Know data on home births

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A recent, quite disturbing front-page story in The Augusta Chronicle (“Rally calls for midwives,” July 13) highlighted a startling increase in the Augusta area’s maternal mortality rate.

While any maternal death is cause for concern and deserves thorough review, the story did not disclose how this statistic was calculated, nor did it indicate that our area’s maternal mortality rate reflected seven maternal deaths during a four-year period, 2007-2011. The causes of these deaths were not identified, and it was not reported how many, if any, of the mothers who died were transferred into the Augusta area in serious or critical condition. These latter points are very important, since any health-care improvement program should be based on specific, potentially preventable risk factors that can be reasonably addressed by those individuals and institutions that provide obstetric care.

Staff Writer Tom Corwin’s article also recognizes the role of midwifery in achieving good pregnancy outcomes. I fully agree that certified nurse midwives provide valuable services for women appropriately selected to receive their care. Not surprisingly, the good outcomes noted in the cited Cochrane Database Systematic Review reflect the low risk nature of typical midwifery patients.

What readers should not take away from this article is an unqualified advocacy for home births. The American College of Obstetricians and Gynecologists recently published and reaffirmed its review of the best available evidence on the safety of planned home birth compared with planned hospital or birthing center birth. This review concluded that while home birth is associated with fewer obstetric interventions, it is linked to a two- to three-fold higher mortality rate for normal infants.

Therefore, healthy women who are considering birth at home rather than in hospitals or birthing centers should be fully aware of the data when discussing delivering alternatives with their health-care providers.

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jkline 07/27/13 - 03:34 am
Cost is Not to be Ignored

The average cost of giving birth in the U.S. has TRIPLED since 1996 to $9,775. The change that seems to have led to this is the way that costs are calculated. Individual expensive fees are assessed for everything from an epidural to placenta removal, rather than just a bottom line for a standard delivery. I compare this with some other countries (taking my cost figures from the UK newspaper "The Daily Mail"). The average cost of a hospital delivery in America is $9,775, the highest in the world. In France, delivery costs $3,541, and in the UK it is just $2,641. Many industrialized countries offer flat fees for prenatal care and delivery, but in America, there is a separate charge for everything from a blood test to removing the placenta

It is all well and good to recommend that women have babies in hospitals, but it is not realistic (or fair) to find fault with them for seeking other options when they simply cannot afford the impossible cost of hospital delivery.

carcraft 07/27/13 - 03:53 am
lets also look at the ever

lets also look at the ever increasing high cost of malpractice for physicians!

Bodhisattva 07/27/13 - 05:28 am
Increases in medical

Increases in medical malpractice insurance premiums have been linked to poor return on investments investments more than lawsuits. Where they've had tort reform, yes, payouts have gone down. That's no big surprise. You get less for being maimed by your doctor. Not exactly a comforting thought. Malpractice rates have gone down, but only a fraction of the amount of payouts. It's an insurer's dream. Drop rates about a fourth and cut payouts by about two thirds. I wonder who the big lobbyists for these lawa are? Medical costs in these states, however, have not gone down. Usually, it's the same doctors responsible for majority of the malpractice cases. If doctors would police their industry better, they could achieve the same result without cheating patients who have been harmed out of desperately needed compensation.

flcracker 07/27/13 - 08:02 am
Home births

Any midwife worth her salt will not take a high-risk patient for a home birth. Home births are best for women who have no risk factors. I have many friends who have delivered multiple times at home or in a midwife-run birth center and they have had no problems. Basically, a pregnant woman needs to research both sides of the issue and decide what is right for her. Midwives and doulas also do post-delivery home visits and check on both mother and child and can provide breastfeeding help (most breastfeeding knowledge has been lost due to past two to three generations of women bottlefeeding). Oh, the cost of delivery in a hospital can run up to $20,0000!

ymnbde 07/27/13 - 09:57 am
irresponsible "journalism"

seems to be the main focus of this letter
in most professions the word irresponsible is synonymous with incompetent
but the main focus in journalism seems to be just to fill a space with words
gleaned from a few official sources
that generate controversy and emotional reactions
and don't need to actually represent reality

deestafford 07/27/13 - 10:15 am
One thing to take away as this onion is peeled is one has

to look at the details below the statistics on the top of any survey. Seventy-five percent of statisticians surveyed said to take statistics with a critical eye (to include this survey of statisticians.)

corgimom 07/27/13 - 11:42 am
"It is all well and good to

"It is all well and good to recommend that women have babies in hospitals, but it is not realistic (or fair) to find fault with them for seeking other options when they simply cannot afford the impossible cost of hospital delivery."

Priced a funeral lately?

And what price do you place on a healthy baby and mother?

Neither my son nor myself were high-risk in any way. My son nearly died, I could've.

Data is just numbers on a page. People's health and lives can't be quantified.

And flcracker, my mother didn't nurse any of her 5 kids. I did. It wasn't rocket science, I didn't need help. For Pete's sake, it's not hard.

"most breastfeeding knowledge has been lost due to past two to three generations of women bottlefeeding"

That will make me laugh all day.

Darby 07/27/13 - 03:20 pm
Just listen to Bod... He knows... It's all the

fault of the evil insurance companies and the mad "quack" scientists who go into medicine to steal money from the poor.

What we need to straighten all this out is for OzBama to come up with an Affordable Care Act.

Oh, wait.... Never mind...

CobaltGeorge 07/27/13 - 09:07 pm

My aunt didn't charge my mother one penny when I pop into this world.

Since the beginning time, I would venture to say that there has been more babies murdered before birth than has died during birth.

Bizkit 07/27/13 - 09:34 pm
Let's see how many human

Let's see how many human beings on this planet. How old is modern man, and now how old is the field of obstetrics? Gosh you mean for tens of thousand of years we managed without physicians. Miracles never cease-the species still survives. Just think though there is a cosmic balance because for much of that time there were high rates of deaths with newborns and during the first ten years. Now the reasons for those deaths are long gone but abortion does the same now and more. Strange to complain about a birth deaths with millions legally aborted since 73'.

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