Why is Lamaze desperate to pretend homebirth is popular when it’s not?

25327384 - lies damned lies and statistics quotation isolated on white background

In a new post, the folks at Lamaze are crowing about homebirth statistics that purport to demonstrate the “popularity” of homebirth Look at Home Birth Trends – The Results May Surprise You!.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Lamaze is a special interest lobbying group that depends on convincing women that its prescriptions for childbirth are the ones you should buy.[/pullquote]

  • 58% increase in the number of home and birth center births in the period of 2004 to 2014. In 2014, over 56,000 births took place out of the hospital.
  • Since 2004, there has been a rapid increase primarily in the number of white non-Hispanic mothers choosing home birth.
  • By 2014, there is a significant number of states who have home birth rates over 1%, primarily clustered in the Northwest, some of the Midwest and in Maine,Vermont and Pennsylvania.
  • In 2014, Certified Professional Midwives (CPM) attend almost half of all out of hospital births. Certified Nurse Midwives/Certified Midwives (CNM/CM) attend just about one quarter of the out of hospital births. 27% of births were attended by “Others” which probably indicates situations where home birth midwifery is illegal or alegal. Dr. Declercq assures us that the “Others” are not taxi drivers!
  • In 2014, 98% of CPM attended home births were planned to be at home, and 99% of CNM attended home births were planned to occur at home.

They’ve helpfully included a graph to illustrate the trend:


That looks impressive until you realize that they’ve left out the rate of hospital birth. I’ve added hospital birth and the resulting graph is far less impressive. Indeed, out of hospital birth is an uncommon fringe practice which has grown to become … an uncommon fringe practice.


Lamaze is so desperate to pretend that homebirth is popular that they’ve included UNPLANNED out of hospital births in the mix. Dr. Gene Declercq insists that the 27% of out of hospital births attended by “Others” were not attended by taxi drivers, but he has absolutely no way to know that. These aren’t even necessarily term births and it is far more likely that those births happened by the side of the road or were attended by EMTS.

That’s doesn’t capture the full extent of Lamaze and Declercq’s duplicity.

First, the death rates are conveniently excluded. The aim is to promote homebirth by convincing women that “everyone” is doing it because it is both safe and delightful. Including the death rates would have been a bummer since a recent study in NEJM showed that PLANNED out of hospital birth at term has double the death rate of comparable risk hospital birth and the best homebirth data, out of Oregon in 2012, show that planned homebirth with a licensed homebirth midwife has a death rate 800% higher than comparable risk hospital birth!

Second, Lamaze has gone on the record as dismissing the bulk of the studies that show that homebirth has a death rate up to 800% higher than hospital birth because they are based on birth certificate data. As recently as March of this year, a Lamaze blogger wailed about Flaws In Recent Home Birth Research May Mislead Parents, Providers. Apparently, parents and providers are supposed to ignore the appalling death rates at homebirth because they are based on birth certificate data and birth certificate data is supposedly unreliable.

Because the number of home births in the U.S. is small, the inclusion of … unplanned, unattended home births in the “home midwife” category is likely to have an appreciable effect on the negative outcomes examined here.

Yet today’s post claims just the opposite about the reliability of birth certificate data.

In 2014, 98% of CPM attended home births were planned to be at home, and 99% of CNM attended home births were planned to occur at home.

Which is it Lamaze? Is birth certificate data unreliable, in which case you should not be making claims about the increased popularity of homebirth, or is it reliable, in which case you must acknowledge the appalling death rate at homebirth?

Let’s leave aside the duplicity for a moment and ask a more fundamental question: why are midwives and other birth workers in general, and Lamaze in particular so desperate to promote homebirth when it is a fringe practice rejected by more than 99% of women? Shouldn’t they be supporting women’s choices, not trying to change them?

Homebirth is exponentially more popular among midwives, birth workers and organizations like Lamaze that represent them than it is among women because the benefits of homebirth accrue to the workers and organizations and the risks are carried nearly entirely by women and babies.

  • Midwives et al. love homebirth because they profit from it; it costs a fortune (as much as $5000 or more out of pocket).
  • They love it because it gives them autonomy to do what they want; there are no safety standards of any kind.
  • They love it because it allows them to worship at the altar of “normal birth” the holy grail of natural childbirth advocacy.
  • They love it because they bear no responsibility for outcomes. Your baby ends up brain damaged or dead? Don’t look to them for help; they don’t bother to carry malpractice insurance to protect mothers and babies because it cuts into their profits.

Lamaze is desperate to pretend homebirth is popular because it is a special interest lobbying group that depends in large part on convincing women that its prescriptions for childbirth are the ones you should buy.

Lamaze couldn’t care less that homebirth kills babies; indeed they actively try to suppress and discredit the growing body of scientific papers that repeatedly demonstrate the deadly risks of homebirth. They figure you’re gullible enough to believe their crude and dishonest attempts to manipulate you. And if your baby is injured or dies as a result? It’s not their problem; it’s yours.

They’ll add your baby’s birth certificate to their statistics to claim that homebirth is popular, and ignore her death because birth certificates are “inaccurate.”