPM credential?

I don’t know, but every death is a tragedy too many.

I’ve been somewhat remiss in posting updates, but I’ve had good excuses. Last week I was in Maui, speaking at the ACOG district conference. Then I took the red-eye to the West Coast to attend my son’s wedding, which was awesome.

In the interim, there have been multiple articles about the lawsuit. Mass Lawyer’s Weekly featured it on the front page, in conjunction with a similar lawsuit brought by Harvard Law Professor Lawrence Lessig, a noted authority on copyright: Cases Promise Clarity on Takedown Notices.

Two federal suits in Boston … are expected finally to answer the question of how much good faith a copyright owner must have before issuing a takedown notice under the Digital Millennium Copyright Act.

Lessig’s complaint, which is pending before U.S. District Court Judge Nathaniel M. Gorton, raises the same issues of first impression addressed last week by U.S. District Court Judge Richard G. Stearns in Tuteur v. Crosley-Corcoran, a copyright case brought by a former clinical instructor at Harvard Medical School.

Why did Prof. Lessig file his lawsuit?

Lessig’s suit concerns a keynote address he delivered in 2010 at a conference in South Korea. The lecture was about cultural developments in the age of the Internet. During the discussion, Lessig showed portions of a copycat video phenomenon that involved computer users around the world posting music videos of the song “Lisztomania” by the French rock band Phoenix. Lessig, the founder of the Stanford Center for Internet and Society who is an outspoken advocate for fewer copyright restrictions, put the lecture on YouTube. In response, the band’s Australian record company, defendant Liberation Music, sent him a takedown notice threatening to sue him for violating its copyright. YouTube took the video down, but Lessig and his lawyer … responded by filing suit under Section 512(f) of the DMCA. Co-counsel Daniel Nazar of the Electronic Frontier Foundation said Lessig’s academic lecture was “so clearly a fair use” that the record label’s takedown notice amounted to a knowing misrepresentation.

Daniel Nazar of the Electronic Frontier Foundation explains why they filed an amicus brief in support of my position:

Although Tuteur’s case involves a dispute over home-birthing, Nazar said, it raises important questions about the standard of proof needed to issue takedown notices, which is what prompted his brief and an opposing one from the Motion Picture Association of America.

“The MPAA doesn’t want to have to consider whether something is authorized by law before they seek to remove it from the Internet,” he said. “That’s a really big problem for free speech because placing the onus on the speaker to defend their critical content is not how it should be, and it is not what the law requires.”

On Monday, September 30, Mass Lawyers Weekly published an editorial on the cases, Takedown cases provide opportunity to clarify law:

The cases have received a significant amount of media attention because the objects of the takedown requests are well-known individuals with the wherewithal to fight back. Most people hit with such a notice can’t afford to get into a legal battle and simply cave.

Unfortunately for Liberation Music and Crosley-Corcoran, Lessig and Tuteur are not only prepared to litigate, they’re also prominent enough to attract amici support. In Tuteur’s case, a joint brief was submitted by the Electronic Frontier Foundation, the Digital Media Law Project in Cambridge and Harvard’s Cyberlaw Clinic.

The bad news for these defendants is good news for attorneys seeking to know where the lines should be drawn in a complicated area of the law. Currently, the correct standard is unclear: While
copyright holders must have a reasonable and articulable basis for sending a takedown notice, there’s a lot of uncertainty over what constitutes sufficient cause.

Now, because Lessig and Tuteur have stepped up, the end result could be welcome clarity where there has been little guidance.

The next step in my lawsuit is discovery, which involves reviewing documents and taking depositions. That phase must be complete by February 7, 2014.

Oregon homebirth midwives have a very serious problem. A recent analysis prepared by Judith Rooks, CNM (a homebirth supporter) showed that for a baby alive at the start of labor, homebirth increased the risk of death by 800%.

That required action on the part of homebirth advocates. No, silly, not tightening requirements for the education and training of homebirth midwives. How about restricting their scope of practice? Are you nuts? Just because babies are dying left and right at Oregon homebirths is not reason to interfere with the income stream of homebirth supporters.

Instead, homebirth partisans have moved to bury dead homebirth babies twice. First they buried them in pathetically tiny coffins. Now they are burying them in report about homebirth that includes a blizzard of numbers, all the numbers EXCEPT the most important one, the death rate of babies who started labor alive.

