Wednesday, 2 April 2008

Report claims home birthers at greater risk if transferred to hospital

Sometimes one wonders at what otherwise presumably professional people do with statistics.

Researchers writing in the journal British Journal of Obstetrics and Gynaecology (BJOG) examined all home births over a decade.

They apparently feel the study indicates there could be ‘serious risks’ for the baby when mothers who chose a home birth are transferred to hospital.

The implication being that home birth is the problem aspect.

The problem is the data is self selecting. They are examining births that have to be transferred to hospital because they have got into trouble serious enough to require it. Also they are not really comparing like for like.

As it stands the particular conclusion mentioned above can really amount to little more than a pointer to a possible direction for further research. Something as easily arrived at by educated logic. It is largely useless - and it needn’t have been, if those conducting it had planned more carefully and harvested the right data. One fears to some extent it is time and money not used to the best advantage it could have been.

Only around 15% of home birthers actually have problems that require they transfer to hospital, for second time mothers the risk is lower.

A valid comparison would have been to look at how women who elected to give birth in hospital, with no contra indications prior to giving birth, fared against women who elected to give birth at home with, no prior contra indications, fared.

One might expect to see that the possible wait and journey to hospital might disadvantage home birthers who got into trouble, compared to Hospital birthers who similarly got into trouble - but it is possible this could be offset by other factors, such as the risk posed by antibiotic resistant infections and other infections present in hospitals, or possible closer individual attention during the initial stages.

Whilst the actual report is more balanced, the BBC headline is dubious in that it baldly states “Home birth to ward increases risk”. It is actually misleading as this is by no means proven, or evident, even from the report. An accurate headline might have prefaced it with “Report claims”.

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