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.