Study validity questioned

American journal of obstetrics and gynecology (Impact Factor: 4.7). 04/2011; 204(4):e14; author reply e14-5. DOI: 10.1016/j.ajog.2010.08.052
Source: PubMed
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    ABSTRACT: A recent meta-analysis on home-births reported a small increase in neonatal infant mortality but considerable reduction in maternal morbidity in association with planned home-birth as compared with hospital-birth (1). This caused the editors of the Lancet to proclaim that '[w]omen have the right to choose how and where to give birth, but they do not have the right to put their baby at risk. There are competing interests that need to be weighed carefully' (2).
    International Journal of Clinical Practice 09/2011; 65(9):918-20. DOI:10.1111/j.1742-1241.2011.02733.x · 2.57 Impact Factor
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    ABSTRACT: Home births are physiological births and form part of the social model of birth. Doctors, traditionally, have been very fearful of out-of-hospital birth, and physiological births happen less frequently in obstetric units. Normal/physiological birth contributes to improving public health, and doctors are often not aware of the extent of this benefit. Normal birth leads to adaptive physiological function in the baby (endocrine, immune system, thyroid function, respiration, neurology, temperature regulation), more mother and baby bonding, and promotes higher breastfeeding rates, which in turn lead to better lifelong emotional and physical health in babies. Normal birth affirms health, promotes empowerment in mothers, and is a societal event that has been linked to promoting positive emotional qualities in society via the birthing hormone, oxytocin. Training within the medical model constrains doctors' appreciation of normal birth. Experience of complications, a lack of awareness of the evidence surrounding home birth, compounded by failure to understand the concept of iatrogenesis, perpetuates fear of home birth among doctors.
    11/2011; 1(4):263-272. DOI:10.1891/2156-5287.1.4.263
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    ABSTRACT: Observational studies of increasingly better quality and in different settings suggest that planned home birth in many places can be as safe as planned hospital birth and with less intervention and fewer complications. This is an update of a Cochrane review first published in 1998. To assess the effects of planned hospital birth compared with planned home birth in selected low-risk women, assisted by an experienced midwife with collaborative medical back up in case transfer should be necessary. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 March 2012) and contacted editors and authors involved with possible trials. Randomised controlled trials comparing planned hospital birth with planned home birth in low-risk women as described in the objectives. The two review authors as independently as possible assessed trial quality and extracted data. We contacted study authors for additional information. Two trials met the inclusion criteria but only one trial involving 11 women provided some outcome data and was included. The evidence from this trial was of moderate quality and too small to allow conclusions to be drawn. There is no strong evidence from randomised trials to favour either planned hospital birth or planned home birth for low-risk pregnant women. However, the trials show that women living in areas where they are not well informed about home birth may welcome ethically well-designed trials that would ensure an informed choice. As the quality of evidence in favour of home birth from observational studies seems to be steadily increasing, it might be as important to prepare a regularly updated systematic review including observational studies as described in the Cochrane Handbook for Systematic Reviews of Interventions as to attempt to set up new randomised controlled trials.
    Cochrane database of systematic reviews (Online) 09/2012; 9(9):CD000352. DOI:10.1002/14651858.CD000352.pub2 · 6.03 Impact Factor
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