And far less people die playing football than die giving birth.

Personally I think anyone who tried to give birth at home without a doctor present is a fucking idiot. Should they be allowed to anyway? It’s the same as the abortion argument I guess. Do the rights of the baby trump the rights of the mother or vice versa?

In any case, Darwin’s law wins.

I agree many of these home birthers are mad. Coming from a farm I have a somewhat clinical approach to the whole thing – there will be a percentage of complications, which on the farm translates into death for mother and baby. You can be damn sure that when my wife is having kids it will be within shouting room of qualified doctors with cesaerian facilities.

But I don’t think a home-birth constitutes child abuse, so I don’t think there is a role for government in making the decision, or regulating one option out of existence.

Science based medicine is a case of the experts know best. That’s not to say we need to live under the boots of experts. They are worth listening to.

Your behaviour before and during and after your pregnancy impacts the health of your child. How your treat your child, which school you send them to, which rules you enforce, which morals you teach, which sports you let them play, etc all have a huge impact on the future health and welfare of your children. And of course, passing on any religion is “child abuse”.

The argument that “the experts know best” I think is dangerous. Yes, sometimes experts know best. If this is all that matters, then the logical conclusion is that our lives should be run by a bunch of smart bureaucrats who are experts in their field. Allow health bureaucrats to make our health decisions. Allow education bureaucrats to make our education decisions. Allow “consumer rights” bureaucrats to make our general consumption decisions. The list goes on. Our decisions would be “better” and we wouldn’t be bothered with all that annoying freedom.

I think it is preferable to leave the decisions with free individuals.

When you are giving birth at home and something goes wrong, it could be 1-2 hours depending on traffic before a doctor can try to help you.

I don’t have any problem with people giving birth using the services of a midwife if they are still in close proximity to a hospital in case of the worst case scenario.

One of my neighbours is a neonatal doctor and he is always banging on about how brilliant the Cochrane systemic review process is. He says we should use this approach to the review of medical evidence for public policy. The wikipedia article on home birth has this from the Cochrane database:-

The most recent research contained in the Cochrane systematic review of the literature, (published on the Cochrane database; the source from which hospital policies are usually created), states that there is not enough evidence to decide one way or another, whether home or hospital birth is safer (Olsen & Jewell: 2000 (CD000352) in Hofmeyr et al:2008:252).

However, Hofmeyr goes on to say, on behalf of the Cochrane database; “The relative benefits and risks of different settings are difficult to quantify. For a woman and her baby with no complications, the risk of an unexpected adverse event during a home birth may be smaller than risks specific to hospitalization, such as hospital-acquired infections” (Hofmeyr et al:2008). Olsen and Jewell (2000), the authors of the systematic review also state: “In countries where it is possible to establish a home birth service backed up by a modern hospital system, all low-risk women should be offered the possiblity of considering a planned home birth….” (Olsen & Jewell: 2000 (CD000352) in Buckley:2005:230).

On reflection however I would expect that the conseqence of this legislation is likely to be the creation of more birthing centres outside the traditional mould. That’s no bad thing because the traditional mould found in most hospitals was not always that great. In particular there is lots of evidence that doctors are far too interventionist (a bit like governments) and in most instances it is good to keep them away from mothers that are delivering.

http://www.telegraph.co.uk/news/uknews/1547417/Women-not-told-of-home-birth-risks.html

I’m actually not advocating any form of enforcement in terms of making mother do things by the force of law. I’m suggesting that supporting home birth is a silly idea.

A home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low risk women, provided the maternity care system facilitiates this choice through the availability of well-trained midwives and through a good transportation and referral system.

There are a lot of caveats is that statement to the extent that it makes it basically worthless.

There’s a bloody good reason why medical insurance carriers don’t insure home birth. The reason is that it could seriously hurt them. In that sense the market has spoken.