This has been so handily covered by the Birth Blogs already, I hardly know where to start. But here's Stand and Deliver has a great roundup of everything that's been written so far. Check them all out. I wasn't even going to write about it myself, others had done such a righteous job of it. But I decided I at least had to write to the producers of the Today Show, which I did, and once that was done, I figured I might as well share it here. A few bits were lifted from my prior comments on some of the aforementioned fabulous blog posts, so if you feel like you have deja vu in a couple spots, that's probably why. )Mucho props to the other bloggers, especially Your Birth Right, who first pointed out the sneaky semantics they slip in by using the word "allege" selectively.)
I didn't even go into the melodramatic flourishes like showing the mother folding baby clothes in the empty nursery, or the intentionally dead-end questions our intrepid reporter Peter Alexander says doctors recommend parents ask midwives at the end of the piece; I was already running long. Anyway, here's my longwinded letter, for what it's worth.
Dear Today Show Producers,
As soon as Matt Lauer said the words "Extreme Birth" in the intro, I knew what kind of a piece we were in for.
I was astonished to see the one-sided, sensationalist, fear-mongering piece you first called "The Perils of Midwifery" and then changed to "The Perils of Home Birth". It would take pages and pages to point out all the gaping holes that riddle this "report", but I'll limit it to a few main points. Let it be said right off the bat that, of course, I feel terrible for the couple that lost their baby. It is a tragedy no matter where it took place. But I feel strongly that this couple is being completely exploited and manipulated into blaming home birth for their loss - without knowing the details of the case, we don't know if it is one of the situations that could have happened anywhere, sadly.
I can't help wishing Cara Mulhahn had been able to say more about the situation, but it's obvious to me that her hands were likely legally tied - which you made seem like an admission of guilt, which is preposterous. But putting that aside - did it ever occur to you to talk to, oh, say, another midwife? Ms. Muhlhahn is actually not the only one in New York City, believe it or not. You could have called MANA, which is the professional organization for certified professional midwives, the ones that most often attend home births, or you could have contacted ACNM, which is the equivalent for nurse-midwives who largely practice in the hospital, but still have an understanding of the goals of home birth and the midwifery model of care.
But you allowed the ACOG to be the mouthpiece for this story. When you mentioned the CDC study that demonstrated home birth outcomes being equal to or better than hospital outcomes, it's just immediately dismissed by the claim that it's because of higher risk women, with no further discussion. End of story. No mention of the recent Canadian study (among others) which specifically compares equivalent risk level! It completely refutes the previous claim about higher risk women, and has, frankly, been widely circulated, so I cannot imagine how a decent reporter could have missed it, so I can only assume it was deliberately left out in order to amp up the scary shock factors.
You also use transparent semantic tactics that insult our intelligence: statements by home birth advocates are "alleged", but anything coming out of a doctor's mouth, or from a doctor's organization, is treated as if it were handed down on a stone tablet, whether the research supports it or not. A few seconds of Marsden Wagner (who is only one among many doctors who also support alternatives to hospital birth) and a clip of one successful home birth do not journalistic balance achieve.
Insinuating that celebrities have anything to do with the rise in home birth is just plain foolish. For every home birthing celebrity, there are celebrities on the opposite end of the spectrum choosing elective, scheduled, non-medically-indicated cesareans. There are plenty of examples on both sides. What is really ridiculous is the ACOG's admonishment that women should not base their birth choices on what is "fashionable and trendy". Do they not realize that birthing in the hospital is the newest "trend" of all, historically speaking? It has been less than a century since this "trend" took hold. So, frankly, if we take their words literally, I actually agree. Women should not birth in hospitals just because everyone else is doing it. They should make that choice based on their risk level, how comfortable they are with their care provider's practices, and most importantly, the real research.
And where do I even begin with the asinine statement about home birth being like a "spa experience"? And "hedonistic"? Yeah, I totally chose a home birth because it would be, like, the ultimate bacchanalian orgy. Who cares if it's supported by research and is the best choice for me and my baby, as a low-risk pregnancy? There was no discussion about the fact that women are really choosing home birth because they want to avoid the cascade of unnecessary interventions that are NOT evidence-based, yet are standard in the vast majority of hospitals, and because of the fact that so many OBs are practicing defensive medicine and thus making choices that hurt their patients, as they themselves admitted just yesterday (what a convenient coincidence). "Cover thy ass" now comes before "First do no harm" for many physicians. Is it all that surprising some families have decided to find another way as a result?
I do not have anything against women choosing to birth in hospitals, as long as it is a truly informed choice. Some women, even low-risk ones, are simply going to feel safer there, and this is fine. The bottom line is that there are risks in both the home AND the hospital (and in birthing centers too, a third option your piece, of course, never even touched). It is up to every family to look at the real evidence, not sensationalism, and weigh those risks for themselves.
Anne C. Tegtmeier