amcdawes | Indy Week

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Re: “Midwives seek autonomy in N.C.

As both a scientist and a father, I come to this article with one question and one comment. First, why should we believe that the past statistics will indicate future success or failure of homebirth in America? As the article clearly states, homebirth is not generally encouraged, even where it is legal and regulated which makes these statistics inherently invalid. Practically outlawing homebirth in America has to have changed the level of success. For a real understanding, we can't use data from the US, and from what I've heard (from both sides!) is that other countries have clearly demonstrated the value of cooperative care that includes midwives and ob's. As for my comment, actually a data point. I plotted the data for my wife's blood pressure readings for the 12 weeks that we went to an OB for prenatal care, and then for the remainder of the pregnancy while we went to a free-standing birth center. There is a difference of over one standard deviation between the readings collected at the two offices (it was lower at the birth center). This doesn't mean much until it shows up as a controlled study in an established journal or something... but my point is subtle: while we talk about including or discarding a few cases, or "data points", it would be great to see some error bars in these arguments! I have a feeling that if the difference between the arguments is 5 or 7 out of 18 cases (in ~5000 births) the statistics are effectively equal given the large uncertainty.

Posted by amcdawes on 06/02/2008 at 8:14 PM

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