So this Friday, we’re going to debunk 3 things.
1. The homebirther battle cry every time a homebirth death is mentioned, “But babies die in the hospital, too!”
So here’s the thing. Technically, “Babies die in the hospital, too,” is true. However, the implication is that “Babies die in the hospital at the same rate and because of the same things as they do in homebirth.” And THAT is not true. Out of the hospital, babies die at a rate 2.5 times the hospital death rate. And with Certified Nurse Midwives? It’s better, but still one-and-a-half times the rate with CNMs in a hospital! So babies do not die at the same rate in the hospital as they do in homebirth.
- Babies outside the hospital die at nearly 3 times the rate of in-hospital babies of complications of the placenta, cord, and membranes. That’s things like placental abruption, nuchal cords, true knots, and so on.
- They die of respiratory issues (birth asphyxia, neonatal aspiration, hypoxia…) at four times the rate.
- Infection causes death at nearly twice the rate outside of the hospital.
But the most shocking number of all is the number for complications of labor and delivery. It is nearly eleven times –ELEVEN TIMES!!! — as high for babies born outside the hospital. This is the category that contains breech birth and other malpresentations. These babies aren’t dying from congenital abnormalities; they’re dying preventable deaths. The only category where homebirth is better than the hospital is maternal pregnancy complications, and that’s nearly equal. Homebirth should be blowing hospital birth out of the water, here — they are all “low risk” women, whereas the hospital numbers include all risk levels.
- Not a single death attributed to complications of anesthesia and analgesia, which can only be done in the hospital.
- I hear lots of scare mongering going on about infection in the hospital, but the out-of-hospital numbers are more than TWICE as high!
- Complications of delivery — the category with those awful c-sections that are slicing babies open and vacuums crushing babies’ skulls — are, best-case-scenario, more than eight times higher outside the hospital, and if you add in precipitous birth, it’s almost eleven times.
Now, I know what you’re thinking: “Those numbers include all births outside the hospital, even those which are unattended!” That’s right. Many births attended by midwives are not reported as such, simply because the midwife is illegal and hides in a closet before the EMTs arrive, telling her clients not to mention she was there when the you-know-what hit the fan. Not only that, many of the same people promoting homebirth are also promoting unassisted childbirth as safe. But I understand your great concern. That is why I ran some numbers for the “other midwife” category out of the hospital:
The death rates are 1.3 times higher than hospital rates, but that is for all risk levels. The best comparison is to CNM’s in the hospital. Other midwives outside the hospital have a death rate almost THREE TIMES the rate of CNMs in the hospital. And in comparing respiratory related deaths with ALL hospital births (including those attending by doctors), the rate of death for out-of-hospital births is more than four times for other midwives, and is a shocking nine-and-a-half times higher than the rate for CNMs in the hospital.