# Neonatal Mortality in Missouri Home Births, 1978-84



## jeremiyah (Feb 13, 2009)

In the rest of this study presented below, the rate of mortality was about 17 per 1000 for unattended home birth: seriously not good statistics, and not recommended. for most people...and there are exceptions; when a farmer has helped several hundred lambs, kids, & calves birth, sometimes he feels qualified to help his wife. Most folks do not have that kind of experience...

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Neonatal Mortality in Missouri Home Births, 1978-84
WAYNE F. SCHRAMM, MA, DIANE E. BARNES, RN, AND JANICE M. BAKEWELL

Please refer to this study from the site below:

http://ajph.aphapublications.org/cgi/reprint/77/8/930.pdf

Comments:

Jeannie Rosberg, who trained Elaine, had already done over 1000 births, without a single neonatal mortality, or maternal morbidity. While midwifery was illegal in Colorado, Jeannie transported to a hospital. When the nurses found out who she was, they came and asked to just shake her hand, and told her what an incredible honor it was to meet her.
Carol Leonard, founder of MANA, Midwifery Alliance of North America, also did over 1000 births, without a single neonatal mortality, or maternal morbidity.

The facts for Missouri are similar; of 1000 Hospital births, attended by physicians, you will have had 2 to 3 deaths. Again, as seen below; Midwives associated with the MMA did almost 400 births, without a single neonatal mortality, or maternal morbidity.

All five deaths which occurred were under the watch-care of allopathic trained physicians, and personnel.

for a complete report, see the PDF file;

http://ajph.aphapublications.org/cgi/reprint/77/8/930.pdf

Also, please see my health compilations at;

http://groups.google.com/group/southwest-mo-county-restoration/web?hl=en

specifically;

http://groups.google.com/group/sout...rtality-in-missouri-home-births-1978-84?hl=en

From the text as presented in the following study as linked above;

"For the three attendant types with the
highest level of training (physicians, CNMs, and MMA recognized
midwives) there were five neonatal deaths compared
with 3.92 expected."

Normal hospital statistics predicted only four deaths. Missouri hospitals had five deaths. In mathematical terms, that is an increase of 25%; a significant and troubling percentage when multiplied by hundreds and then thousands over the years.

*From a non-edited edition of this study;*

"The rate for home-births attended by physicians, CNMs and direct entry midwives who were MMA members was 2.8 per 1000 (5 deaths out of 1770).

Four of the deaths were infants delivered by physicians, one was an infant delivered by a CNM.

There were no deaths associated with 396 births attended by direct entry midwives who were Missouri Midwives Association members.

The neonatal mortality rate for hospital births attended by physicians attending women in hospitals was used to calculate the expected number of deaths if their outcomes had been the same as outcomes of births in hospitals.
Based on this rate, the expected number of deaths for home-births attended by physicians, CNMs and MMA midwives was 3.92."

*In other words, the figures based on infant deaths in hospitals, attended by physicians,
indicated that there would be four deaths out of 1770.

There were five infant deaths.

All five were attended by conventional allopathically trained personnel; 
four by physicians and one by a Certified Nurse Midwife.

Zero deaths occurred in births which were attended by MMA midwives.*

The number of births, 396, attended by midwives was a sizable percentage of the total, just over 22%.
These figures are most likely representative of any given country and era. There was a midwife in Colorado who at one point, In spite of the fact that midwifery was illegal at the time, needed to transport to a hospital. When the nurses found out who she was, they were honored to be able to meet her, and to shake her hand. Jeannie had done over 1000 births and had not lost a single mom, or a single baby. The nurses knew and highly respected the fact.
Jeannie Rosberg is the midwife who trained Elaine.

It would be instructive to determine if there is a single doctor in the entire United States which could say the same.

It would also be instructive to compile a list of the number of midwives who have personally done over 1000 births, without a single neonatal mortality, or maternal morbidity. I would hazard a prediction that it would be a staggeringly large number.

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## Bobbb (Jan 7, 2012)

I hate shoddy studies like this. Physicians get the hard cases, midwives don't, so we should expect to see more birthing complications from the cases that physicians have to handle. Secondly, when a complication with a midwife attended birth arises the midwife often hands off to a physician and if the outcome is bad this reflects on the physician efficacy numbers presented in this study.


