Just in case anyone is unclear on what the initial claim Dr. Amy made was and that she continues to make...I believe what Henci is referring to is Dr. Amy's repeated claim that homebirth has a 3 times greater neonatal mortality than hospital birth.  She got this from her calculation of a perinatal mortality rate of 2.7/1000 for homebirth vs. a neonatal mortality rate of 0.9 for hospital birth.  If someone were to challenge her to provide stats now to support the "3 times" allegation, I'm guessing she would cite the CNM in-hospital neonatal mortality rate (around 0.3?) from the CDC Wonder website. 

However, I'd counter that she does not have a fair comparison group because most CNM's are so very stringently controlled on the risk level of patient that they can accept (for example, many can not attend VBACs, or babies over a specific predicted size), so that the CNM patient risk profile does not match the the DEM patient risk profile at ALL.  There is also the issue with the CDC Wonder website that the data is reported as how the birth ended up, not how it was planned...which can really skew the data.  Specifically, many "out of hospital" births are planned hospital births--and these can be pretty high risk because they are often unattended and include people who really doesn't know what to do (just last week a story on the front page of my local paper reported on one such case where a mother birthing her 4th child while standing in a parking lot was assisted by a former maintenance man and another mother of 4...you'd think between 7 prior births those women would have a clue...but NO, they let the maintenance man tie off the umbillical cord with a scrap from a shirt--not necessarily a clean shirt!  And let me guess...in his haste to rip the fabric, he most likely bit it to start the tear rather than finding scissors...) if a risk were to develop during labor with a CNM, care would be transferred more quickly to an MD resulting in many poor outcomes getting shifted out of the CNM data (I had a client who THOUGHT she was going to birth with a midwife, but at the last minute the midwife called in an OB without consulting the mother to catch--or rather to use a vacuum that he barely got out of the package before the baby came out by maternal efforst alone after less than 10 minutes of pushing--because she suspected problems from a suspected big baby--despite the mother's previous history of not having a problem birthing a big baby--so that birth was listed as an MD birth).  This kind of transfer would be less likely to occur with out-of hospital DEM birth...but it does happen, so even for them, we are loosing the data on births that were intended homebirths, but transferred to the hospital. The CDC Wonder website...while intriguing...I feel has a lot of significant drawbacks when it comes to trying to compare different types of care providers.  But oh heck...lets have some fun here...

Using Dr. Amy's cherry picked "low risk" women--20-45 years old, white, singleton babies 37+ weeks, 2500+ g...here are some comparisons of neonatal mortality risk (per 1000) for the 2003-2004 data set:

MD in hospital: 0.61

"Other Midwife" in hospital: 0.36

MD out of hospital:  2.89

"Other Midwife" out of hospital:  1.15

OMG!  Look at that...it doesn't matter where the birth occurs, match the Dr. to the midwife, and the midwife has better outcomes!  We need to ban Dr's!  All births should be in the hospital with "other midwives" to acheive optimum neonatal mortality.

Ridiculous, right?  ;-)