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Sunday
Jan172010

Beyond the Abstract of the New South Australian Home Birth Study

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The media coverage of the new study Planned home and hospital births in South Australia, 1991-2006: differences in outcomes has begun. From the Sydney Morning Herald:

Govt urged to tighten homebirth laws

The federal government has been urged to push on with its plans to tighten homebirth laws, after a new study found the practice to be more risky than conventional hospital deliveries.

A comparison of South Australian births between 1991 and 2006 found the perinatal mortality rates of homebirth and hospital births to be similar.

However, babies were seven times more likely to die from complications during a homebirth than a planned hospital delivery.

They were also 27 times more likely to suffer asphyxiation during labour, according to the study published in the latest Medical Journal of Australia.

The Australian Medical Association, which is opposed to homebirthing, says the study throws more weight behind the government’s planned overhaul of maternity care.

“The safety of mothers and babies must come first in any debate about maternity care,” AMA president Andrew Pesce said in a statement. Read more…

 

But what lies beyond the study’s abstract? Please read Lauredhel’s summary on Hoyden About Town. In a nutshell:

There was no such scrutiny of the 2440 perinatal deaths in the planned hospital birth group, except to say that 87 of them were attributed to intrapartum asphyxia (lack of oxygen supply to the fetus in labour). Of the three deaths attributed to intrapartum asphyxia in the planned home birth group, two occurred in hospital. One at home. One.

 

The study’s authors write in the discussion:

Although it is not anticipated that large numbers of women will opt for home birth, women’s autonomy in choosing reproductive behaviour is a fundamental human right enshrined in Australian law. Respecting their choice and achieving the best out come for all concerned is likely to remain a challenge that will require more light and less heat than it has received thus far.

 

Related Posts:

Feminism and birth in Australia: moving from stat-wrangling towards a reproductive choice perspective (Hoyden About Town)

Aussie Labor Party Put a Bit of Rancid Ham in a Legislative Sandwich

Pregnant Woman in Australia Gets a Visit from the Pitocin Police

Aussie Hospital Debate, Take Two

Aussie Debate Over Private Versus Public Hospitals

 

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Reader Comments (12)

Three....two...one....

January 17, 2010 | Unregistered CommenterJill

What?? Six whole hours and no "THAT STUDY IS WRONG HOMEBIRTH IS WRONG YOU'RE ALL WRONG BECAUSE YOU'RE WRONG WRONG WRONG" from you-know-who? My radar must be broken....damn.

January 17, 2010 | Unregistered CommenterJill

I know.....Maybe someone is getting t-shirts made or their face painted!

January 17, 2010 | Unregistered CommenterNaomi

Hey, hey, hey!!! I come over here to check in on the madness, and it is NOT HERE!! I demand my rights!!! Jeepers! Can't even find a good fight to read on a lazy Sunday afternoon. I'll be sitting here with my coffee WAITING!! :)

January 17, 2010 | Unregistered CommenterDiana J.

She must be sick. I can't imagine what else would keep Voldemort off the internet short of the "out both ends" virus (ya know, sitting on the toilet with your face in a trash can). Feel better soon, doc!

January 17, 2010 | Unregistered CommenterJill

Where does this 27 times higher risk come from? Based on a sample of what, 3?

January 17, 2010 | Unregistered CommenterEmma Archer

The authors claim that this study shows that homebirth increases the risk of neonatal death, but it shows nothing of the kind. It is a lousy study and proves nothing. I'll be writing about it on my blog tomorrow.

January 17, 2010 | Unregistered CommenterAmy Tuteur, MD

Excellent- Dr. Tuteur- write away on your own blog- we'll make it a point not to read it.

January 17, 2010 | Unregistered CommenterBarbara-Jean

That post sounds like one worth clicking over for.

January 18, 2010 | Registered CommenterJill

The study does not show that homebirth increases the risk of neonatal death. What does it show? In my judgment, it doesn't show anything because it is poorly done. The authors should go back and reanalyze their data. First they should create the groups by intention to treat at the start of labor. Second, they should remove high risk women from the hospital group. Only then is there a chance of obtaining valid, useful results.

If the intention of the authors was to bolster the case against homebirth, it has certainly back fired. Instead, they've given Australian homebirth advocates a gift. Homebirth advocates be able to point to this study as showing that homebirth doesn't increase the risk of neonatal death. Perhaps more importantly, though, homebirth advocates will be able to point to this study as evidence that opponents of homebirth disingenuously sliced and diced the data to make hospital birth look good on at least one criterion. And that criterion, the fact that the homebirth babies died during labor instead of after labor, is absurd.

January 18, 2010 | Unregistered CommenterAmy Tuteur, MD
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