Science, politics, and headlines in the home birth war

Last month the Medical Journal of Australia published a study on outcomes of home birth that generated many media stories sounding the alarm about the safety of such births.1

Many stories focused on the study’s findings that babies were seven times more likely to die during labour in a planned home birth and in particular were 27 times more likely to die from asphyxiation. Some also did mention the finding that there was no significant difference in the overall perinatal mortality rate between planned home births and those planned for hospital delivery.

These were also all findings highlighted in the media release accompanying the journal,2 which made no mention of uncertainty surrounding the relative risk estimates. The confidence interval for both was wide: 1.53 to 35.87 for intrapartum deaths and 8.02 to 88.83 for deaths from intrapartum asphyxia.

Nor did the press release mention the numbers of deaths involved or the absolute risks. Among 297 192 planned hospital births in South Australia between 1991 and 2006 there were 2440 perinatal deaths, including 247 intrapartum deaths and 87 deaths attributed to intrapartum asphyxia. …