You can find the unabridge document here.

It is 7 complete pages and includes a variety of pages, but search for any mention of “death rate” and you will find there is NOT A SINGLE MENTION of the deaths rates.

Why does that sound familiar? Maybe it’s because it’s just like the most recent report from Colorado homebirth midwives that ALSO neglected to mention the death rates. Maybe because it’s strikingly reminiscent of MANA’s decision to publicly proclaim the C-section rate, intervention rate, transfer rate, prematurity rate, and many other rates, and in a striking coincidence, they ALSO neglected to mention the death rates. It’s almost if there is a conspiracy among homebirth midwives and their supporters to hide the death toll of homebirth from American women!!

The abridged version tries another tactic: adding in stillbirths to dramatically soften the impact of the homebirth deaths.

The term perinatal mortality rate§ for planned out-of-hospital births (4.0/1,000 pregnancies) was nearly twice that of in- hospital births (2.1/1,000).

Doesn’t that sound so much better than an 800% increased death rate for babies who were alive at the start of labor? And it’s so much less informative, too, which comports with the efforts of MANA and homebirth midwives to obtain “misinformed consent.”

The folks at the Oregon Department of Health should be ashamed of themselves for agreeing to participate in a patently unethical whitewash.

The fact remains (even if they won’t include it) that for babies alive at the start of labor homebirth increases the risk of death by 800%. That is an appalling number, only slightly less appalling than the fact that homebirth partisans are desperate to hide the number by any means at their disposal.

Homebirth kills babies. Homebirth midwives and their partisans KNOW that homebirth kills babies and they are doing everything they possibly can to hide that information from American women.

When it comes to homebirth midwives, their lack of ethics is nearly as appalling as their lack of education and skill.

Homebirth advocates in general, and the Midwives Alliance of North America in particular, love the “big lie.” They have no intellectual respect for each other and operate on the assumption that homebirth advocates will believe anything, no matter how ridiculous or outrageous, if you just say it loud enough and long enough.

For example, MANA executive Wendy Gordon CPM (and placenta encapsulation specialist!), writing in the comment section of her Science and Sensibility piece, which has been ripped to shreds. is still telling lies as fast as she can make them up.

But what seems to be clear, time and time again in the most rigorous studies on homebirth safety, is that for women with healthy low-risk pregnancies, there is no increased risk of death (however that is defined in those studies) …

That, like most of what comes from Wendy Gordon and MANA is bullshit!

Why? For a very simple reason.

Prior to the recent Grunebaum paper showing that homebirth increases the risk of an Apgar score of 0 by nearly 1000%: THERE HAS NOT BEEN A SINGLE HIGH QUALITY STUDY OF NON-NURSE MIDWIFE ATTENDED HOMEBIRTH IN THE PAST 8 YEARS!

In fact, the has only ever been ONE STUDY that specifically addressed non-nurse midwife attended homebirth, the Johnson and Daviss study, which claimed to show that homebirth with a certified professional midwife (CPM) in 2000 were as safe as hospital birth. There’s just one teensy problem. The authors didn’t compare homebirth in 2000 with low risk hospital birth in 2000 because that would have shown that homebirth with a CPM had a death rate nearly 3X higher. In order to hide that fact, Johnson, the former Director of Research for the Midwives Alliance of North America, and Daviss, his wife and a homebirth midwife, compared CPM attended homebirth in 2000 with a bunch of out of date papers extending back to 1969 when (conveniently) the perinatal death rate was much higher than 2000.

All the other homebirth papers that Wendy Gordon and MANA like to quote come from different countries where there are NO CPMs because CPMs are considered to have too little education and training to qualify for licensure in the Netherlands, the UK, and Asutralia. As it happens, those studies from the Netherlands, the UK and Australia ALSO show that homebirth increases the perinatal/neonatal death rate, too. There have been several studies of homebirth in Canada that showed that — with strict eligibility criteria, and a massively high transfer rate — deaths as homebirth could be avoided. There were no CPMs in that study, either, as Canada, which used to recognize the CPM, abolished it several years ago on the grounds of inadequate education and training of CPMs.

