Oct 28, 2005 |
In The News,  |
Kellie Moeller, CNM

Midwife Attended Births at Home are Statistically Safe

The following citations from various sources indicate research outcomes pointing to the safety of birth at home under the care of nurse midwives in Houston, TX.
  • "Every study that has compared midwives and obstetricians has found better outcomes for midwives for same-risk patients. In some studies, midwives actually served higher risk populations than the physicians and still obtained lower mortalities and morbidities. The superiority and safety of midwifery for most women no longer needs to be proven. It has been well established." (Madrona, Lewis & Morgaine, The Future of Midwifery in the United States, NAPSAC News, Fall-Winter, 1993, p.30)
  • "In the U.S. the national infant mortality rate was 8.9 deaths per 1,000 live births [in 1991]. The worst state was Delaware at 11.8, with the District of Columbia even worse at 21.0. The best state was Vermont, with only 5.8. Vermont also has one of the highest rates of home birth in the country as well as a larger portion of midwife-attended births than most states. " (Stewart, David, International Infant Mortality Rates--U.S. in 22nd Place, NAPSAC News, Fall- Winter, 1993, p.36)
  • This study compares matched populations of homebirths attended by non-nurse midwives with hospital births attended by physicians. It concludes that the midwife sample has significantly better maternal and neonatal outcomes and attributes this fact to physicians high rate of intervention.”Evaluation of Outcomes on Non-Nurse Midwives.Matched Comparisions with Physicians.” By Lewis Mehl, M.D. et al. Women and Health, Vol. 5, 1980.
  • The Texas Department of Health's own statistics shows that midwives in Texas have a lower infant mortality rate than physicians. Texas Midwifery Program, Six Year Report, 1983- 1989, Berstein & Bryant, Appendix Vlllf.
  • "Mehl and his colleagues (1975, 1977) reviewed the medical records of 1,146 home births attended by five home delivery services in northern California between 1970 and 1975. These investigators provided detailed descriptions of demography (e.g., urban or rural), attendants, population served, process of care, outcomes, and complications. The incidence of various events among home births was compared to the incidence of similar events in the birth population of the state of California or as reported in the literature. No maternal deaths were noted, and the perinatal mortality rate of 9.5 per 1000 births was lower than the California average." (Research Issues in the Assessment of Birth Settings, Institute of Medicine, National Academy Press, Washington, 1982, p. 76)
  • From the same source (Figure 1, p. 175): In the state of Oregon from 1975-1979, there were approximately 3-4 neonatal deaths per 1000 births in homebirths attended by midwives, as opposed to approximately 9-10 deaths per 1000 births for all residents. The same figure indicates approximately 5 infant deaths per 1000 births in homebirths attended by midwives, as opposed to approximately 12 deaths per 1000 births for all residents. (Research Issues in the Assessment of Birth Settings, Institute of Medicine, National Academy Press, Washington, 1982, p. 175)
  • "Of the 3,189 midwife-assisted deliveries studied, episiotomies were done on 5 percent of the women, the Caesarean section rate varied from 2.2 percent to 8.1 percent, and perinatal mortality (the number of babies who die during or shortly after birth) averaged 5.2 per 1,000. Compare these numbers to those for New Mexico obstetricians and physicians during the same period: nearly routine use of episiotomies in many hospitals, a Caesarean rate that varied from 15 percent to 25 percent,and a perinatal mortality rate of 11.3 per 1,000. Looking at these numbers, Rebecca Watson, the maternal-health program manager at the New Mexico Department of Health commented, 'I sometimes wonder why [we bother compiling statistics on midwives], since their statistics are so much better thaneveryone else's. " (Sharon Bloyd- Peshkin, Midwifery: Off to a Good Start, p. 69, Vegetarian Times, December 1992)
  • Records kept from 1969-73 in England and Wales indicate still birth rates of 4.5 per 1000 births for home deliveries as opposed to 14.8 per 1000 births for hospital deliveries. (The Place of Birth, Sheila Kitzinger & John Davis, eds., 1978 Oxford University Press, pp. 62-63)
  • "In The five European countries with the lowest infant mortality rates, midwives preside at more than 70 percent of all births. More than half of all Dutch babies are born at home with midwives in attendance, and Holland's maternal and infant mortality rates are far lower than in the United States..." ("Midwives Still Hassled by Medical Establishment," Caroline Hall Otis, Utne Reader, Nov./Dec. 1990, pp. 32-34)
  • "Mothering Magazine has calculated that using midwifery care for 75% of the births in the U.S. would save an estimated $8.5 billion per year." (Madrona, Lewis & Morgaine, The Future of Midwifery in the United States, NAPSAC News, Fall-Winter, 1993, p. 15)

Blog Posted: Oct 28, 2005
Posted by: Kellie Moeller, CNM
President HomeBirth Experience, Inc.
281-309-8030

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