The new MANA blog: the gift that keeps on giving


I don’t know that I’ve every chortled before, but I’m chortling now. The new blog of the Midwives Alliance of North America (MANA), the organization that represents homebirth midwives, is a dream come true for me. I’m nearly giddy over the possibility of an endless stream of stonewalling and misrepresentation. If the first post is anything to go by, this is going to be a goldmine!

I wrote about the post two days ago pointing out the mistruths, half truths and outright lie in the piece. The comments by MANA executive Jeannette McCulloch trying to defend the piece are so delicious, I think they merit this follow up post.


1. I submitted the following comment to the blog:

The heart of Gordon’s piece is this:

“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).”

But the Northam & Knapp article, SPECIFICALLY says the OPPOSITE!

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

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.

There was no denial of my claim despite the fact that I basically said that Wendy had included a bald-faced lie in her piece. How could anyone deny it? If you can read, you can see that Wendy misrepresented the findings of the study.

There was no correction. Why correct it when the intent was to mislead? I guess they figure their own followers are not smart enough to understand the comments, so they can simply pretend they don’t exist.

2. When it was pointed out that failure to list place of birth on the birth certificate means that the study being discussed, the one that showed that homebirth increases the rate of stillbirth by nearly 1000%, likely UNDERCOUNTS the real rate of homebirth stillbirth, McCulloch responded with this bit of misleading information:

… [Wh]ile a small percentage of intended home birth deaths are wrongly attributed to hospital deaths using birth certificate data, a much larger percentage of home births with no injury to mother or baby are wrongly attributed to hospitals as well.

So what?

There were 200 times as many hospital births as homebirths, so even if a massive proportion of homebirth attempts ended in a live hospital birth, it would have NO IMPACT on the overall rate of hospital birth death or hospital live birth. However, since the number of women attempting homebirth is only 1/200th of that attempting hospital birth, and since death is a relatively rare outcome, leaving a few deaths out of the homebirth group would make a very big difference in the homebirth death rate.

In other words, the hospital birth death rate is basically unaffected by the liveborn homebirth transfers, while the homebirth death rate is considerably lowered by removing the deaths that occurred after transfer.

The study shows that homebirth increases the stillbirth rate by nearly 1000% and that’s an underestimate of the true rate.

McCulloch offered no denial and no correction.

3. The very best comment from McCulloch so far is the latest one, just another in an endless string bizarre excuses for not releasing their own death rates:

Thanks for your questions relating to the topic of MANAstats and how and when that data is available. We hope the following will help answer all of your questions. Please read this first before asking a question about MANAstats release, as we’re going to limit new comments on the subject to questions not answered here…

Midwives, mothers, and others interested in conducting research with MANA Stats data but who do not have academic affiliations and thus no access to IRB or ethics boards are invited to access the dataset through the DOR’s ConnectMe program. This program connects individuals with researchers for support and mentorship and provides the IRB access needed to allow non-academics to access the data while still maintaining ethical protection of research subjects. All academic journals require that researchers go through ethics or IRB review before conducting research, so this process also insures that applicants to the data set will be able to take their work through to publication if they so choose.

But NO ONE is asking to do research with the MANA death rate; they simply want to know what it is.

MANA has had no problem releasing other statistics from the database. As early as April, 2011, they went public with the C-section rate for the database and in July of 2012 they released all of these statistics from the database.

MANA stats 2004-2007

Obviously they could release the death rate, but they won’t.

Let’s be honest here: is there anyone in the US homebirth community who believes those death rates are anything other than hideous? I doubt it. Yet by refusing to release the death rate, MANA can maintain the illusion of plausible deniability and continue to fool unsuspecting women who are contemplating homebirth.

It’s only taken one post, and MANA has already resorted to “moderating” comments because they know the facts are not on their side.

As far as I’m concerned, this is just awesome. The first post contained an outright lie, which MANA does not deny, but does not correct, either, and is filled with obvious attempts to mislead readers.

Bravo, MANA! And thanks. When it comes to my campaign to abolish the CPM credential I am willing to give credit where credit is due: I couldn’t do it without you, MANA. Keep up the good work!