I told you so!


I’ve been at this for quite sometime. I started the predecessor of this blog, Homebirth Debate in 2006. Over the years, I’ve approached the issue from many different angles, but my central contention has never changed: homebirth increases the risk of perinatal death.

And now, yet another player in the homebirth debate has acknowledged the truth of that claim. In an article in today’s Wall Street Journal (in which I’m mentioned), Marian MacDorman of the CDC admits it:

Marian F. MacDorman, a statistician who studies birth trends, said that more families are choosing home birth to avoid what they perceive as unnecessary hospital interventions…

Ms. MacDorman said that planned home births might be somewhat riskier than hospital births, but that “the absolute risks of home birth are very low, no matter how you slice it.”

Apparently those hospital interventions aren’t so “unnecessary” after all.

In other words, homebirth advocates are giving up the lie at the center of homebirth advocacy: the lie that homebirth is as safe as hospital birth, and replacing it with another tactic. Yes, babies die completely preventable deaths at homebirth, but who cares, since the absolute risk of dying is still low.

As far back as November 2011, Hannah Dahlen, spokesperson for the Australian College of Midwives uttered this gem:

When health professionals, and in particular obstetricians, talk about safety in relation to homebirth, they usually are referring to perinatal mortality. While the birth of a live baby is of course a priority, perinatal mortality is in fact a very limited view of safety.

Really? On what planet would that be?

Even the Midwives Alliance of North America, the organization that represents homebirth midwives, and the organization that has hidden the death rates of its members for years is throwing in the towel. MANA executive Wendy Gordon CPM, LM, MPH, MANA Division of Research, Assistant Professor, Bastyr University Dept of Midwifery (and placenta encapsulation specialist!) wrote back in March of this year:

Let’s say that a person’s odds of getting struck by lightning in a heavily populated city are one in a million, and those same odds in a rural area are five in a million. These odds are called your “absolute risk” of being struck by lightning. Another way to look at this is to say that a person’s odds of being struck by lightning are five times higher in a rural area than in a densely-populated area; this is the “relative risk” of a lightning strike in one area over another.

A common approach of anti-homebirth activists is to use the “relative risk” approach and ignore the absolute risk, because it’s much more dramatic and sensationalistic to suggest that the risk of something is “double!” or “triple!” that of something else …

How amusing that Gordon and other homebirth advocates have suddenly discovered the difference between absolute and relative risk. The same people who have been howling about the “dangers” of epidurals (the risk of death from an epidural is less than the risk of being killed by a lightening strike), are suddenly insisting that the risk of death at homebirth, which is anywhere from 100 to 1000 times higher, is actually so small that you should ignore it.

As I wrote back in March, there are two important messages to take away from this:

Homebirth (particularly homebirth at the hands of grossly undereducated and undertrained CPMs) dramatically increases the risk of perinatal death.

More importantly, professional homebirth advocates have steadily and repeatedly lied about the increased risk of perinatal death. They should never have been trusted before, and cannot be trusted now.

Women contemplating homebirth need to ask themselves an important question: why should you trust anything that homebirth advocates have to say when they have been lying to you for years, claiming that homebirth is as safe as hospital birth, while simultaneously hiding data that shows that it leads to preventable perinatal deaths?

And let me point out: I told you so!