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Subject:	two questions
Body:	<div class="NTForums_Quote">Posted By n/a on 06/29/2008 5:55 PM<br>Neither the WHO or the NICE say that "home birth has an increased rate of neonatal death compared to hospital birth for low risk women." I can find no statement from the World Health Organization that describes home birth as having an increased rate of neonatal death compared to hospital birth. The statement from NICE: "There is a lack of good-quality evidence relating to women’s and babies’ short- or long-term outcomes for birth at home compared with hospital and there is no evidence on serious maternal morbidity and mortality. Limited low-quality evidence shows less intervention with a planned home birth compared with a planned birth in hospital. Transfer rates between home and hospital settings show great variation. While only three low-quality studies reported IPPM or intrapartum perinatal mortality rates, the findings suggest that there may be a trend towards higher rates when birth was planned at home. The unreliability of these data means that these findings should be interpreted with caution. Factors leading to the unreliability of the data include: • a lack of routine collection of data on place of birth • the mix of high- and low-risk women in the home-birth studies • the majority of women in these studies were self-selected populations, which questions the generalisability of the studies • inconsistent definitions • questionable relevance to the UK setting." Is the MANA data not published in the BMJ? http://www.bmj.com/cgi/content/full/330/7505/1416 But this only confuses a mother trying to make a decision. Because data from studies like these are collected, analyzed, and published by providers who have financial and personal investment in the outcome, she always feels that someone is pushing their agenda. A source of information that is somewhat more objective might be Childbirth Connection. http://www.childbirthconnection.org/article.asp?ClickedLink=252&ck=10145&area=27 What would really be terrific is for independent organizations who answer directly to the consumer, the patient/ mother/ client to provide an analysis of the immense information out there about pregnancy and childbirth. These centers would have an incentive to provide accurate and thorough information to the consumer because that is how they would stay in business. One model of this type is the "Center for the Childbearing Year" proposed by Raymond DeVries. http://docserver.ingentaconnect.com/deliver/connect/lamaze/10581243/v16n4/s8.pdf?expires=1214781533&id=44888322&titleid=10348&accname=Guest+User&checksum=BEE114ED9A0F06724724E7D92BDC23A9 Tienchin</div><br><br>
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