Haven't had a chance to look at the full study but this is going to be one to watch especially for those countries that have recently become less 'friendly' towards homebirth such as the US and Australia.

Looks like there will be a similar UK study coming out at the end of the year - it'll be interesting to see what their results are.


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Often times the data on these studies are one-sided. Either way, what can we do to make home birth safer, or ensure that home birth is safe for both mother and baby? To start, certain factors should be assessed, such as the mother's health. Check out this great post on Bring Birth Home about risk factors during pregnancy, and who might want to consider in hospital birth over home birth.
Not surprised that this was published in an American journal given the attitudes towards homebirth evident through its governing medical body. I'm pretty dismissive of this research - all countries have different training programs for their midwives, and the sad reality is that some of these training programs are *far* more rigorous than others. The training programs in the UK and Canada, for instance, are among the most rigorous you'll find anywhere. Canada's done its own research on this, clearly showing that there's less risk for mom and baby going the homebirth route, so we're not worried. And I'm not surprised that the UK is insinuating it needs to do its own research on the safety in their quarters - given their rigorous training system over there, I'd be shocked if the findings of this overly general comparative study still hold true there. Given that I know how publication works, it's significant that one of the leaders mentioned in this article claims an article is coming out next year that addresses the UK system more precisely. Because essentially, what that means is that the speaker *already* knows the results and is simply waiting for the study to be published (lag time between the acceptance of a paper and the publishing of it are terrible across academia). I don't think the speaker would mention the study unless it directly contradicts/challenges the findings of the study in question in the article. So the UK is likely breathing easy as well.

Sadly, I'm sure that the anti-home birth crew will be sure to use this study to convince women that home birth is for women who are prioritizing their own health above that of their child. You only need to look to the introductory sentence in this article to see exactly how this study will be abused. So instead of people realizing that their regions system of midwifery care may need to be improved, this study will be taken as gospel - it's a very damaging message, really.
I'm looking forward to some detailed analysis of this study.. Hopefully Henci Goer and others will review it soon enough. Marci I agree the UK study will most likely take a very different stance considering the UK Government is so openly pro homebirth as an option.

Another thing - I figured that Amy T, The Skeptical OB, would have something to say about this study. And I guessed right. But believe it or not, she's surprisingly candid about the serious flaws in this study.

An interesting read, at least!!!
I actually thought her analysis was really good. She simply said that it was quite flawed and pointed out the safest countries to have a home birth in. Which I don't think is a bad thing to look at. She was surprisingly moderate in her language about midwives too.
Even with outdated data, the study said that the risk for neonatal death was doubled- at 0.2%. People hear double and think that it drastically increases the odds. That's 2 babies out of 10,000 rather than 1 baby out of 10,000 and they were using data from a couple of decades ago. Not a good study, in my opinion.
I agree - I just read the overview of the article on a site called 'Medscape Nurses' - and questioned the validity of the research. Data is always suspect when it states something like "neonatal death was doubled"
What a terrible way to get your flawed research published -by scaring women who are already nervous about birthing a baby.
I'm just so frustrated with the medical community thinking they always know best about what women should do - And I'm a RN with over 30 years experience; the majority in OB. Women need to learn to trust themselves and their bodies and not take advice at face value - Question, seek information, and make informed decisions - and learn how to read and interpret research.
Additionally, the data is from different countries using different data collection methodologies.
thanks for posting these links. I'm glad to see researchers and activists responding and explaining to the public the problems with this large study. Using old studies in a contemporary research project and including births where the caregiver isn't known?!? Not okay at all - why couldn't people be above board in their research? How is the large study supposed to be useful for your average woman - most will not have access to read the full text of the study when it's out, so if their doctor manipulates this study when addressing their questions about the safety of homebirth, all were going to have are vanishing options....
Some more responses

Midwifery Today response by Gail Hart - great analysis!

Also see Michael Klein's response to data from his study being used in the




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