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Normal Birth Forum Featuring Henci Goer
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Posted By n/a on 7/8/2008 2:32:31 PM
Subject: RE: two questions
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Posted By Dr. Amy on 06/28/2008 3:18 PM

Actually, both claims are both true.

Goer's quote from the WHO is out of date. The WHO said in April 2006:

Home-like settings for childbirth are associated with reduced likelihood of medical intervention. ... However, the evidence shows an increased risk of perinatal mortality, the reasons of which are not fully established.

Dr. Amy's quote is indeed from WHO, and certainly does not make Henci's "out of date," simply older.  I'll also point out that the quote Dr. Amy uses specifically refers to "home-like" settings.  The study upon which they base this conclusion looked soley at birth center births.   Who is to say that birthing in a birth center doesn't increase the risk of perinatal mortality over homebirth?  We really don't know.

Posted By Dr. Amy

As far as the NICE report is concerned, Goer didn't even answer the question. She was asked if NICE reports a higher rate of neonatal mortality at homebirth, and they do. From the same report that Goer quoted:

... intrapartum-related perinatal mortality (IPPM) for booked home births, regardless of their eventual place of birth, is the same as, or higher than for birth booked in obstetric units.

So the NICE report says that the perinatal mortality is the same as, or higher, than birth in a hospital.  I certainly think that people should be aware of this...but the statement isn't exactly rock solid.  Did they state "the same as" first because that was the statement they had more confidence in, or was "higher" stated last so that it would stick in the reader's mind?  I don't know.

Goer tried to sidestep the direct question that she was asked about DEM qualifications. American DEMs have less education and training than ANY midwives in the industrialized world. There's no denying it and she didn't deny it.

The education required by NARM is certainly less than other midwives.  However, there are many individual midwives who have credentials far exceeding those required by NARM.  I think it is worth-while to push for more stringent requirements.

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Subject:  two questions
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