They compared the death rate at homebirth with the death rate in tertiary [high risk] facilities, but that's not what we want to know.
When
we compare the death rate at homebirth of 2.06 / 1000 with the CDC death rate for low risk white women, ages 20 - 44, at term, with babies that are not growth restricted of 0.38, we find that homebirth has a death rate 5.5 X higher than hospital birth.
To find out,
they compared death rates in New Jersey between 2004 and 2009 to concentrations of fine particulates — meaning especially tiny, nano - size bits.
Not exact matches
Death rates ballooned for almost every one of the top 10 causes of death compared to
Death rates ballooned for almost every one of the top 10 causes of
death compared to
death compared to 2014.
I suspect that the number of
deaths attributed communist dictators is a drop in the bucket
compared to the estimated 90 %
death rate of indigenous Americans when Christian explorers arrived in the New World.
We want to know how the
death rate at homebirth
compares with the
death rate at all hospital births, not the
death rate at tertiary facilities.
That makes it possible to
compare neonatal
death rates at home vs. in the hospital.
Intrapartum and neonatal
death rates were
compared with those in other North American studies of at least 500 births that were either planned out of hospital or comparable studies of low risk hospital births.
And I agree with you, that it would be completely inappropriate to say that homebirth has lower risk of
death if the
rate is say, 1 / 100
deaths, but 1/40, 000 in a hospital (obviously those are fictitious numbers used for illustration purposes)... but then you also have to account for the
rate among individual OB's if you want a more accurate comparison, since there are multiple OBs typically in a hospital, being
compared to only one midwife.
When
compared with data on planned home birth in other industrialised countries, the perinatal
death rate in Australia was much higher.
Don't forget about the 2005 study that
compared outcomes of CPM attended births and hospital births, where the results showed similar IP and neonatal
death rates for both, but CPM attended births fared better in other categories.
When this 20 % risk of
death is
compared to the 0.02 %
rate of cord prolapse during labor at homebirth that might have a better outcome if it happened in hospital, this means that a low risk woman has a 1000 times higher chance of having a life threatening complication either to her life or her fetus / newborns life at planned hospital birth, than if she plans to have an attended homebirth with a well - trained practitioner.
The
death rate for infants weighing 2500 g in 1985 - 8 was 5.7 per 1000 in home births
compared with 3.6 per 1000 nationally (relative risk 1.6; 95 % confidence interval 1.1 to 2.4).
During 1985 - 90 there were just over 1.5 million births in Australia, giving a
death rate (including late neonatal
deaths) of 10.8 per 1000
compared with 7.1 per 1000 in planned home births (table 4).
While there was no difference in maternal complications and
death rates, the
rate of complications for babies, including
death, was significantly lower in the planned cesarean group (1.6 %
compared to 5.0 % in the vaginal breech group).
Without having looked into it, I am just wondering how the
death rate of ONLY the higher risk women
compares to similar risks at the hospital.
So it makes no sense whatsoever to try and
compare the two groups as you are attempting to, since you have no way of knowing whether the difference in
death rate is due to the place of birth or due to the underlying conditions which make the women in question high risk.
This is why it is appropriate to
compare the term
death rate in hospital births to home births in general.
The authors are well aware of this and that's why they had to be forced to acknowledge the
death rates in the first place and why they refused to
compare them to the appropriate comparison group, which is white women at term.
So she is
comparing the all around
death rate of home birth to a very specific
death rate in hospital.
Compare with the
death rate for low - risk pregnancies for babies born at home: 1.6 per thousand, which suggests around 32 per thousand permanently injured or 33 per thousand dead or permanently injured.
What I seem to gather is this: 1) The absolute risk of
death from home birth is LOW, which is why homebirth advocates say that this study proves homebirth is «safe», however: 2)
Compared to HOSPITAL births, the
rate of
death for homebirth is MUCH higher, and 3) The midwives reporting did so on a voluntary basis, so this isn't a study that is worth very much anyway.
All sorts of hilarious errors — using one type of data (ICD10 code data from «white healthy women» and essentially
comparing the best possible data from one set of hospital data related to low - risk births to the worst possible single set of data related to high - risk at - home births)-- if you use the writer's same data source for hospital births but include all comers in 2007 - 2010 (not just low - risk healthy white women), the infant
death rate is actually 6.14 per 1000, which is «300 % higher
death rate than at - home births!»
Those who have actually read the Cheyney study can see that the authors
compared their outcomes to many other studies on planned home birth and found no differences in intrapartum and neonatal
death rates.
Compared with intermittent auscultation, continuous cardiotocography showed no significant improvement in overall perinatal
death rate (risk ratio (RR) 0.86, 95 % confidence interval (CI) 0.59 to 1.23, n = 33,513, 11 trials), but was associated with a halving of neonatal seizures (RR 0.50, 95 % CI 0.31 to 0.80, n = 32,386, nine trials).
A study large enough to
compare perinatal
death rates accurately, if the annual
rate of home births with regulated midwives in BC were to remain the same as it is today, would require 7 — 8 years of data collection.
These data report intrapartum and early neonatal
death rates in full term women who intended to deliver out of hospital (and subsequently deliver either out of hospital or in hospital) at the start of labor
compared with women who intended a hospital birth (thus «higher risk» pregnancies are included in this group) in 2012.
