An open letter to homebirth advocate Jennifer Block


Homebirth advocate and author Jennifer Block just posted a long screed on RH Reality Check asking why homebirth midwives are not taken seriously as components of a reformed healthcare system. The reasons are obvious. Homebirth increases the risk of neonatal death. Homebirth midwives are grossly undereducated. Moreover, the Midwives Alliance of North America (MANA), the trade union for homebirth midwives, is doing everything legally possible to hide their own safety data from the public.

I posted a long comment on RH Reality Check. I have repeated it here in the form of an open letter since I’m not sure whether the comment will be allowed to remain on the RH Reality Check website:

Dear Ms. Block,

As you well know, homebirth increases the rate of neonatal death. When you interviewed me for several hours the summer before last, I provided you with the evidence, and I will provide it now for your readers.

1. All the existing scientific evidence, as well as all the state and national statistics show that homebirth increases the risk of neonatal death to almost triple the rate for hospital births of comparable risk. In fact, the most dangerous form of PLANNED birth in the US is homebirth with a direct entry (lay) midwife.

As this chart shows, the neonatal mortality rate for DEM (direct entry midwife, another name for homebirth midwife) assisted homebirth is almost double the neonatal mortality rate for hospital birth with an MD. This is all the more remarkable when you consider that the hospital group contains women of all risk levels, with all possible pregnancy complications, and all pre-existing medical conditions. An even better comparison would be with the neonatal mortality rates for CNM assisted hospital birth. The risk profile of CNM hospital patients is slightly higher than that of DEM patients, but CNMs do not care for high risk patients. Compared to CNM assisted hospital birth, DEM assisted homebirth has TRIPLE the neonatal mortality rate.

The chart shows the data for 2003-2004, but the data for 2005 has recently become available. Homebirth death continues to be far higher than death in the hospital for comparable risk women. In 2005 the neonatal death rates were CNM in hospital 0.51/1000, MD in hospital 0.63/1000 and DEM attended homebirth 1.4/1000.

2. Certified professional midwives (CPM) are grossly undereducated and grossly undertrained. Unlike certified nurse midwives (CNM), American homebirth midwives do not do not meet the standards of midwives in the Netherlands, Great Britain, Canada or Australia, or anywhere else. Indeed, American homebirth midwives including CPMs do meet the standards for licensing in ANY industrialized country in the world.

3. The Midwives Alliance of North America (MANA), the trade union for homebirth midwives, has been collecting its own safety data from 2001-2008. They have publicly offered that data to those who can prove they will use it for “the advancement” of midwifery. Even then, you have to sign a legal non-disclosure agreement not to show the data to anyone else. The data is NOT available to the public. It does not take a rocket scientist to suspect that MANA’s OWN DATA shows homebirth with a CPM increases the risk of neonatal death.

Homebirth kills babies. It’s as simple as that. And no amount of pretending or hiding the data from the public changes that fact.

Amy Tuteur, MD

addendum: RH Reality Check removed this data from the comment section, as I suspected that they would. It’s all true, and they know it. I guess they figured that it was more important to hide the data from the public than to acknowledge it.

According to Brady Swenson of RH Reality Check:

“You have posted this exact same comment many times on this site. The views contained in it have been debated many times. This post that you are copying and pasting onto any post that touches on the subject of homebirth is now being considered spam and thus has been removed…”

Here’s what I wrote in response:

Indeed I’ve posted the same information before. That’s because I believe that women deserve to know it. However it has never been debated. That’s because there’s nothing debatable about it. It simply a recitation of the facts.

Obviously, you are frightened by the truth. Rather than address the data and statistics that I posted, you simply deleted them. That’s as good as acknowledging that I am correct. Thanks for the validation.