It is not possible to say how many were told they could home birth as this data is not collected.

They key point is that you can spin the statistics any way you choose as has been clearly done in the case of this study.

If I am biased in any way it is by a deep respect for women’s right to choose how she births and my own experiences as a woman and a birthing mother.

All the references are in the article if you click on the links in the titles in the Resources section above.

“There were 2091 fetal deaths in Australian hospitals in 2006.”

…you don’t say how many of these would have been told they could home birth in the first place. Since you don’t, it’s just a number without any bearing on the current discussion. How do you know that this number would have changed if those particular women had given birth at home? Would they have been told that they probably shouldn’t in the first place?

In other words, a woman cannot look at that and answer the question: “I’ve been told I’m at a low enough risk of complications to give birth at home. What difference will it make if I decide to do that?” Because most of those 2091 would not have been in that situation in the first place.

This misrepresents the relative risk just as much as anyone else. Does that mean that you are biased by a political agenda, or financial gain?

(Also, you don’t give references for the Netherlands study, the Canadian study or others.)

“Perhaps you would like to also do a similar critique of Dr Pesce’s editorial in the Medical Journal of Australia?”

There’s plenty of criticism and discussion there already, and not much I could add.

Perhaps you would like to also do a similar critique of Dr Pesce’s editorial in the Medical Journal of Australia?

Don’t a lot of the risk factors that would indicate some of these outcomes form part of the decision to have a home birth in the first place? If there are well known factors that indicate that a birth might be risky, wouldn’t the mother be more likely to forgo a home birth? And therefore the results for hospitals are far more conflated with these factors than home birth results are? Or have I missed something in your analysis? I admit I haven’t taken the time to read through most of the references.

Also, take the statement: “the outcomes for mothers and babies are vastly improved by choosing to birth at home,” — is this really universally applicable? If every mother chose homebirth, would that really be safer every time?

“Women will continue to home birth as they have done for centuries” — I don’t think that this is a particularly compelling statement, and has some really terrible connotations. It’s hard to get good numbers, but the rate of complications and mortality was pretty high even 100 years ago. (Of course, *that* difference is due to both medical advances and general sanitation levels, and separating those two factors is not something I really want to try myself.) Not sure about 500 years, since they didn’t have the internet back then.

Claims that the AMA are conspiring against you are really adversarial. If they took out ads in the paper, then maybe it’s warranted (although I guess it’s not really a conspiracy then, is it?). But equating disagreement on the interpretation of some difficult-to-interpret studies to an actual conspiracy? It just comes off as ad-hominem. It’s the work of medical professionals in the first place that allow women to have the information they require to safely make the decision to have a home birth. It’s also their work that allows women who have higher risks of complications to lower those risks during a hospital birth. Setting up this “us vs. them” culture — and underestimating the power of that kind of culture — really undermines the efforts of anyone trying to get people to just listen to the numbers. All of a sudden it’s not about the numbers, it’s about where they came from.

I agree with you that the newspaper headline writers are morons, though. I think we can all agree on that.

Unfortunately we can make no such assumptions from this study – and that is one of its many flaws. Any woman who planned to have a homebirth when she started prenatal care was included in the planned homebirth group. She may have changed her mind and chosen to birth in hospital for any reason at any time during her whole pregnancy and labour and if her baby then died, it is recorded in this study as a planned homebirth fetal death. To be more accurate a study like this should only include women who planned a homebirth at the start of their labour. There were actually 7 babies who died in a hospital birth who were included in the planned homebirth group, not 5.

There is no analysis of the 2447 babies who died in hospital in the same period. Rather the study concludes from 2 babies who died at home in 16 years that homebirth is 7 times more likely to result in a dead baby and a baby is 27 times more likely to suffer intrapartum asphyxiation in a planned homebirth.

The key point is that you can spin the statistics any way you want if you have an agenda to push which is what the AMA and the authors have clearly done.