The
death toll for c - sections are still higher
compared to natural births and the recovery
rate is undeniably slower with a lot more complications thrown in.
Our study showed that planned home birth attended by a registered midwife was associated with very low and comparable
rates of perinatal
death and reduced
rates of obstetric interventions and adverse maternal outcomes
compared with planned hospital birth attended by a midwife or physician.
A comparison of neonatal
death rate of 1.3 / 1000 is still concerning
compared to.3 / 1000 and is a more approriate comparision of like to like.
Yet, when I analyzed all of the studies that the Midwives» Alliance of North America (MANA) says comprise the best evidence for the safety of home birth, I found that every study that looked at nonhospital birth in the United States (and many of the studies that looked at other countries, as well) reported much higher
death rates for babies when
compared to similar hospital births.
Intrapartum
death are not in the Wonder data so it isn't appropriate to add intrapartum
death to neonatal for one group for an overall
death rate of 2.06 / 1000 and
compare it to the neonatal
death of.3 / 1000.
Comparing intended home and hospital births in a cohort of 529688 low risk pregnancies in primary care in the Netherlands, de Jonge et al recently found low
rates of perinatal mortality (intrapartum and neonatal
death before 7 days) and admission to the NICU.11 They concluded that an intended home birth does not increase risks
compared with an intended hospital birth in this population.
0.41 / 1000 early neonatal
death rate in the MANA study
compared to 0.46 / 1000 early neonatal
death rate from national data; 0.35 / 1000 late neonatal
death rate in the MANA study
compared to 0.33 / 1000 late neonatal
death rate from national data.
Between 1984 and 2004, ASSB infant mortality
rates more than quadrupled, from 2.8 to 12.5
deaths per 100 000 live births, 15 which represents 513 infant
deaths attributed to ASSB in 2004
compared with 103 in 1984.
When she
compared Daviss and Johnson's home - birth figures with data on hospital births in 2000 from the National Center for Health Statistics, she found that for women with comparable risks, the perinatal
death rate was almost three times higher in home births.
SIDS
deaths have historically been observed more frequently in the colder months, and the fewest SIDS
deaths occurred in the warmest months.23 In 1992, SIDS
rates had an average seasonal change of 16.3 %,
compared with only 7.6 % in 1999,24 which is consistent with reports from other countries.25
Maybe I'm wrong looking at the increased neonatal
death rate in MANA's study, the increased risk of HIE in January 2014 ACOG, the increased risk of Apgars of 0 at 5 minutes (Grunebaum 2014) at homebirth as
compared to hospital birth.
Higher
rates of prelabor cesarean delivery are associated with lower perinatal
death rates and both prelabor cesarean and labor induction are associated with late preterm birth.2 But it made me wonder how the overall changes
compared to the United States.
Prior to this discovery, in most western industrialized countries SIDS
rates ranged between approximately 1.5 to 4 infants per 1000 live births (
compared to industrialized counties in Asia, such as Japan, which has the lowest SIDS
rates in the world,.05 infants per 1000 live births21) with enormous increases amongst minorities, especially impoverished indigenous peoples such as the Maori of New Zealand, the Cree of Northern Canada, and the Aborigines of Australia.19, 22,23 Native peoples in the United States demonstrated similar exponentially increased SIDS (or SUDI
rates, see below), as much as two to seven the times the
rates found amongst white Americans.13, 19 Despite significant declines among almost all cultural and / or ethnic groups, SIDS
rates still remain the leading cause of
death for infants between one month and one year of life in the United States and elsewhere.13
«If you look at this country
compared to any other industrialized country, we have one of the highest c - section
rates of any,» Nan Strauss of Amnesty International told «Good Morning America, «and along with the increase is coming an increase in very severe complications, and in
deaths as well.»
The IRR is not
comparing black and white
death rates, but there is evidence to show that because of stereotyping - for example expectations that black people will be irrational, inordinately strong or angry — they face a disproportionate level of force.
«He has previously described the Prime Minister as a dead woman walking who is on
death row, and
compared the Prime Minister to the living dead in a second -
rate horror film.
The
death rate is about 27 in 100,000 people,
compared to roughly 16 per 100,000 people statewide, per the release.
In addition, an analysis of the corrected
rates over the decade revealed that white women's
rates of
death from cervical cancer decreased by 0.8 percent per year,
compared with an annual decrease of 3.6 percent in black women.
The SMRs were also consistent across all age groups, except for the age - group younger than 30 years in whom a non-significantly higher
death rate was observed (SMR 1.65)
compared to the general population.
A standardized mortality ratio (SMR) was calculated based on the actual
death rate of the cyclists
compared to the
death rate in the age - matched French population according to the Human Mortality Database.
In women,
death rates from breast and colorectal cancer will fall by 8 % and 7 % respectively, but lung and pancreatic cancer
rates will rise by 5 % and 4 %; in 2016 the
death rates from lung cancer in Europe will be 14.4 per 100,000 women (
compared to 13.51 in 2011) and 5.6 per 100,000 for pancreatic cancer (
compared to 5.39 in 2011).
When we
compare the
rates for 2014, when there are more elderly people now than there were in 1988, we have avoided a major rise in mortality
rates, with over 250,000
deaths avoided this year,» said Prof La Vecchia.
Over 325,000
deaths will be avoided in 2015
compared with the 1988 peak
rate.