For anyone wondering whether homebirth is safe, that fact that MANA (the Midwives Alliance of North America), the organization that represents homebirth midwives, is hiding their own death rates is glaring red flag. It doesn’t take a rocket scientist to conclude that MANA won’t release the number of deaths among the 23,000 planned homebirths in their database, because the number is unacceptably high.
I have raised this issue repeatedly, and in a variety of forums, with a variety of professional homebirth advocates, and have never received an even remotely reasonable explanation. Now, I’ve been alerted to the explanation offered by Melissa Cheyney, the health of the Oregon Board of Direct Entry Midwifery and, in a massive conflict of interest, the Director of Research for MANA.
I have always maintained that MANA is hiding their death rates because they are unacceptably high, and Cheyney confirms this. The minutes of the August 5, 2010 Board meeting reports that the state of Oregon asked for the ability to retrieve information on Oregon midwives from the database:
Cheyney stated that the MANA board’s official policy is to give state-level accounts to professional organizations as a tool to evaluate areas where more training might be needed for the purpose of self regulation, and to not provide the data to regulatory entities.
In other words, the database is only to be used by MANA itself, and not shared with anyone who could potentially identify unqualified midwives and discipline them. How does MANA justify hiding that information from the very agencies (such as the one she leads) who are charged with protecting the public from unqualified or dangerous providers?
Cheyney explained that MANA suspected that, due to some state regulatory boards having very hostile relationships with midwives, the quality and quantity of data submitted might be adversely affected if regulatory authorities were provided access.
So let me see if I get this straight: If homebirth midwives knew that the number of babies who died at their hands would be reported to regulatory authorities, they might refuse to report the number of babies who died at their hands? And that’s a problem because …? Because homebirth midwives have no intention of being called to account for the babies who died preventable deaths at homebirths.
Amazingly, Melissa Cheyney (the Director of the Board of Direct Entry Midwifery, no less!) not only supports the midwives’ effort to avoid any responsibility for homebirth tragedies, she has publicly admitted that she is willing to collude with the effort to keep this information from regulatory authorities and from the public.
A board staffer asked why, if the goal is to protect midwives as individuals, MANA would not provide aggregate data so that the Board could evaluate the safety of direct entry midwifery in general. Cheyney chose to heed the old aphorism, if you can’t dazzle them with brilliance, baffle them with bullshit.
Cheyney explained that there is a critical review of data entered into the MANAstats database performed by a group of trained individuals. These individuals assist with correcting data collection errors. This review process results in a lapse in time between the aggregate data and true accurate data, which is completed after the aggregate data.
So they can’t provide the aggregate data because it takes time to ensure that the aggregate data is correct? Yup, definitely bullshit.
The state of Oregon, in the form of their Attorney General, should demand immediate access to the MANA database, and other states that license direct entry midwives [homebirth] should follow suit. It is beyond absurd to license a class of health care providers and then fail to follow outcomes. Any state that is considering licensing direct entry midwives should demand, as a condition for even considering licensure, the results from the entire database.
Homebirth kills babies. Every scientific study on US homebirth confirms this, and the statistics collected by the CDC on planned homebirth corroborate this. MANA should not be allowed to hide these deaths from the public or from regulatory agencies. If homebirth midwives want to be acknowledged as professionals, they must act like professionals. They must report outcomes and be accountable for those outcomes. Anything less is a crime.
