Monday, August 30, 2010

That pesky meta-analysis

Posted by Tatiana

I don't know about you, but that meta-analysis that has been all over the news has made me uneasy.  I hear the criticisms of it, but it still makes me uneasy.  If it is true that there is this large increase of neonatal mortality in home birth, would I really want to be a home birth midwife?  I kinda don't think so.  I want to think the study is just wrong, but it doesn't satisfy to say, "Oh well, people I respect have dismissed the study, so... that should be cool."  I want to be a bit more clear than that.  If a client or, say, a policy maker happens to ask me "What about that study published in 2010 about the threefold increased risk to babies in home birth?" I'd like to answer coherently, and in a way that's grounded in real science.  Not convenience science.

I've alluded before that I really want a stronger understanding of how studies are conducted so that I can be a better judge of their quality, and I'm not there yet.  (Pan camera across floor riddled with toys and clothes to baby cheerfully pinching my arm and erupting with a river of spit-up.)  In time.  In the meanwhile, I've read a bunch of articles about this study over the last few weeks, and I came accross this reponse today which does well with specifics and left me curious to see what better studies in the future would show:

Planned home birth and neonatal death: Who do we believe? - posted by Amy Romano of Science and Sensiblity

I look forward to the results of the de Jonge and Buitendijk analysis she mentions.


  1. I would love to read the study to confirm what she says is true. If it is true that they didn't actually include the neonatal death rates from the de Jonge study then I would question all of their results.

  2. I have the article and I can email it to anyone who is interested in reading it, just jet me a note a As I sort through it, I'll post another comment!