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Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA


Summary of Homebirth Debate from sci.med.obgyn (October, 1996)

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These are easy to read and understand and are beautifully presented.

Well, I'm flattered that someone is interested in who is reading this debate. I've been reading since the debate began, but I have not contributed much. Here are my impressions (sorry so long), in case anyone is interested in the impressions of a totally random person:

First of all, for the record, I am not a doctor or midwife; I'm not even pregnant, and I never have been.

I have been pretty turned off by many of the posts by doctors on this issue. They have made a number of comments which are extremely rude, insulting, and/or patronizing. These types of comments are just unnecessary for any debate, and they fail to convince intelligent people. On the other hand, many of these posts hint that their authors feel attacked (or "maligned"), and so that the unnecessary comments stem from defensiveness. Those of us who are not doctors, it seems to me, would do well to be sensitive to the fact that we are talking about someone's profession. Similarly, civility would require all of us to be respectful toward the profession of midwifery.

Here is a summary of what I feel have been the main points of the debate, on both sides of the issue. Please note that this summary is biased because I am human.


Position: hospital birth is safer than home birth for low-risk women.

Several doctors and nurses have contributed stories of babies of low-risk mothers who survived hospital births, but who in their professional and experienced opinions would not have survived if their mothers had planned to give birth at home.

Some doctors have had experience with direct-entry midwives who were deficient in training, knowledge, experience, and/or good judgment.

Infant mortality in developing nations without adequate access to medical technology is higher than that of the United States.

None of the studies, which show home birth for low-risk women to be as safe as or safer than hospital birth, are randomized and double-blind. Since no study of this issue can be, it is impossible for statistics to show that home birth is as safe as hospital birth.


Position: home birth is at least as safe as hospital birth for low-risk women.

Many studies, including some published in highly esteemed medical journals, have concluded that home birth is at least as safe as hospital birth for low-risk women. If their statistics are accurate, then for every baby who lives in a hospital birth but would die in a planned home birth, there is another baby who lives in a planned home birth but would die in a hospital birth. ("Planned home birth" statistics include mothers who, despite their original plans, end up giving birth in a hospital.)

No doctor or other person has mentioned a study which concludes that hospital birth is safer than home birth for low-risk women.

Infant mortality in other Western nations, which have relatively high frequencies of home birth, is lower that that of the United States.

Although none of the studies have been randomized and double-blind, neither have the studies of most social and health issues, including smoking and seat-belt use. Some people believe that these studies continue to have value, despite the imperfect data.

Forgive me if I have forgotten some major points. These are the ones that stuck in my mind. I hope this is helpful in some way.

This Web page is referenced from another page containing related information about Homebirth Safety/Advocacy


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