Midwifery associations (like many other people) have not found it funny the meta-analysis that called into question the safety of home birth, which we echoed here and that has provoked varied reactions in different fields.
Various associations, among which we highlight Midwifery Today and MANA (The Alliance of Midwives of North America) have expressed their discomfort and disagreement with the conclusions of the meta-analysis that, remember, spoke of up to three times of neonatal deaths in home births compared to those They take place in the hospital.
There have also been criticisms about the methodology of the study, about which we will return. But focusing now on the reaction of the midwives' collective, we can summarize it in, along with the punctualization of defects in form, a feeling of discomfort and a claim of their profession against what they consider an attack.
As we read in a response from an experienced midwife on the Midfirey Today website (“Midwifery Today”),
This study is a strong attack against home birth, but I think it will be used primarily to attack midwives. Already, some are pulling data from this study and claiming that it shows that "unregulated midwives" are the reason for a higher rate of neonatal mortality in home births.
The author of the article summarizes her ideas about meta-analysis, which can be condensed into the following points:
- Fact: The study has important flaws and does not reach precise conclusions. Extremely large studies have consistently shown that there is no real difference in neonatal mortality between hospital deliveries and home births.
- Fact: The study does not give any information at all about the different types of midwives or the high rates of neonatal death associated with unlicensed midwives compared to midwives with regulated licenses. There is no information in this regard, and many demand that this distinction be demonstrated.
- Fact: The births in this report are all (with the exception of one of them, the Washington State study) carried out by trained midwives, officially licensed, or doctors. There is a failure in the meta-analysis, which contradicts the individual conclusions of many large studies that show that these births have a similar risk of neonatal mortality with hospital births. The error is probably the result of the use of old and small studies, and of including their data incorrectly in a larger study.
- Fact: This report can fuel an attack against all types of midwives, everywhere. No matter the credential, or lack thereof, it is the midwives who mainly carry out the assistance in home deliveries. Accepting the wrong conclusion in this report will hurt everyone. Those who are already claiming that midwifery credentials are better, have to carefully examine this report. This report states (erroneously) that home birth is dangerous and therefore any professional home birth is dangerous.
I observe, both in this article and in others consulted, that there is a more or less disguised animosity between midwives and gynecologists, thus, in general, speaking of professions and in a bi-directional sense.
This makes me think if it would not be better to join forces in the same direction looking first and foremost for the well-being and safety of mothers and babies during pregnancy, childbirth and postpartum, in whatever field.
Y I have trouble getting the answers clear why he paddles in the opposite direction. What could gynecologists or midwives have against each other when they are supposed to have been trained to care for and help women.
The midwifery response article to the meta-analysis ends up emphasizing that the best way to fight against incorrect information is to counteract it with the truth, that it is not necessary to fall into fear and the truth can be sought.
I do not possess this truth, but we can effectively inform ourselves about it. In the end you have links to some of the studies that show that giving birth at home is safe, about what we will continue talking about, and also from this link you can consult the controversial meta-analysis that ensured that the rate of neonatal death is triple in home births, Full, in English.
A study that continues to bring Opinions found about home birth safety, as we see with criticisms of midwifery associations that are attacked with these conclusions.
