Push Back

This Thursday, May 5th marks International Day of the Midwife. This is a day to raise awareness about midwives and the quality care they give to mothers and families around the world.

It’s not surprising that Amy Tuteur has kicked off this week with a seething opinion piece on the dangers of home birth midwives. She claims the NYT approached her and asked her to write something on the topic. They published it yesterday, "Why is American Home Birth So Dangerous?". Reliably, it was one of the most highly shared articles in the Times and had 337 comments before they were closed. Many of you sent messages or shared the link with me as soon as it came out. Her tone is so condescending and hateful, her reasoning and research so lacking I almost didn't want to respond.

It’s easy to write one-sided, inflammatory criticisms about a group you dislike, it’s much more difficult to take an objective view and advocate for improvements in a broken maternity care system (it tends to get fewer likes, comments, and shares too).

Slate did a story back in 2012 calling into question the credentials and motives of Dr. Amy after a journalist relied heavily on her as a source for what was presented as an objective piece of journalism about home birth.

If she wants to blog angrily about the dangers of home birth on her blog and it helps her sell books and drive ad revenue for her site that’s her prerogative, but find it irresponsible of the New York Times to spread this brand of thinly veiled propaganda. 

The one thing she got right was that home birth in the Netherlands and Canada is as safe or safer than hospital birth. It’s Dr. Amy’s claims about home birth safety in the US where I think she got it wrong.

Oregon is one of the few states whose birth certificates now collects the intended place of birth. She states that Oregon’s data shows a 7 fold increase in perinatal death. This just isn’t true. Anyone who took a minute to click on the data cited in the article can see that the perinatal mortality rate for planned out-of-hospital birth was 4.0/1000, whereas the perinatal mortality rate for the hospital birth group was 2.1/1000. Nearly twice as many. If you look a little closer, 75% or 6 out of the 8 losses in out-of-hospital birth group were pregnancies that did not meet published low-risk criteria (meaning they were multiples, post-dates, or breech). 

Another thing Dr. Amy failed to mention about the Oregon data is the maternal health outcomes. The c-section rate for women who planned an out-of-hospital birth was 7%, while the c-section rate for those who planned hospital birth was 27.8%. Women who had previously had a c-section were 10 times more likely to have a repeat c-section in the hospital than they were if they planned a home birth. 

No one wants poor outcomes for mothers and babies. No one. Any loss is tragic. But preying on people’s fears and falsely inflating risks is not advocacy, it’s bullying. I’m disappointed that the New York Times would publish a piece like this.

The US doesn't need more division or polarization. What we need are people willing to listen to each other, to look critically at the issues, and work together. That's how we'll improve outcomes for mothers and babies--in all settings.

If you’ve seen my film you know that I’m passionate about correcting misperceptions and improving both outcomes and experience.

This Thursday Why Not Home?  is showing at 9 locations across the country. If you would like to join the conversation and bring this kind of dialogue to your community e-mail info@whynothome or fill out the screening request form here. Together we can shift the conversation about maternity care to one that is more positive and focused on solutions and less based on fear and blame.