Increased risk of home birth is "pure fiction"

The Big Push for Midwives released a statement today in response to publicity surrounding a forthcoming article in the American Journal of Obstetrics and Gynecology that claims to show home birth is unsafe. From the press release:

As New York and Massachusetts moved to pass pro-midwife bills in the final weeks of their legislative sessions, the American Journal of Obstetrics and Gynecology fast-tracked publicity surrounding the results of an anti-home birth study that is not scheduled for publication until September. Described as unscientific and politically motivated, the study draws conclusions about home birth that stand in direct contradiction to the large body of research establishing the safety of home birth for low-risk women whose babies are delivered by professional midwives.

The release further quotes Dr. Michael C. Klein:

“Many of the studies from which the author’s conclusions are drawn are poor quality, out-of-date, and based on discredited methodology. Garbage in, garbage out.” said Michael C. Klein, MD, a University of British Columbia emeritus professor and senior scientist at The Child and Family Research Institute. “The conclusion that this study somehow confirms an increased risk for home birth is pure fiction. In fact, the study is so deeply flawed that the only real conclusion to draw is that the motive behind its publication has more to do with politics than with science.”

Several days ago, Amy Romano at Science and Sensibility expressed her own doubts about the study, highlighting these points:

1. The meta-analysis is compromised by the inclusion of a deeply flawed study that relies on birth certificates and includes preterm births, unplanned home births, and home births attended by unqualified providers. In the only analysis in which the researchers excluded this study, the significant excess of neonatal mortality disappeared.

2. The meta-analysis also includes studies that report on births that took place as early as 1976.

The Big Push notes that the timing of publicity initiated by AJOG is questionable, at best:

“Given the fact that New York just passed a bill providing autonomous practice for all licensed midwives working in all settings, while Massachusetts is poised to do the same, the timing of this study could not be better for the physician groups that have been fighting so hard to defeat pro-midwife bills there and in other states,” said Susan M. Jenkins, Legal Counsel for The Big Push for Midwives Campaign. “Clearly the intent is to fuel fear-based myths about the safety of professional midwifery care in out-of-hospital settings. Their ultimate goal is obviously to defeat legislation that would both increase access to out-of-hospital maternity care for women and their families and increase competition for obstetricians.”