Whoa.. What? (Higher Newborn Death Rate w/ HB)
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Thread: Whoa.. What? (Higher Newborn Death Rate w/ HB)

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    Posting Addict OneLuckyScoop's Avatar
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    Default Whoa.. What? (Higher Newborn Death Rate w/ HB)

    Very recent article on how there is a higher newborn death rate linked to home births.
    http://www.webmd.com/baby/news/20100...orn-death-rate

    Kind of goes against everything I have heard previously.. What the...?

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    Mega Poster krazykat's Avatar
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    One question I would have: Does this include parents who are aware that they are having a stillborn child, and plan to deliver quietly, within the comfort of their own home, or people who know they will likely lose the baby soon after birth, and choose not to fight mother nature (there are folks out there)? I don't think that birth certificates give enough medical information to be a totally reliable source, and that is where they have gotten their numbers from. Interesting... but I would bet there are quite a few hidden factors there as well.
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    Posting Addict momW's Avatar
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    My first reaction is WTF!!!

    But on a side note there was one quote in there that I wish was closer to the top of the article or at the very least on the 1st page.

    Kimberly D. Gregory, MD, MPH, vice chair of women's healthcare quality and performance improvement, department of obstetrics and gynecology at Cedars-Sinai Medical Center in Los Angeles, says the findings will have little impact on the rate of home births.

    “Those women who are truly motivated are going to do it despite the odds, and most will do well and have a good outcome. It would be great if women (and clinicians) could take this message as evidence to encourage more ‘natural’ management of the birth process in a hospital where resources would be available if needed in an emergency.”

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    Posting Addict OneLuckyScoop's Avatar
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    I just don't get it either.. and besides, other than listing "names" -- there were no actual sources listed for the article. Not like a genuinely researched article would include so you know where exactly they got their facts.

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    Super Poster DJMandyB's Avatar
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    I don't like where they got their data from either. There is a large variety of "planned home births". I wonder what the number would be if it was "planned home births" that were attended by certified/licensed midwife or similar professional, and as Ariel said, with planned stillborns removed.
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    Posting Addict mommys's Avatar
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    Interesting article. Not good references, a few good points though. Nice that it wasn't all negative.
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    Mega Poster krazykat's Avatar
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    Quote Originally Posted by DJMandyB View Post
    I don't like where they got their data from either. There is a large variety of "planned home births". I wonder what the number would be if it was "planned home births" that were attended by certified/licensed midwife or similar professional, and as Ariel said, with planned stillborns removed.
    Yes, that is a good point as well about the attendants. If I remember correctly in my studies, birth certificates listed as homebirth also include accidental, unattended births and everything in between like the road-side scenarios, etc. I do wish they had provided resources like you said... it would make it possible to figure those variables out.
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    Posting Addict OneLuckyScoop's Avatar
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    To me, the article just seemed incredibly bias. It didn't seem well rounded at all.

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    Prolific Poster Winky_the_HouseElf's Avatar
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    It isn't a new study. It's an analysis of several other studies. (Some of those studies at very old.) Here s a good article about it:

    http://www.cbc.ca/health/story/2010/...hs-safety.html

    Unfortunately, I know some home birh midwives are practicing outside their scope of practice by staying home with moms and/or babies that would be safer in a hospital. I'm not talking about gray areas like VBAC where some mothers are good candidates for home birth. There are some midwive in my community who encourage staying home even in situations where it is very obvious that hospital care would be more appropriate. My SIL's midwife had hours and at least four very good reasons to transfer, yet she continued to say they could stay home. My nephew was born dead (in the hospital because my SIL insisted on transport at the last minute), but then revived. He has brain damage because of it. I have no doubt that his chances for a good outcome would have been higher with timely appropriate transfer of care. My SIL very much wishes that her mw had transferred her sooner, even though a c-section would have been the probable outcome.

    Now, I have had four home births and one of those very nearly was an emergency transport during labor. It was a $&@$ hits the fan sort of situation where my mw and I had to decide the fastest way to get my baby out safely. I chose to just push her out as quickly as possible because that seemed like the faster option. It worked and we were both very glad. I don't see how I could have gotten her out any faster even with a hospital transfer and a c-section, unless I had already been in a hospital. Considering my labor was only 3 hours, I'm not sure I would have been there.

    Anyway, my point is that if home birh infant mortality rates are higher, it may be because of mws who insist on or recommend staying home even when there is time and medical indication to transfer. Obviously, babies die in hospitals from medical interventions and mismanaged care, too. All of this emphasizes the importance to me of asking lots of questions about a particular caregiver's statitics AND to continue to ask questions during the birth. My mw gets some flack for having a higher transfer rate than other mws, but I feel more comfortable with her approach of erring on the caution. There shouldn't be a contest to see who has the lowest transfer rate, but sometimes it feels like "My transfer rate is lower because I trust birh more." That is an unsafe attitude, IMO. Also unsafe is the idea that more interventions always equals more safety. As usual, somewhere between these two extremes is the safest place to be.

    Well THAT turned into a rather long-winded rant!
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    Posting Addict momW's Avatar
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    I wonder too though if hospital mortality rates aren't a little under their mark. They can resuscitate babies with better equipment than a homebirth attendant. However, how many of those babies don't make it past 1 week or 2 months or 1 year and live on life support or various technological advances for that time. I'm not saying it's wrong, I'm just asking for more. I don't like to read studies of studies. I think a lot of information gets left behind, left out or just flat out isn't known to the authors. There's too many questions you can ask about the results, on either side. But the media and people with herd-like instincts will take it as the Gospel because AJOG published it.

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