Midwives on the march

So, The Lancet publishes a paper which shows that home births have a three times greater risk of death of the baby.

Midwives are outraged.

Then we get obstetrician saying that perhaps a quarter of births are suitable for home births. Midwives point to Holland where the mortality rate is very low which has one third of births at home.

However, the argument from the midwives does really seem to be in ideological terms.

She said midwives now \”feel there is a concerted and calculated global attack and backlash against home birth which is being unfairly pilloried by some sectors of the global medical maternity establishment.

\”There is a danger that risk during childbirth is presented in a way which is leading women to believe that hospital birth equals a safe birth. It does not. There is no hard and fast guarantee that a woman will have a safer birth in a hospital than at home\”.

There are concerns globally that midwives, who have long campaigned for mother-friendly births, have lost ground in recent years. Hannah Dahlen, the president of the Australian College of Midwives, backed her counterpart in Britain saying that \”intense medical lobbying and strategically released journal articles\” had put the profession in Australia \”in the hands of the medical profession\”.

Warwick said there has been a trend for some doctors to cast birth as a \”medical problem and not a natural process\”.

OK, maybe it\’s ideology and maybe it\’s a power struggle but do note that the one set of numbers they don\’t argue against, don\’t even attempt to show to be wrong is….whether or not a home birth carries a higher risk of death of the baby.

Wonder why?

Or am I just being excessively male with my insistence upon facts rather than how people feel?

8 thoughts on “Midwives on the march”

  1. Brian, follower of Deornoth

    “insistence upon facts rather than how people feel”.

    Quite, you heartless beast. Didn’t you know in right-on land that feelings are facts? That all you have to do is really really want something to be true, and it becomes true?

    And there are you, nasty sceptic, sending out all the wrong feelings and counteracting the desires of dozens and dozens of right-thinking people.

    There should be a law against it.

  2. I have a friend who is a paedeatrician. When he and his wife had their first child he went to pre-natal classes. He was told he needed to pretend he did a different job as the teachers of these classes don’t much like doctors. He pretended to be dustman (sorry, domestic refuse collection co-ordinator).

    He was subjected to a load of dirge about how 1000s of years ago on the African savannnah we didn’t have things like epidurals and nature should just be allowed to take its course.

    When he pointed out that the average birth weight on the African savannah would have been about 60% that of a modern British baby and there would have been a c.35% death rate for mothers and children he was kicked out of the class for being unhelpful.

  3. Or am I just being excessively male with my insistence upon facts rather than how people feel?

    Professor Warwick, general secretary of the Royal College of Midwives, said, “What shocked us about the Lancet editorial was its language and tone and how it pumped the hype about the dangers of home birth, and made sweeping and misogynistic statements.”

    I can’t see anything at all misogynist in the editorial.

  4. More here from Straight Statistics blog:

    http://www.straightstatistics.org/blog/2010/08/16/angry-midwives-turn-flawed-evidence

    “”
    The Lancet’s editorial, she said, “pumped the hype about the dangers of homebirth, and made sweeping and misogynistic statements such as “Women do not have the right to put their baby at risk.” The exaggeration of risk in childbirth “highlights the way women can be persuaded and frightened into making choices they don’t want”.
    “”

    Saying “Women do not have the right to put their baby at risk” is an “ought” statement, which you may or may not agree with.

    I for one say that women definitely **DO** have the right to put their baby at risk.

    Saying anything else is an open invitation to the State to meddle in every aspect of our lives. Horse riding lessons? No better way for a child to break her back. Skiing? Lots of people die like that.

    The parents are the right people to decide what risks their children should run, starting with childbirth.

    Cheers,
    Ben
    (Father of 3, all by ceasarean. That woman makes me so proud.)

  5. Ben,

    Surely ‘it depends’ (as ever)?

    Exercise of state power is warranted if it is to prevent harm to others.

    The public is quite satisfied for the state to interfere when kids are at various kinds of risk. Suppose the risk of a child dying during home birth is 95% (obviously it isn’t) and hospital birth 1%. Wouldn’t it be justifiable for the state to ban home births?

  6. “Suppose the risk of a child dying during home birth is 95% (obviously it isn’t) and hospital birth 1%. Wouldn’t it be justifiable for the state to ban home births”

    It isn’t though, is it?

    You can’t say “it depends” about propositions with *known factuality*.

    Yes if a ludicrous counterfactual was true, an horrendous immoral proposition would follow.

    But it isn’t, and it doesn’t.

  7. You can’t say “it depends” about propositions with *known factuality*.

    My claim that “it depends” was in response to your assertion that “women definitely **DO** have the right to put their baby at risk.”

    Because they definitely don’t, even disregarding “ludicrous counterfactuals”.

  8. Since it is an “ought” question I am unlikely to persuade you.

    I don’t think you really mean a pregnant woman doesn’t have the right to drive, fly, ski, or even drink or smoke in moderation. Probably you think those risks are small enough.

    But who decides how much risk is too much?

    My answer: She does.

    Which is the same as saying she has the right to put the baby at risk.

    Mostly she will choose not to put the baby at significant risk, beacuse she agrees that the risk is too high. But she has the right to decide.

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