Of course, that doesn’t mean there has been no data on non-nurse midwife attended homebirth in the US. The CDC has noted both place of birth and attendant since 2003. They looked at birth certificates signed by non-nurse midwives certifying that they were the attendant who delivered the baby. That means they looked only at PLANNED homebirths and they found, in each and every year, that homebirth had a neonatal mortality rate from 3-7X HIGHER than comparable risk hospital birth. You can see a chart of the results below:

Moreover, the state of Oregon collected their 2012 data of planned homebirths attended by licensed midwives and had it analyzed by Judith Rooks, CNM. It showed that homebirth has a mortality rate than is 9X higher than comparable risk hospital birth.

There is ANOTHER source of data for the death rates of homebirth attended by non-nurse midwives. That’s the database of approximately 27,000+ planned homebirths assembled from 2001-2009 by MANA itself. What’s the death rate for those births? MANA REFUSES TO RELEASE THE DEATH RATE!

At this point, EVERYONE understands that the MANA death rates are hideous, even homebirth supporters. They spend their time spinning absurd reasons why MANA should release the hideous death rates, claiming that they must be “flawed” in some unspecified way that justifies hiding them.

So let’s review why Wendy Gordon’s claim that studies have shown that homebirth is as safe as hospital birth is nothing but a bald faced lie:

1. There have been NO high quality studies of non-nurse midwife attended American hospital birth in the past 8 years.

2. The ONLY study of CPM attended homebirth shows a mortality rate nearly 3X higher than comparable risk hospital birth in the same year.

3. Studies from other countries are not applicable since their midwives are far more highly trained.

4. The CDC data shows that homebirth, in every year from 2003-2008, had a neonatal death rate at least 3-7X higher than comparable risk hospital birth.

5. The Oregon data fro 2012 shows that planned homebirth with a licensed non-nurse midwife has a mortality rate 9X higher than comparable risk hospital birth.

The recently published Grunebaum study merely confirms what we (and MANA) already know: homebirth dramatically increases the risk of perinatal death.

The data is pretty clear and the MANA statistics would merely provide the coup de grace. That’s why it is important for MANA to release their own death rate.

Nearly 300 people have signed the petition to MANA demanding the release of the death rate. Please sign the petition now and urge your friends (real and virtual) to sign, too.

Let MANA know that the time for lying and hiding has passed. American women deserve to know what MANA executives know: how many of the babies in their 27,000+ database died at the hands of homebirth midwives?

I created a petition on Change.org with the (probably vain) hope of publicly embarrassing the Midwives Alliance of North America into releasing the death rate of the 27,000 homebirths in their database.

You can find the petition at Release the Homebirth Death Rate!

To:
Midwives Alliance of North America
Release the Homebirth Death Rate!

American women need accurate information to make an informed decision about homebirth. Until MANA releases the number of babies who died at the more than 27,000 homebirths attended by their members, women will lack access to critical information that they deserve.
Sincerely,
[Your name]

Several of the people who have already signed have done so in memory of babies they have loved and lost, unwittingly trusting “midwives” who never told them the real risks, the actual death rate, of homebirth.

I read yet another story of a preventable neonatal death yesterday on message board. The mother introduced herself back in March:

I’m a FTM and doing home birth as well. We made that decision when we saw the documentary “The Business of Being Born.”

My midwife said that these “complications” can be foreseen way in advance and can be fixed as long as the signs are noticed. With hospitals, they don’t keep an eye on you so they miss those signs and then rush you to get a c-section…

Last Thursday, baby Natalie died during labor, fatally compromised most likely during the pushing phase:

After 6 hours of pushing, not only was I in pain and tired but she hadn’t moved and there was meconium running down my leg which indicated that she was in stress. My midwife was still checking her heartbeat and it was a little slow. They had me lay on one side and have oxygen and that seemed to help her heart but it wasn’t helping anything else. At that time I told my midwife I was done. I couldn’t do it anymore. She tried to lift my spirits and say I COULD do this but I told her I did not want the encouragement. I was tired and I didn’t want to be in pain anymore. I wanted the hospital.

Now Natalie’s mother is left bereft and bewildered:

… By the time they opened me up, she didn’t have a heartbeat. She was covered in meconium and the umbilical cord was wrapped several times around her neck and body. They tried resusitating her for 15 minutes but she never made it.

I was in disbelief. Wait, what? But this wasn’t supposed to happen. None of this was. I was supposed to have my little baby girl at home, she was supposed to be in our arms, we were supposed to be happy. That was the plan. How could she die?