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## Grimm (Sep 5, 2012)

Bobbb said:


> I hate shoddy studies like this. Physicians get the hard cases, midwives don't, so we should expect to see more birthing complications from the cases that physicians have to handle. Secondly, when a complication with a midwife attended birth arises the midwife often hands off to a physician and if the outcome is bad this reflects on the physician efficacy numbers presented in this study.


I think these childbirth posts are sparked by the maternity kit thread that a few of us ladies started to prep for possible childbirth AFTER the SHTF.


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## Bobbb (Jan 7, 2012)

Grimm said:


> I think these childbirth posts are sparked by the maternity kit thread that a few of us ladies started to prep for possible childbirth AFTER the SHTF.


Thanks for the heads up on that thread.


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## jeremiyah (Feb 13, 2009)

Grimm said:


> I think these childbirth posts are sparked by the maternity kit thread that a few of us ladies started to prep for possible childbirth AFTER the SHTF.


Grimm,

Correct, and I should have posted it as a reply on the Midwife Kit thread, maybe, but thought it would get wider viewing here. Apparently I was right.

No matter. It is the same approach which applies, whether it be vaccinations, or homebirth, Pneumonia, Cancer, Lymes, Hepatitis C...or any other Complementary & Alternative Medicine vs Allopathic Knife /Chemo / Radiation Medicine.

In the thread Next pandemic, I stated it thus:

"Comes down to this:
free country (ehhh)
do what you want...
believe what you want...
pay yer $ & take yer (Russian Roulette) chances...
We will see who lives, & who dies from Pandemic. (fill in your blank here:
cancer, pneumonia, childbirth, etc"

You who strongly believe in MDs and hospitals, etc (best place in the world to contract & die from Iatrogenic Diseases, MRSA, VRE, etc) 
-it is a free country -please, by all means, have all of your children there.
Those of us who do not believe the way you do -will not. Pretty simple.
In the next generations, we will see who has more descendents.

jeremiyah


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## Bobbb (Jan 7, 2012)

jeremiyah said:


> Those of us who do not believe the way you do -will not. Pretty simple.
> 
> In the next generations, we will see who has more descendents.
> 
> jeremiyah


That's fine. You can believe what you like and it's not my mission in life to change your faith but why must you set out to mislead those who read your posts by selectively editing the supporting material? That's what is objectionable.

From the very paper (long out of date too, I might add) you cite:

Of the 3,645 home births whose planning status was available, 3,067 (84.2 per cent) were planned to be at home. Physicians attended the largest number of planned home births (1,156) during the 1978-84 time period, followed by non-MMA midwives (725), father and other attendants (474), MMA midwives (396), and CNMs (218).

*Generally, planned home births were at lower risk demographically* than unplanned home births or hospital births as shown in Table 2. The proportion of teenage births, unmarried mothers, Black births, or smoking mothers among planned home births* was one-fourth to one-third the levels for hospital births.*​
So right off we see that there is a selection bias at work - those mothers who present as high risk tend to favor hospital births. The plurality of planned home births were attended by physicians.

Then you completely omit relevant findings from this study, such as:

Abstract: A study was conducted of 4,054 Missouri home births occurring from 1978 through 1984. Of the 3,645 births whose planning status was identified, 3,067 (84 percent) were planned to be at home. *Neonatal mortality was elevated for both planned (17 observed deaths vs 8.59 expected deaths) and unplanned home births (45 observed vs 33.19 expected) compared with physician-attended hospital births.* Nearly all of the mortality excess for planned home births occurred in association with lesser trained attendants (12 observed vs 4.42 expected) . .​
Women who intend to give birth in a hospital have a higher representation of high-risk profiles and yet home birthing from women who tend to be drawn from a lower risk profile still has a higher neonatal mortality rate than hospital births.

I have no problem with you believing in goblins, just don't try to dress up your belief as based on facts and if you're going to link to papers, even long outdated ones, in support of your position, then you should count on some of the people who read your posts actually clicking the links and reading the papers you cite and so it doesn't advance your position to misrepresent the nature of those papers. You'd be better serving your position to not even include the links to the papers if your intent is to misrepresent them.


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