Monday, August 23, 2010

Facts VS Bias: An Analysis of the Wax Study

** sigh **

I have to completely re-write and re-compile all the information from a "Note" I posted on my HBMS FaceBook page, because FB "decided" that the content of my note "violated [their] Terms of Use." GRRrrrrr...
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The note itself contained nothing "hateful, threatening, or obscene," nor did it "attack an individual or group, or advertise a product or service."

Thus, I must conclude that the photo, included with the note, of naked new mother holding her newly born baby was the material considered "obscene" by FB or was reported by someone who viewed my note. This is the photo that I attached to my FB Note. Obscene, isn't it?


Well, any whooooo.... on with my "Facts VS Bias: An Analysis of the Wax Study" note...

I was recently asked by a new client about the Wax Study, "Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis." Am J Obstet Gynecol, 2010; 203(3) DOI: 10.1016/j.ajog.2010.05.028, which concludes that babies born at home have a mortality rate THREE TIMES HIGHER than babies born in hospital.

Their conclusion is controversial because many large and rigorous studies have concluded that homebirth and hospital birth have essentially the same safety for mother and baby. Some recent studies, including one from British Columbia, Canada, reported that planned homebirths actually have better outcomes for the mother compared to planned hospital births.

The study originally intended for print publication in the September 2010 issue of the American Journal of Obstetrics and Gynecology (AJOG), was published online on July 1.  Researchers and critics suspect that the early release was politically motivated to discredit midwives who attend the majority of home births in the U.S. and to discourage legislators from passing increasingly pro-midwife state legislation such as New York State's Midwifery Modernization Act (Bill S5007a/A8117b), which passed on June 28 with overwhelming bipartisan support, providing autonomous practice for all licensed midwives working in all settings.

The Coalition for Improving in Maternity Services ~ CIMS' advisor, Dr. Michael C. Klein, a senior scientist at the Child and Family Research Institute in Vancouver and emeritus professor of family practice and pediatrics at the University of British Columbia believes this is "an unabashed attempt to have poor science cover-unsuccessfully-a political agenda.  I am very surprised that the [Journal] would publish it, let alone call it 'Editors Choice'."

So, how does one know WHAT to believe with regard to research, studies, meta-analysis, etc? How does one wade through the myriad of information available on the web to discover the FACTS and uncover BIAS, and political agendas?

Well, in THIS case, it is little 'ole ME to the rescue to help my clients and others interested in understanding quality research related to the safety of home birth. Thus, we begin with an exploration of much of the discussion surrounding this meta-analysis known as the Wax Study...


OK... So, now let us look at the research, articles, discussion and blogs regarding the Safety of Home Birth:
So... I will leave the rants and raves to the scientists, researchers, writers and other Blogsters.
I have compiled quite a bit of reading material here for those interested in learning.

What I KNOW is that home birth is SAFE. Home birth is made SAFER with one-on-one midwifery care and a skilled attendant at the birth. Safer still when a second attendant is present to assist the first.

Home birthing families do not choose home birth because it is "trendy" or "cool" or because some celebrity says they should. Women and their partners choose home birth because its their BEST CHOICE. It speaks to their sensibility, to their hearts, to their intellect, to their joy, to their minds, to their partnership, to their peace, to their spirituality, to their togetherness, to their concerns, to their interests, etc... etc... etc...

Home Birth is SAFE... otherwise I, a home birth midwife of 17 years, WOULD NOT/COULD NOT do this work. It is my calling, my job, my joy, my heart, my hands, my mind, my spirit, my responsibility, my promise, to protect mother's and baby's safe passage. Within that promise is the understanding that I am only the hand-servant through which health and life passes. I am not in control, as much as I might have thought I was in my early career, I have learned life & death's lessons, bitter-sweet and beautiful. I, too, surrender to the power of birth.

Home Birth is NOT for everyone. But for those who choose to give birth with midwives at home, let not your hearts be troubled by the controversy of biased agendas. It has and always will be YOUR RIGHT, YOUR CHOICE where and with whom to give birth.
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1 comment:

  1. Kim Lane, CPM-RetiredApril 2, 2011 at 9:21 PM

    From Medscape:

    http://www.medscape.com/viewarticle/739987

    ‎"Conclusion:

    The debate over the safety of home birth is deeply divided and emotionally charged. Reliable information is required to allow productive debate and informed decisions. In an era of evidence-based medicine, it is incomprehensible that medical society opinion can be formulated on research that does not hold to the most basic standards of methodological rigor."

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