Yet another mother is left in agony for no better reason that because homebirth midwives want to preserve their ability to earn money from their birth junkie hobby, dead babies be damned.

… I want a do-over. Why can’t I have a do-over? I’ll do it right this time, I promise.

I’m sorry, baby girl. I’m sorry you were in stress. I’m sorry I didn’t know. I’m sorry you didn’t have a chance to be held and to be loved by us. All we wanted was you.

Please sign the petition to prevent tragedies like these. I have arranged it so that Melissa Cheyney, Director of Research at MANA will get an email every time someone signs.

Sign in memory of baby Natalie … and Aquila, and Marybeth, and Shahzad, and Wren and the many other babies who died because their mothers never gave informed consent to homebirth, because they never knew the death rate. Even the Midwives Alliance of North America knows that homebirth kills babies who didn’t have to die. They’ve done everything in their power to make sure that American women don’t find out the truth. Let’s end the needless, senseless deaths NOW!

There are times when I could almost feel sorry for Wendy Gordon. Her desperation to fool her followers has become thoroughly pathetic. But then I remember that it takes a special kind of unethical to trick people into ignoring a growing pile of tiny dead bodies for no better reason than that she and her cronies make their money from it.

How desperate is she?

As I’ve noted before, Wendy’s efforts to discredit the Grunebaum study that showed that homebirth increases the risk of 5 minute Apgar score of 0 by nearly 1000% are not going well. As I pointed out, the Grunebaum study comports quite well with the data from Oregon that showed that homebirth increased the risk of death by more than 800%. Others have pointed that out to Wendy, and she has tied herself into a knot trying to explain why we should ignore the correlation.

Here is her pathetic effort:

The Grunebaum study does not examine deaths, so there is no correlation to be made here.

What breathtaking bullshit! The Grunebaum study most certainly looks at deaths since only a vanishing percentage of babies with 5 minute Apgar scores of 0 will survive. Think about it: a 5 minute Apgar score of 0 means that the baby had NO HEARTBEAT for at least 5 minutes. Moreover, the Grunebaum study excludes babies who died in the hours or days after birth so it actually UNDERCOUNTS early neonatal deaths.

A 5 minute Apgar of 0 is a terrible outcome regardless of whether in rare circumstances the baby might survive with significant brain damage and/or cerebral palsy. Wendy is insisting that the two studies have nothing to do with each other because one looks at the almost certainly dead and the other looks at the definitely dead.

The Wendy proceeds to recycle her original crap:

A misclassified death in the homebirth group causes the mortality rate to swing dramatically, while a similar misclassification on the hospital side has essentially no effect.

You’ll get no argument from me that homebirth midwives are ignorant clowns, but even I don’t think they are so incompetent that they can’t tell the difference between a dead baby and a live one.

I believe that midwives are eager to understand what the evidence has to say about the safety of our model of care and the location of birth …

Oh, please, Wendy. You won’t even acknowledge that the studies are true, let alone understand why the events described actually happened.

And guess what? You know those articles “in press” that will reveal the MANA death rates next year. Well it turns out they’re not really “in press” at all.

… When I say “in press”, that means that the research articles are in the hands of the editors and reviewers of the journal to which they have been submitted.

That’s bullshit, too. “In press” means just what it sounds like: the article has been accepted for publication and is being formatted and printed. The MANA “articles” aren’t in press; they haven’t even been accepted for publication and they may NEVER be published.

But Wendy, like the rest of MANA’s homebirth stooges, is so desperate that she is willing to say ANYTHING in order to direct your attention away from the growing pile of tiny dead bodies. The entire executive board of MANA are breathtakingly unethical. The stooges who publicly lie and mislead on behalf of MANA are more concerned about protecting the income they make from pretending to be midwives than whether babies live or die. They literally do not care WHO dies in order to preserve their ability to make money from their birth junkie hobby.

Wendy and MANA’s goal appears to be making stooges out of their followers. They don’t expect to be taken seriously by anyone in the mainstream medical or scientific communities. They’re merely hoping to provide plausible deniability so their gullible followers will continue to pay them for risking their babies’ lives.

Wendy Gordon and the other MANA executives should be embarrassed at their profoundly unethical behavior, but, apparently, nothing embarrasses them. They are stooges, attempting to preserve their income in any way they can, dead babies be damned.