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Western medicine treats pregnancy and childbirth like a disease. So, yes; I do think they probably get delivery wrong.

by rosser 13y ago

daughart 13y ago
In what way?
rayiner 13y ago
Western medicine treats pregnancy and child birth like a high-risk situation, which it is. It's the same principle behind having doctors standing by at a boxing match, except the natural rate of maternal mortality in child birth is far higher than the mortality rate of even the dirtiest fight scenes.
- toomuchtodo 13y ago
  Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742137/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742137/ "The rate of perinatal death per 1000 births was 0.35 (95% confidence interval [CI] 0.00–1.03) in the group of planned home births; the rate in the group of planned hospital births was 0.57 (95% CI 0.00–1.43) among women attended by a midwife and 0.64 (95% CI 0.00–1.56) among those attended by a physician." No offense, but the data says you're wrong.
  - smokey_the_bear 13y ago
    The average woman who plans to have a homebirth is having a complication free pregnancy, and anecodotally, everyone I know who has had one it has been for their 3rd or higher birth after complication free deliveries in hospitals. You can't compare those numbers, they aren't the same populations of pregnant women.
  - rayiner 13y ago
    The problem with such comparisons is that high-risk pregnancies won't be planned for home birth to begin with. Also, in a hospital, a physician will be called in at the first sight of any complication, so midwives won't be attending births that go wrong. A comprehensive study in Oregon found death rates 6-8x higher in home births than hospital births: https://olis.leg.state.or.us/liz/2013R1/Downloads/CommitteeMeetingDocument/8585 https://olis.leg.state.or.us/liz/2013R1/Downloads/CommitteeM.... See also this meta-survey of the literature: http://www.ajog.org/article/S0002-9378(10)00671-X/abstract http://www.ajog.org/article/S0002-9378(10)00671-X/abstract ("Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate.").
    - pit 13y ago
      Your first point is spot-on. Home births are bound to be statistically more successful because they are (usually) only planned for low-risk pregnancies. However, the increased death rate in the Oregon study is a) localized to that state, and b) attributed to an overabundance of uncertified midwives: > But out-of-hospital births are not as safe as births in hospitals in Oregon, where many of them are attended by birth attendants who have not completed an educational curriculum designed to provide all the knowledge, skills and judgment needed by midwives who practice in any setting. In other words, there are a lot of "birth attendants" practicing midwifery in Oregon who aren't necessarily CNMs (certified nurse-midwives) or CMs (certified midwives) -- which is perhaps closer to the barber acting as surgeon analogy. EDIT: Here's a rebuttal to the Wax study: http://www.midwiferytoday.com/articles/ajog_response.asp http://www.midwiferytoday.com/articles/ajog_response.asp
    - yetanotherphd 13y ago
      From the study's abstract: "Studies of planned home births attended by registered midwives have been limited by incomplete data, nonrepresentative sampling, inadequate statistical power and the inability to exclude unplanned home births. We compared the outcomes of planned home births attended by midwives with those of planned hospital births attended by midwives or physicians." and "We included all planned home births ... and all planned hospital births meeting the eligibility requirements for home birth that were attended by the same cohort of midwives ... We also included a matched [my emphasis] sample of physician-attended planned hospital births (n = 5331)."
  - CamperBob2 13y ago
    Perfect example of selection bias.
superuser2 13y ago
Given the fairly extreme historical levels of death during/immediately following childbirth, isn't that pretty reasonable?

Western medicine treats pregnancy and childbirth like a disease. So, yes; I do think they probably get delivery wrong.

by rosser 13y ago

Western medicine treats pregnancy and childbirth like a disease. So, yes; I do think they probably get delivery wrong.

daughart 13y ago

In what way?

rayiner 13y ago

Western medicine treats pregnancy and child birth like a high-risk situation, which it is. It's the same principle behind having doctors standing by at a boxing match, except the natural rate of maternal mortality in child birth is far higher than the mortality rate of even the dirtiest fight scenes.

toomuchtodo 13y ago
Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742137/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742137/ "The rate of perinatal death per 1000 births was 0.35 (95% confidence interval [CI] 0.00–1.03) in the group of planned home births; the rate in the group of planned hospital births was 0.57 (95% CI 0.00–1.43) among women attended by a midwife and 0.64 (95% CI 0.00–1.56) among those attended by a physician." No offense, but the data says you're wrong.
- smokey_the_bear 13y ago
  The average woman who plans to have a homebirth is having a complication free pregnancy, and anecodotally, everyone I know who has had one it has been for their 3rd or higher birth after complication free deliveries in hospitals. You can't compare those numbers, they aren't the same populations of pregnant women.
- rayiner 13y ago
  The problem with such comparisons is that high-risk pregnancies won't be planned for home birth to begin with. Also, in a hospital, a physician will be called in at the first sight of any complication, so midwives won't be attending births that go wrong. A comprehensive study in Oregon found death rates 6-8x higher in home births than hospital births: https://olis.leg.state.or.us/liz/2013R1/Downloads/CommitteeMeetingDocument/8585 https://olis.leg.state.or.us/liz/2013R1/Downloads/CommitteeM.... See also this meta-survey of the literature: http://www.ajog.org/article/S0002-9378(10)00671-X/abstract http://www.ajog.org/article/S0002-9378(10)00671-X/abstract ("Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate.").
  - pit 13y ago
    Your first point is spot-on. Home births are bound to be statistically more successful because they are (usually) only planned for low-risk pregnancies. However, the increased death rate in the Oregon study is a) localized to that state, and b) attributed to an overabundance of uncertified midwives: > But out-of-hospital births are not as safe as births in hospitals in Oregon, where many of them are attended by birth attendants who have not completed an educational curriculum designed to provide all the knowledge, skills and judgment needed by midwives who practice in any setting. In other words, there are a lot of "birth attendants" practicing midwifery in Oregon who aren't necessarily CNMs (certified nurse-midwives) or CMs (certified midwives) -- which is perhaps closer to the barber acting as surgeon analogy. EDIT: Here's a rebuttal to the Wax study: http://www.midwiferytoday.com/articles/ajog_response.asp http://www.midwiferytoday.com/articles/ajog_response.asp
  - yetanotherphd 13y ago
    From the study's abstract: "Studies of planned home births attended by registered midwives have been limited by incomplete data, nonrepresentative sampling, inadequate statistical power and the inability to exclude unplanned home births. We compared the outcomes of planned home births attended by midwives with those of planned hospital births attended by midwives or physicians." and "We included all planned home births ... and all planned hospital births meeting the eligibility requirements for home birth that were attended by the same cohort of midwives ... We also included a matched [my emphasis] sample of physician-attended planned hospital births (n = 5331)."
- CamperBob2 13y ago
  Perfect example of selection bias.

superuser2 13y ago

Given the fairly extreme historical levels of death during/immediately following childbirth, isn't that pretty reasonable?