Hi all. After months of development a dream of connecting midwifery communities, wherever the midwife lives, has come to fruition. Birthspirit’s first Breech Birth Online Workshop is up and running and will start on 5 May 2014 – a great way to celebrate International Midwives Day.

http://www.birthspirit.co.nz/workshops-4/

Also… I think one reply to these data might be, rather than the traditional pitched battle about data quality, to say to US professionals and politicians, if these data are true,  this is not a problem of home birth per se (given that it can be done successfully and safely almost everywhere else in the high income country world!) but one of quality of care delivery – a case of physician heal thyself! Don’t get rid of homebirth (because you cant – some women will always birth at home ‘under the radar’ as Holly kennedy says), make your maternity care system work better so that home birth in the US becomes as  safe as it is in many other comparable countries!!!

 

All the best

 

Soo

 

From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Soo Downe
Sent: 05 April 2014 09:31
To: [log in to unmask]
Subject: Re: ACOG paper - Early and Total Neonatal Mortality in Relation to Birth Setting in the United States, 2006-2009

 

The most important issue as others have mentioned is that home birth in the US is occuring in an atmosphere that is very antagonistic, and where referral is sometimes very difficult. I haven’t read the paper, but if as others have said there is no control for socio-demographics, this is a serious flaw, as very high risk women in the US are making a forced choice to birth at home because hospital is such a bad option for them.

 

All the best

 

Soo

 

From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Sophie Alexander
Sent: 05 April 2014 04:54
To: [log in to unmask]
Subject: ACOG paper - Early and Total Neonatal Mortality in Relation to Birth Setting in the United States, 2006-2009

 

My answer to the paper below is that

a.       US midwives do not have appropriate back up

b.       or training.

c.       Routine data make quality unreliable (as opposed to Birthplace where the results were OK.

In a country like Belgium, because of the increased risk, and also because co-author Arabin is a European from a Nordic country, this paper will be extensively referred to.  

 

Has anybody got more arguments to tell people not to be worried about these data, and to stick to the Birthplace data?

 

 

Sophie Alexander, MD, PhD

PERU (Perinatal Epidemiology and Reproductive health Unit)

Ecole de Santé Publique

Université Libre de Bruxelles

808 Route de Lennik

1070 Bruxelles

 

Tel +322 555 4063

 

 

 

Early and Total Neonatal Mortality in Relation to Birth Setting in the United States, 2006-2009

 

·         Amos Grünebaum, M.D.

Affiliations

·         Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, New York

,

·         Laurence B. McCullough, Ph.D.

Affiliations

·         Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas

,

·         Katherine J. Sapra, M.P.H.

Affiliations

·         Department of Epidemiology, Mailman School of Public Health , Columbia University, New York, New York

,

·         Robert L. Brent, M.D., Ph.D., DSc (Hon)

Affiliations

·         Thomas Jefferson University, Alfred I. DuPont Hospital for Children, Wilmington, Delaware, and, Adjunct Professor of Obstetrics and Gynecology, Weill Medical College of Cornell University

,

·         Malcolm I. Levene, M.D., FRCP, FRCPH, F Med Sc

Affiliations

·         Division of Pediatrics & Child Health University of Leeds United Kingdom

,

·         Birgit Arabin, M.D.

Affiliations

·         Center for Mother and Child Philipps University Marburg, Germany and Clara Angela Foundation Berlin, Germany

,

·         Frank A. Chervenak, M.D.

Affiliations

·         Department of Obstetrics and Gynecology Weill Medical College of Cornell University New York, New York

Received 19 January 2014; received in revised form 12 February 2014; accepted 19 March 2014. published online 24 March 2014.
Accepted Manuscript

·         Abstract

·         PDF

Abstract

Objective

We examined neonatal mortality in relation to birth settings and birth attendants in the United States from 2006-2009.

Study Design

Data from the CDC linked birth and infant death data set in the US from 2006-2009 were used to assess early and total neonatal mortality for singleton, vertex, term births without congenital malformations delivered by midwives and physicians in hospital and midwives and “others” out of hospital. Deliveries by hospital midwives served as the reference.

