Posted By n/a on 06/29/2008 9:47 AM
Those claims were mine. Maria quoted them without attributing them to me.
Ms. Goer, you did not manage to rebut either claim, both of which are quite simple:
1. The CDC says homebirth increases the risk of neonatal death
2. US DEMs (including CPMs) have less education and less training than ANY midwives in the industrialized world.
Marsden Wagner himself acknowledges that the CDC strongly disagreed with him on his personal opinion that homebirth is safe. He writes about it proudly in his chapter, Confessions of a Dissident, in the book Childbirth and Authoratative Knowledge by Brigitte Jordan.
Moreover, you did not even address the latest CDC statistics from the linked Linked Birth/Infant Death 2003-2004 dataset. The data show that homebirth with a direct entry midwife has double to triple the neonatal death rate as hospital birth for low risk women.
And as long as we are discussing this issue, I will mention two additional points that you have never addressed:
1. MANA (the Midwives Alliance of North America) has been collecting safety data on homebirth since 2001. They have publicly offered the data to those who can prove they will use it for the "advancement" of midwifery. Even those people must sign a legal non-disclosure agreement preventing them from revealing any data to anyone. In contrast, the US and state governments make all birth data available each year on the internet. MANA's data almost certainly show that homebirth with a CPM has a much higher neonatal death rate.
2. Over a year ago, we argued about whether Johnson and Daviss used the correct comparison group in the BMJ 2005 study. I said that the correct comparison group was low risk hospital births in 2000. With that comparison (which Johnson and Daviss left out of the paper), they had ACTUALLY showed that homebirth with a CPM had a neonatal death almost triple that of hospital birth. You gave all sorts of excuses as to why they didn't need to use that group. Johnson and Daviss have since publicly acknowledged on their onw website that I am correct. You have not acknowledged it, and instead (as far as I can tell) deleted the posts you wrote in support of the wrong control group.
3. Maria pointed out to you in another post that the World Health Organization 2006 report on perinatal mortality (which shows that the US has a lower rate of perinatal mortality than Denmark, the UK and the Netherlands) and that this cannot be reconciled with your public claims that the US has a higher rate of perinatal mortality than other first world countries. Fortunately, you now acknowlede that the US perinatal mortality rate is comparable to other developed countries.
Finally, I would appreciate it if you would stop insinuating that I am not who I say I am, that I do not have the credentials I list in my CV (Harvard '79; BU School of Medicine '84; Boston's Beth Israel Hospital internship, residency, staff appointment OB-GYN, Brigham and Women's Hospital staff appointment, Harvard Medical School Instructor in Clinical Obstetrics and Gynecology) or that I am in the employ of ANY organization. A public apology for your completely baseless, fabricated accusations would be appropriate. If you promote such obvious and easily checked falsehoods about me, people might begin to think you are using the same tactic to promote homebirth.
In case you refuse to post or to delete this entry, readers can find it on my website.
My bad for not getting back to this Forum sooner. The last time you posted to this Forum, I set ground rules for you: you would have your opportunity to state your case and make one rebuttal to my response, and then we were done. I'm going to reinvoke that rule and delete all of your posts that appear after this one.
1. You have provided no source for the allegation that the CDC reports a higher perinatal death rate at home births. I have tried various search combinations, but I am unable to find your source. If you write back with the source so I can review it, I will not delete your post, and I will respond to it.
2. You have supplied no information about the training of DEMs or how it compares unfavorably with the training of other midwives--not that such a comparison would be useful or valid for the reasons I stated in my first response to you, namely, In what country? Under what circumstances? What are the specific defects of DEM training? Appropriate training would vary according to the midwife's scope of practice and the conditions under which she works. To repeat, the key issue is whether a midwife with NARM certification, that is, a "Certified Professional Midwife" or CPM, has the requisite knowledge, skill, and experience to properly care for women planning home birth. If you perceive flaws or weaknesses in the training, by all means list specific deficiencies, and, again, I will not delete your post, and I will ask a guest expert to respond. If not, then please cease to malign DEMs. I would also add that midwifery training to work in hospitals would not adequately prepare a midwife to work out of hospital.
3. I will not rehash the argument over the Johnson and Daviss study. My response is elsewhere on this Forum.
4. I have no problem correcting what I have said if someone presents facts that contradict it or a reasoned argument why I am wrong. You have never done either. In this case, I was lazy in that I was repeating what I have read and heard. I will add, though, that the singleton preterm birth rate and low birthweight rates are on the rise and that the overuse of cesarean surgery is playing a role in this.
5. I have nothing to apologize for. It is a fact that no one can find evidence that you currently hold a license to practice medicine. One correspondent who tried to get background information on you found that the holder of your domain name is hidden, something that, according to this same poster, costs more and is not usual practice. Your website appears as a "sponsored site" when searching on certain topics, which I would expect--although this is speculation--probably costs a pretty penny. If any of these statements are factually incorrect, let me know, and, as before, I will not delete your post. Meanwhile, putting these facts together, it is not unreasonable to speculate that you are backed by an organization, ACOG being the most likely candidate, although it escapes me why you would want me to apologize for that. I, for example, am pleased and proud to be an independent contractor with Lamaze International.
Finally, thanks for the free promotion. Two new posters to this Forum found out about it via your posts on your website.
-- Henci