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Nacpm Responds to Acog

Nacpm Responds to Acog

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Published by Ciane
Press release from the National Association of Certified professional midwives (US)

You may be aware of a recent article claiming to have found a 3-fold increase in neonatal mortality among home born infants when compared to hospital born babies. This meta-analysis by Wax et al has been widely publicized by ACOG with a timing that appears to be designed to have maximum political impact.

The press, including the New York Times, has reached out to NACPM, as well as to MANA, ACNM and other organizations, seeking comment. NACPM connected with home birth researchers and prepared the following comments for release to the press, and has been in touch with the reporter from the New York Times.

http://www.nacpm.org/documents/070610-NACPM-Press-Release-Wax-etal.pdf
http://www.nacpm.org/


http://archive.constantcontact.com/fs013/1101776730575/archive/1103547855457.html

Press release from the National Association of Certified professional midwives (US)

You may be aware of a recent article claiming to have found a 3-fold increase in neonatal mortality among home born infants when compared to hospital born babies. This meta-analysis by Wax et al has been widely publicized by ACOG with a timing that appears to be designed to have maximum political impact.

The press, including the New York Times, has reached out to NACPM, as well as to MANA, ACNM and other organizations, seeking comment. NACPM connected with home birth researchers and prepared the following comments for release to the press, and has been in touch with the reporter from the New York Times.

http://www.nacpm.org/documents/070610-NACPM-Press-Release-Wax-etal.pdf
http://www.nacpm.org/


http://archive.constantcontact.com/fs013/1101776730575/archive/1103547855457.html

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Categories:Types, Brochures
Published by: Ciane on Jul 13, 2010
Copyright:Attribution Non-commercial

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02/11/2013

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July 6, 2010FOR IMMEDIATE RELEASEContact: Mary Lawlor, CPM, 917-453-6780,president@nacpm.org RE: Maternal and Newborn Outcomes in Planned Home Birth Vs. Planned HospitalBirths: A Meta-Analysis, Wax JR, Lucas FL, Lamont M, et al., Am JObstet Gynecol 2010 ______________________________________________________________________________ 
High-quality research on the safety of out-of-hospital birth with professional midwives is anessential support to good practice and to continuous improvement in the delivery of services towomen and infants. Unfortunately, the recent meta-analysis by Wax, et al, of the Maine MedicalCenter in Portland, Maine published online on July 1, 2010 in the American Journal of Obstetricsand Gynecology (AJOG) on newborn outcomes in planned home birth vs. planned hospital birth,is far from the high-quality rigorous review that health care providers and the public expect. Notonly are Wax’s conclusions in direct conflict with a growing international body of qualityresearch that demonstrates the safety of home birth for low-risk women and their infants whenattended by trained professional midwives, but his methodology is deeply flawed. Rather thancontributing to the improvement of services and reliable information for childbearing women and providers, his alarmist conclusions will only serve to support the increased use of medicalinterventions in childbirth that have consistently been shown to cause more harm than good towomen and infants.The widely publicized conclusion that implies risk to neonates is not supported by the bestquality data. Indeed this author acknowledges the similar outcomes of low neonatal mortalityshown by most of the articles he reviews, yet amazingly arrives at an opposite conclusion byusing statistics drawn from several highly criticized and poor quality studies. Michael C. Klein,MD, a University of British Columbia emeritus professor and senior scientist at The Child andFamily Research Institute in Vancouver, states, “A meta-analysis is only as good as thecomponent studies. When the author does his sensitivity analysis, after excluding the old andlower-quality papers, there is no statistically significant difference in either perinatal or neonatalmortality by place of birth.”Among the many flaws and troubling inaccuracies in this analysis are: Wax’s misrepresentationof the support of listed citations for his claims for increased neonatal mortality; referral to studiesthat are poorly designed and which mix low-risk and high-risk cases; failing to account for thequality of the trials included within the inclusion and exclusion criteria; the omission of severalkey, well-designed studies; and the flawed and completely unsubstantiated association of low-intervention maternity care with increased newborn death. His discussion includes findings fromhis own poorly designed review based on birth certificate data which is known to be unable todifferentiate between planned and unplanned home birth and is therefore unreliable in studyingneonatal outcomes. And by his selection criteria and careful crafting of his search strategy, the

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