Homebirth Study...

[Theoretica]

http://www.ajog.org/article/S0002-93...671-X/abstract

I just had our latest addition to the family a few days ago (at home..ahem...) and saw this. I'll read through it when I'm not so sleep deprived and chime in, but wanted to get it on here for everyone else to start perusing as well.

Thoughts?

[mitintraining]

This is strictly from their abstract! I think I am missing a few steps somewhere, how does it get its info! Where does the elevated neonatal mortality rate come from? It seems that the things involved in the positives as listed below would negate this from happening?
Results

Planned home births were associated with fewer maternal interventions including epidural analgesia, electronic fetal heart rate monitoring, episiotomy, and operative delivery. These women were less likely to experience lacerations, hemorrhage, and infections. Neonatal outcomes of planned home births revealed less frequent prematurity, low birthweight, and assisted newborn ventilation. Although planned home and hospital births exhibited similar perinatal mortality rates, planned home births were associated with significantly elevated neonatal mortality rates.

Conclusion

Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate.

[HeatherB]

Um, wait, is this the same one that came out a few weeks ago? The US one that is so badly done that its results are irrelevant? There have been other threads around on that one... And major replies from other groups/agencies involved in birth.

IIR, it didn't *actually* look at only planned home births with midwives in attendance. It was no wonder, from what they really did, that they found a higher incidence of neonatal death. I mean, it's almost like they were *trying* to pain homebirth badly...

Remember that EVERY other study done has shown homebirth to be as safe - or safer! - than hospital birth. Even the people involved in the original studies that this meta-analsysis is based on can't understand how they got their results. They did, conveniently, publish their abstract *early* before voting in NY and MA on midwifery legislation. Yeah, there's nothing weird about that at all, is there?

[EMAID]

I just tried to post a response article from the ACNM that I believe is about the study you're talking about, but it didn't work. The article is titled "The American College of Nurse-Midwives Expresses Concerns with Recent AJOG Publication on Home Birth" and is available on medscape.com. I read it on a friend's FB page, but apparently you need a password to link to medscape. Basically it said that they used poorly done studies most of which actually included UNPLANNED homebirths, and that they eliminated other studies that reflected positively on homebirth for no apparent reason. (I'd say the reason is pretty apparent though!)

[Pirogi]

Gail Hart has an excellent critique of the study at the midwiferytoday website.

I also find it suspicious that this study came out a few days before ACOG announced their changing stance on VBAC. OBs know that more and more women are waking up to the realities of hospital birth, and IMO this is just an attempt to scare and coerce women to stay in/return to the hospital.