Results

Midwife home births had a significantly higher total neonatal mortality risk than deliveries by hospital midwives (1.26/1,000 births; RR: 3.87 versus 0.32/1,000; p<0.001). Midwife home births ≥ 41 weeks

(1.84/1,000; RR: 6.76 versus 0.27/1,000; p<0.001) and midwife home births of women with a first birth (2.19/1,000; RR: 6.74 versus 0.33/1,000; p<0.001) had significantly higher risks of total neonatal mortality than deliveries by hospital midwives. In midwife home births, neonatal mortality for first births was twice that of subsequent births (2.19 versus 0.96/1,000; p<0.001). Similar results were observed for early neonatal mortality. The excess total neonatal mortality for midwife home births compared to midwife hospital births was 9.32/10,000 births, and the excess early neonatal mortality was 7.89/10,000 births.

Conclusion

Our study shows a significantly increased total and early neonatal mortality for home births and even higher risks for women ≥41 weeks and women having a first birth. These significantly increased risks of neonatal mortality in home births must be disclosed by all obstetric practitioners to all pregnant women who express an interest in such births.

 

De : A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] De la part de Macfarlane, Alison
Envoyé : vendredi 4 avril 2014 16:06
À : [log in to unmask]
Objet : Re: Researchers in London using public health data

 

Dear Mary,

 

Can you please tell him that public health analysts can no longer access the data they need for their work, so heaven help PhD students.

 

What is the Public Health Data Forum? If it has money, please ask it to contact the Health Statistics User Group asap, as we have none, but nevertheless are trying to organise a series of workshops on public health data.

 

Oh, I see that the work has been outsourced to a private company. http://www.metadatatechnology.com/ Par for the course.

 

Ali

 

 

 

From: Stewart, Mary [mailto:[log in to unmask]]
Sent: 04 April 2014 12:32
To: [log in to unmask]
Subject: Researchers in London using public health data

 

Apologies, as I know this is only relevant to a limited number of users.  However, I am forwarding the email below on behalf of a colleague. 

 

I am leading a short project that is looking at data discoverability for public health research. This has been commissioned by Wellcome Trust on behalf of the Public Health Research Data Forum and, as part of this work, we plan to convene some small focus groups at Wellcome Trust in London. We’re looking for a small number of PhD students and post docs who could spare a few hours of their time on either 9^th or 10^th April (see below). Would it be possible to please circulate an invitation within your department? You can find out more about the project here.

 

If anyone is interested in participating in the focus groups they should contact Arofan Gregory at: [log in to unmask]  . The following text provides a bit more information on the focus groups.

 

The Wellcome Trust is conducting some focus groups to determine how easy it is for researchers to find the Public Health data they need for their work.

 

Two focus groups will be held, one on April 9 and one on April 10 at the Wellcome Trust facilities in London, at the Gibbs Building (215 Euston Rd)

 

Researchers will be asked to discuss their experiences in finding existing data for research, and how easy it is to understand and use such data. Opinions will be sought based on some examples of portals and other web-based mechanisms for locating data in archives and repositories.

 

We are looking for volunteers to participate in these focus groups - if you work with research data in any field, we are interested in your input.

 

On April 9, the focus group will start at 10:30 AM and run until 2 PM. On April 10, the focus group will start at noon and run until 4 PM. Lunch will be provided to participants.

 

Thanks in advance for any assistance you can offer.

 

Kind regards,

 

Tito

 

 

Mary Stewart

Research midwife, Life Study

 

Life Course and Statistics

Population, Policy and Practice

UCL Institute of Child Health

30 Guilford Street

London WC1N 1EH

               

Internal ext. 42216

Within UK:  0207 905 2216

[log in to unmask]

 

Websites:

www.lifestudy.ac.uk

www.ucl.ac.uk/ich/research-ich/population-policy-practice

 

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