In 2003 the US standard birth certificate form was revised to include place of birth and attendant at birth. That makes it possible to compare neonatal death rates at home vs. in the hospital. The latest set of statistics (2008) have been released by the CDC and can be found on the CDC Wonder website. The statistics from the latest year show what the statistics have shown every year: homebirth with a non-nurse midwife increases the risk of neonatal death.
The beauty of the CDC Wonder database is that you can set the parameters to find specific information and control for various risk factors. Therefore, it is possible to look specifically at white women (almost all homebirths are to white women) ages 20-44, singleton pregnancies, at term (37+ weeks), not suffering from intrauterine growth restriction (2500+ gm). Moreover, because the data are based on who signed the birth certificate, we know that all out of hospital births with a non-nurse midwife were PLANNED births.
This year’s data is shown below:
The table shows that the neonatal mortality rate for PLANNED homebirth attended by a non-nurse midwifes (CPM, LM) is 3.5 time higher than comparable risk hospital birth attended by a CNM (certified nurse midwife). In fact, the rate of homebirth death is more than double that of MDs and their statistics include all high risk births.
Keep in mind that these statistics dramatically undercount the real rate of homebirth death. Why?
1. All homebirth transfers are included in the MD numbers. That means that any deaths that occurred after the mother was transferred to the hospital are in the MD group and not in the homebirth group where they belong. This is important because we know that many homebirth deaths occur because even being “10 minutes from the hospital” is not close enough to save a baby in a life threatening emergency.
2. Intrapartum deaths are not included in these statistics at all, because those babies don’t get birth certificates. All those homebirths where dead babies drop into the hands of unsuspecting homebirth midwives (“the heart rate was just fine a minute ago”) are not noted here.
So the real rate of homebirth death could be double or more the death rate of these CDC statistics.
The dramatic increase in homebirth death rates has been remarkably consistent over the years.
The consistency over a 6 year period demonstrates beyond doubt that homebirth increases the risk of neonatal death.
No wonder the Midwives Alliance of North American (MANA) continues to hide their death rates. How many of the 27,000 babies in their database of outcomes from 2001-2008 died at the hands of homebirth midwives? They won’t say, but the rate is probably comparable to, or likely even higher than the CDC data.
Homebirth with an American homebirth midwife kills babies. There is simply no question about it. Even the Midwives Alliance of North America knows that this is true. It’s time that American homebirth advocates stopped lying about the safety of homebirth and start doing something to reduce the number of preventable neonatal deaths.
