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CONTACT: Gaby Merediz, 718-753-1174


Friday, September 11, 2009





The Today Show segment aired the morning of September 11, 2009, (just a few weeks
after the American College of Obstetricians and Gynecologists, or ACOG, posted a
survey on their website for obstetricians asking for adverse outcomes for home birth
transfers) entitled “The Perils of Midwifery” wrongly implicates midwife-attended home
births as unsafe and draws unsubstantiated conclusions between the safety of midwifery
and infant mortality. The very title, “The Perils of Midwifery” (emphasis ours) should
alert the viewer to the bias of the story against midwifery care. Further, Meredith Vieira
and Matt Lauer both introduced the story with the words “extreme birth.” This
sensationalistic use of terms calls to mind “extreme sports,” and scares or warns the
viewer that they are about to view something dangerous. Webster’s definition of
“extreme” includes “outside the normal,” “the farthest point from the center,” and “of
relating to…a form of sport that involves an unusually high degree of physical risk.”

Worldwide statistics and research show that midwife-attended births are just as safe as
physician-attended births. The unfortunate story about the birth of the McKenzies’
stillborn baby is irresponsibly correlated with midwifery care and implies that midwifery
care is inherently riskier than maternity care by an obstetrician. As consumers of
healthcare in this country, we should all be advocating for an increase in options for
maternity care for women, including increased access to midwifery care, and not scaring
the public with unsubstantiated, sensationalistic claims.

Infant mortality rates are lowest in countries with the highest rates of midwife-attended
births. The five countries with the lowest infant mortality rates in the world have 70% of
births attended by midwives. In contrast, the U.S. ranks second highest in the
industrialized world in terms of infant mortality. A recent 4-year study conducted in
Canada found that perinatal death and other adverse perinatal outcomes were low in
planned home births attended by registered midwives, and comparable to midwife- and
physician-attended planned hospital births (August 31, 2009). In the Netherlands, 1/3 of
births take place at home, yet the infant mortality rate there is lower than that of the U.S.
(4.73 deaths per 100,000 live births compared with 6.26 deaths per 100,000 live births in
the U.S. in 2009 according to the CIA World Factbook). With these statistics readily
available, how can NBC, as a trusted media outlet, purport that midwifery is unsafe,
stemming from one unfortunate event?

Mrs. McKenzie states (regarding her midwives) “We trusted them. They were the
experts.” The mere act of living carries inherent risks. So does pregnancy and birth.
Accidents occur, and babies and mothers die in both midwife- and physician-attended
childbirth every year, in every country. The baby in this story died from a nuchal cord
(the cord was wrapped around the baby’s neck), not because her birth was attended by a
midwife. According to the March of Dimes, approximately 25% of babies are born with a
nuchal cord. Only rarely does this lead to complications. Without knowing the details of
this pregnancy, mother’s and baby’s health, the labor, and other circumstances related to
this delivery, one cannot responsibly draw the conclusion that the fact that this home
birth was attended by a midwife caused the death of this baby. Regardless, one adverse
outcome in a home birth should not taint the practice of midwifery as a whole, or home
births, for that matter, just as one adverse outcome in a hospital should not taint the entire
obstetrical profession. The ACOG is quoted in this segment as saying that the safest place
for birth is in a hospital or a birthing center within a hospital complex. However, a
woman who gives birth in a U.S. hospital has a 1 in 3 chance of delivering her baby via
c-section. About 36 women per 100,000 die while undergoing a c-section, compared with
9.2 deaths per 100,000 vaginal deliveries. If we follow the argument as portrayed in this
segment, should we conclude that all obstetricians are incompetent surgeons who should
be avoided if you want to survive your childbirth? We don’t think so. We think that
statistics and data should be accurately portrayed in order to increase options for
women’s health care in this country, not restrict it.

As a grassroots organization seeking to increase access to midwives in hospitals, free-

standing birth centers, and at home through education and advocacy, Wilmington, NC
based Where’s My Midwife? (WMM?) seeks to refute claims made in the Today Show
story. The segment uses sensationalism and manipulation to scare and to gain viewers,
rather than fair reporting about the safety of out of hospital birth and about midwifery
care. Little attempt is made to report the substantial evidence from numerous studies
(1998, 2005, 2009), and underscored in statements made by numerous health
organizations (including ACOG’s cohorts in England, The Royal College of
Obstetricians and Gynaecologists, 2007) that out of hospital birth under the care of
skilled midwives is safe for low risk women. Midwifery care has been around for
centuries, and is not a trendy, hedonistic style of birthing as Andrew Goldman from New
York Magazine purports in this segment, but is an educated decision to which pregnant
women in the U.S. should have unlimited access, as they have the same type of access to
obstetrician care.