Pushing back against home-birth critics

British and Australian midwives are pushing back against a recent editorial in The Lancet, a British medical journal, which builds on a study released last month that appears to show that home births are less safe than those that occur in a hospital.

"Women have the right to choose how and where to give birth, but they do not have the right to put their baby at risk," stated the unsigned editorial from July 31.Pregnant Graffiti

In an interview today with the Guardian, a British newsaper, Cathy Warwick, the general secretary of the Royal College of Midwives, said that midwives believe home birth is "being unfairly pilloried by some sectors of the global medical maternity establishment."

Hannah Dahlen, the president of the Australian College of Midwives, weighed in as well. "Intense medical lobbying and strategically released journal articles" had put midwifery in her country "in the hands of the medical profession," she said.

Warwick said, "What shocked us about The Lancet editorial was its language and tone and how it pumped the hype about the dangers of home birth, and made sweeping and misogynistic statements."

"The Lancet said it stood by its editorial," wrote Randeep Ramesh in the Guardian article.

The impetus for the piece in The Lancet was a meta-analysis scheduled for release next month in the American Journal of Obstetrics and Gynecology, a peer-reviewed journal published jointly by a number of organizations that includes the Society for Maternal-Fetal Medicine. The meta-analysis was presented at the SMFM meeting in Chicago in February.

The article, published on-line last month, "provides the strongest evidence so far that home birth can, after all, be harmful to newborn babies," according to The Lancet editorial.

Home births account for about 3 percent of births in the United Kingdom, according to the article in The Lancet; in the United States, the figure is about 1 percent.

American midwifery groups and out-of-hospital birth advocates like The Big Push for Midwives have already questioned the findings of the AJOG article.

The Coalition for Improving Maternity Services called the report a "poorly designed and methodologically unsound study," expressed itself "outraged" that AJOG accepted it for publication, and suggested the report was rushed on-line as a ploy to stop legislation then pending (since signed into law) in New York that will make the practice of midwifery easier in that state.

"Pregnant Graffiti" by Petteri Sulonen

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