Electronic letters to:

Research:
Patricia A. Janssen, Shoo K. Lee, Elizabeth M. Ryan, Duncan J. Etches, Duncan F. Farquharson, Donlim Peacock, and Michael C. Klein
Outcomes of planned home births versus planned hospital births after regulation of midwifery in British Columbia
CMAJ 2002; 166: 315-323 [Abstract] [Full text] [PDF]
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Electronic letters published:

[Read eLetter] My Niece is Dead
LEDA M: PRYTULUK-ALTHOFF   (11 June 2007)
[Read eLetter] Home birth, not assisted by a midwife (Legislation in Ontario)
Franz SCHIESSER   (4 November 2005)
[Read eLetter] Evidence?
Lillian Not given   (10 April 2002)
[Read eLetter] Please re-read method used
Sharon Peters   (5 March 2002)
[Read eLetter] Comparing apples to oranges
Sachit Shah   (8 February 2002)
[Read eLetter] Suspicious Study: Risk for Home Birth
Claudio De Lorenzi   (5 February 2002)

My Niece is Dead 11 June 2007
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LEDA M: PRYTULUK-ALTHOFF,
blumenstrasse 35, 44791 Bochum Germany

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Re: My Niece is Dead

ledaprytuluk{at}hotmail.com LEDA M: PRYTULUK-ALTHOFF

One month ago my sister-in-law chose a home birth. The birth was in Edmonton, Alberta, Canada. Her husband was supportive of her choice, but they did not tell his family knowing that we would not agree with a home birth. This was to be her second child, and the first child was successfully delivered by Caesarian Section in a hospital. Two midwives were present along with her mother, who is a registered nurse, at the birth of her second child. They had visited the doctor once to be sure that the baby was properly positioned in the womb. My sister-in-law refused to be induced after she was 10 days overdue. Labor came on day 13 past the initial due date. How is it possible that two midwives and a registered nurse could support such a decision? Was she at this time not considered a high risk pregnancy? She had not yet had a healthy vaginal birth. The midwives lost the heartbeat in the womb as the large child struggled to come out. An ambulance was called and the mother gave birth to a still born child in the ambulance. It was a tragedy for everyone. My sister and I were also pregnant at the time. I still am, and I have 6 weeks left to go before I give birth in a hospital. When an emergency arises for a home birth, we race to the hospital, losing precious time. When an emergency arises in a hospital while giving birth...do we race home to our comfy bed?. This is about a human life. I am shocked at the statistics coming out regarding home birth. I am having a hard time believing them to be fully true. Thank you for your time.

Conflict of Interest:

None declared
Home birth, not assisted by a midwife (Legislation in Ontario) 4 November 2005
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Franz SCHIESSER

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Re: Home birth, not assisted by a midwife (Legislation in Ontario)

franz.schiesser{at}bluewin.ch Franz SCHIESSER

While your analyis is comparing planned homebirths assisted by midwives vs. planned hospital births not much is mentioned about homebirths without assistance of a qualified medical person.

Two questions:

1. Is such a non assisted homebirth legal in Ontario - what are the legal consequences for the parents in case of an emergency with a fatal issue? (e.g. child protection act etc.). While the legal aspect of the midwives status is regulated I do not find any comment on the parental responsibility.

2. Is there any data of such non assited home births?

Many thanks and best regards,

Franz Schiesser Paradiesstrasse 100 4102 Binningen / Switzerland Tel. 0041 61 421 46 75

Conflict of Interest:

None declared
Evidence? 10 April 2002
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Lillian Not given,
Student midwife (UK)

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Re: Evidence?

lily73_{at}hotmail.com Lillian Not given

The family physician who posted such negative comments about the safety of home birth should know better than to make such remarks without backing them up with research evidence. However, I think he would have great difficulty doing so considering that all evidence points in favour of home births for low risk women.
I would also like to point out that a safe birth is not simply about having a live mother and baby at the end of it, but also about how the mother feels both physically and emotionally. A traumatic experience can be dangerous as it can lead to the mother having problems bonding with her baby and is a likely cause of postnatal depression.
Please re-read method used 5 March 2002
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Sharon Peters
MAMA - Manitoba Advocate for Maternity Alternatives

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Re: Please re-read method used

sharpet{at}mts.net Sharon Peters

The previous eLetters regarding the BC study on the safety of home births argued that only low risk women were considered in the experimental group while high risk women were in the contral (hospital) group. The method clearly states Comparison subjects who were similar in their obstetric risk status were selected from hospitals in which the midwives who were conducting the home births had hospital privileges.

Only low-risk women are only allowed to have midwives at home births then only low-risk doctor clients were eligible for the study. This was made abundantly clear when I read through the entire study. There is a long list of high-risk factors that disqualified women from the study so that only low-risk mothers would be evaluated.

This study didnt compare apples and oranges. It compared the outcomes of women who chose midwifery care with physician care, in both the home and hospital setting. The women in midwifery care go through careful screening and so did the women selected for the doctor group.

I believe that the research was well done. The media did a good job at presenting such a controversial topic, I heard both sides of the arguement. It is now up to parents to become informed about the choices that are available to them.
Comparing apples to oranges 8 February 2002
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Sachit Shah,
Family Physician

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Re: Comparing apples to oranges

sachitshah{at}yahoo.com Sachit Shah

I would like to state that it is unforgiveable that people in the ivory tower have commenced this debate yet again.

The women in the home birth demonstration project were carefully selected in terms of their medical stability.

Already this paper has been broadcast around the media in BC that it may be safe to have home births.

It may be safe to home births if you live in the vicinity of the BC womens hospital and are carefully chosen. However it is not safe to promote this in for majority of people who live away from the Centre of Excellence.
Suspicious Study: Risk for Home Birth 5 February 2002
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Claudio De Lorenzi,
Plastic Surgeon

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Re: Suspicious Study: Risk for Home Birth

delorenzi{at}golden.net Claudio De Lorenzi

A new study by UBC researchers shows a planned birth at home with the help of a regulated midwife is just as safe as giving birth in a hospital for both mother and baby. was the report on CBC Radio on Feb. 4, 2002.

Well that piqued my interest, (even though I am in a completely unrelated field of surgery). Upon further investigation, I locate the article in question and find that they are not talking about an experimental design at all here, but naturally selected groups. Naturally selected groups, who are said to be of similar risk status...that makes me suspicious. Sorry,that just doesnt happen.

How likely is it that anyone who had any significant risk opted for home birth? Inconceivable. No midwife or doctor would ever suggest a home birth for a mother with a less than perfect situation- they were all delivered in hospital. How could it otherwise be?

My interpretation of the results would be as follows: the study showed a similar outcome for home births because the poorer outcomes expected of the more vigorous mothers who gave birth at home matched the better outcomes of the less healthy mothers who selected hospital birth.