Friday, July 13, 2012

No wonder Colorado homebirth midwives hid their 2010 death rates



Each year, licensed Colorado homebirth midwives (certified professional midwives, CPMs) are mandated to report their safety statistics. As I detailed in a post about the 2009 statistics, in every year since homebirth midwives were first licensed in 2006, the midwives had a death rate that exceeded the state as a whole (including all races, all gestational ages, all pregnancy complications, all pre-existing medical conditions). Even worse, from 2006 to 2009, the death rate rose dramatically.

Imagine my surprise, therefore, when I looked for the 2010 statistics and learned that the homebirth midwives had failed to released them. Now I know why. They were ever more horrendous than the 2009 statistics.

How did I obtain the 2010 statistics? It's not because the midwives publicly released them. No, they were required to hand them over after a Colorado citizen filed a CORA petition (Colorado Open Records Request). She shared those statistics with me, both the raw data and the summary data complied by the midwives themselves.

I've created a table of mortality rates from 2006-2010.



As you can see, the perinatal death rate for planned homebirth with a licensed Colorado midwife rose from 11.3/1000 in 2009 to an astounding 16.4/1000 in 2010! Compare that to the overall perinatal mortality rate for the entire state of Colorado (all races, all gestational ages, all pregnancy complications, all pre-existing medical conditions) of 6.3/1000.

Colorado homebirth midwives cared for fewer than 1000 patients and managed to lose 15 babies. It is difficult to convey just how appallingly large a number that is. Colorado licensed midwives have a perinatal mortality rate nearly triple that of the state as a whole. That actually dramatically understates the danger of homebirth in Colorado since the correct comparison (if it were available) would be to the mortality rate of low risk white women at term with normal sized babies.

It's easy to understand why Colorado homebirth midwives hid their 2010 statistics; they are an appalling indictment of the midwives and irrefutable evidence that they are unfit and unsafe practitioners.

This is the same tactic being employed on the national level by the Midwives Alliance of North America (MANA). MANA collected death rates for the years 2001-2008. While they were collecting the statistics, they publicly promised they would be used to demonstrate the safety of homebirth midwives, but once they saw the results, they decided to hide them instead.

Now that Colorado homebirth midwives have been licensed for 5 years and had appalling and RISING death rates over that period, it is time to acknowledge the obvious. Licensed homebirth practitioners are grossly incompetent. They lack the education and training required of ALL other midwives in Europe, Canada and Australia and required of US nurse midwives (CNMs). It is time to end the experiment and declare it a resounding failure.

Homebirth in Colorado (and everywhere else in the US) is not about babies, and it is not about birth. It is about a bunch of high school graduates who couldn't or wouldn't get real midwifery training and made up a pretend credential they award to themselves to fool an unsuspecting public.

Colorado homebirth midwives are unethical in the worst possible way; they don't care how many newborn lives are sacrificed, indeed that will go to great lengths to hide how many newborn lives are lost, in an effort to continue collecting fees for appallingly incompetent care. Of course, they are merely copying the behavior of their national leaders. The entire leadership of American homebirth, from the President of MANA on down should be ashamed of themselves.

How do American homebirth midwives handle their mistakes? They bury them --- both literally and figuratively.


This piece first appeared on The Skeptical OB in June 2012.


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