Stupidest excuse for homebirth deaths ever


Logic has never been the strong point of homebirth advocacy. That’s not surprising, since the central premise, that giving birth at home attended by a pretend “midwife” is as safe as giving birth in the hospital, defies both common sense and basic fact. Therefore, I’m used to goofy, illogical excuses from homebirth advocates confronted with appalling death rates.

Apparently desperate times call for desperate measures, however. Homebirth midwifery is entering a period of desperate times because homebirth midwives can no longer hide their hideous death rates. States are starting to collect the statistics on planned homebirth attended by licensed midwives and the results are nothing short of appalling. In Colorado, licensed homebirth midwives have a perinatal death rate more than double that of all hospital birth in the state (including premature babies). Most recently, the Oregon homebirth death rates have come to light. Planned homebirth with a licensed homebirth midwife in Oregon has a death rate 9X higher than term births in the hospital.

I brought up this point in a the comment section of the latest post by homebirth advocate Jennifer Margulis. The post is entitled When Obstetricians Hate Homebirth Midwives, Birth Becomes Less Safe For Everyone and it is the usual amalgam of mistruths, half truths and outright lies favored by all homebirth advocates. The fundamental problem with the post is that is has the cause and effect relationship entirely backward; obstetricians hate homebirth midwives (to the extent that they think of these fringe “providers” at all) because they are incompetent clowns who have horrifically high death rates.

The post itself is the worst kind of “journalism,” with its unsourced claims (“The government official (who spoke to me off the record)”), ignorance of childbirth (“Doctors in America are trained to believe that birth, even low-risk birth, is dangerous.” A glance at homebirth death rates confirms that even low risk birth IS dangerous), and outright lies (“Most American obstetricians have never even seen an unmedicated childbirth when they finish their residencies;”).

When I challenged Margulis to defend that lie, she could not. Then I moved on to the heart of the issue:

I’d also like to know why Ms. Margulis fails to acknowledge the hideous death rates at planned homebirth with licensed homebirth midwives in Colorado (4x term hospital birth) and Oregon (8x higher). No less an authority than Judith Rooks CNM MPH publicly testified that Oregon homebirth midwives are not safe providers.

And Margulis responded with the stupidest excuse for homebirth deaths I have ever heard:

Amy, Oregon has some of the safest best homebirth stats in the country IF YOU DON’T COUNT PORTLAND…

Duh. Homebirth is apparently very safe if you just remove the dead babies from your calculations. And what reason does Margulis provide for removing Portland from the calculations? None, of course. She hoping that homebirth advocates are stupid enough to be persuaded by that inane excuse, or, worse still, perhaps she actually believes that it is a valid excuse.

My response:

You’re joking, right? That has to be one of the most inane excuses I have ever heard. Of course Portland has most of the deaths; it has most of the homebirths. You can’t exclude it no matter how much you’d like to pretend that you can…

Homebirth midwives are not professionals. What kind of professionals, when confronted with an appalling death rate at their own hands, try to hide it and make absolutely no effort to improve their education and training? Homebirth midwives are lay birth junkies who lack the education and training of ALL other midwives in the first world. Their hideous deaths rates are evidence of their gross incompetence. Why are you defending them?

Margulis reponds with a nonsensical non-sequitur:

Good question. If you ask Marsden Wagner, MD, a perinatologist and perinatal epidemiologist from California and director of Women’s and Children’s Health in the World Health Organization for 15 years, he will tell you: Doctors.

And then goes on to share a McCarthy-esque claim

I have a binder of over 1,000 pages of evidence about the safety of out-of-hospital delivery in Oregon. I suspect you will discount this as evidence.

As if we should accept the blustering of “an award-winning travel, culture, and parenting writer” over the epidemiological analysis of Judith Rooks, CNM MPH.

She insists:

Dr. Melissa Cheyney is a careful and scrupulous researcher. I have a high regard for her work…

Melissa Cheyney has behaved with an appalling lack of ethics, professional or otherwise. She has known for YEARS that homebirth midwives in Oregon and across the US have horrific death rates and she has done everything in her power to hide that information.

Margulis concludes:

Let me try one more time: I would like for everyone who cares about birth in America, as you and I both do, to try to remember that we all want the same thing: the best possible outcome for mom and baby, a safe and happy birth, and a good start in life.

Actually, we don’t want the same things. Homebirth midwives and homebirth advocates couldn’t care less about the best possible outcome for mothers and babies. When babies die they ignore them, try desperately to hide the evidence, and make absolutely no effort to improve their education and training or hold responsible midwives accountable. When it comes to homebirth, midwives profit and babies pay the deadly price.

I am used to stupid excuses from homebirth advocates, but when confronted with the appalling death rate in Oregon, Jennifer Margulis offers the goofiest excuse yet. I had expected something more from Margulis than the intellectual equivalent of covering her eyes, putting her fingers in her ears and pretending that the deaths of these babies don’t count. My mistake.

Addendum: Surprise! Jennifer Margulis forgot to mention that her husband James di Properzio is a lay member of Oregon’s Board of Direct Entry Midwifery. Did she get her 1,000 pages of documents from him? Does this mean that she is publicly challenging the analysis of Judith Rooks, CNM MPH? I wonder what Rooks’ would say about Margulis’ pathetic attempt to excuse the hideous homebirth death rate in Oregon, and the blithe dismissal of Rooks’ conclusions.