I read it as a comparison between MLU's and homebirth? But now I've read it again I realise I misinterpreted the text in a different way!
It appears that these guidelines have been generated from mostly Cochrane reviews which would make these statements due to the lack of place of birth RCT's. I think this needs to be explicitly stated alongside some narrative regarding the evidence that we do have i.e. Birthplace. The wording might need some adjustment to clarify, we don't need the press jumping on this and running with it!
Best wishes,
Claire Feeley
PhD Student/ MidwifeUniversity of Central Lancashire
On Wednesday, 21 November 2018, 10:28:40 GMT, Page, Lesley <[log in to unmask]> wrote:
Dear All
I have only read the guidelines quickly but I agree with Sheena and Debbie the evidence summary appears to lack congruence and is therefore confusing. Of course in most areas there will be some conflicting evidence. This makes presenting a summary of evidence in such a complex area very difficult. We always have to remember people will want a quick read. However It might need some narrative around some of this old evidence, and the suitability of the methodology for the question. Could this be added as a footnote or an addendum?
It is a pity to see this statement so early on, particularly because Dorothy Shaw proposes midwifery led care as a solution to the too little too late: too much too soon problem in the Lancet Maternal Health special edition referred to in the guidelines.
I am sorry to be commenting after the guidelines have been published. Was there a consultation that I missed?
In regard to epidurals I recommend the book by Elizabeth Newnham and others, Towards the Humanisation of birth: A study of epidural analgesia and hospital birth culture published by Palgrave MacMillan 2018.
With thanks and best wishes
Lesley
Professor Lesley Page CBE
Visiting Professor in Midwifery KCL
Adjunct professor UTS Australia
Griffith University Australia
Honorary research fellow Oxford Brookes University
mobile +44(o)7747708630
https://www.all4maternity.com/author/lesleypage/
<https://www.all4maternity.com/author/lesleypage/>twitter: lesleypageCBE@humanisingbirth
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