I'm following this thread with great interest. I believe "evidence based" needs to apply equally to all practices, and I'm wanting a better understanding of the statistics at play here. To that end, I downloaded the full text of the analysis posted on Dr. Amy's website. There are a couple of things in it that strike me as extrapolation, but this part from section 2, Neonatal Morbidity:
"Alarmingly, of the 245 infants with low recorded APGARs, 69 were transferred to the hospital intrapartum, but only 66 were transferred postpartum, meaning that over 100 low-APGAR infants did not receive prompt medical attention."
in particular is confusing to me. If 69 of the 245 infants were transferred to the hospital intrapartum, then they should have counted toward the statistical assessment of hospital outcomes, no? Am I reading incorrectly? This is specified as an analysis of a 5-minute APGAR score. According to the National Library of Medicine National Institutes of Health:
"Any score lower than 7 is a sign that the baby needs medical attention. The lower the score, the more help the baby needs to adjusting outside the mother's womb.
Most of the time a low Apgar score is caused by:
Fluid in the baby's airway
If your child has a low Apgar score, he or she may receive:
Oxygen and clearing out the airway to help the baby breathe
Physical stimulation to get the heart beating at a healthy rate
Most of the time, a low score at 1 minute is near-normal by 5 minutes.
A lower Apgar score does not mean a child will have serious or long-term health problem. The Apgar score is not designed to predict the future health of the child."
This might go back to the question about various certifications and qualifications where midwives are concerned, but in my location, midwives carry oxygen and other implements, which, according to NIH would be part of the medical attention protocol, whereas the statistician above is assuming that no medical attention was given. This reads as a bias to me, but I'm not sure that I'm reading correctly.
Last edited by mama2004; 01-03-2015 at 11:51 PM.
Reason: a letter :)