https://www.smithsonianmag.com/smart-news/us-home-births-may-never-be-successful-those-other-countries-180963108/
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U.S. Home Births Aren’t As Safe As Many Abroad
Home birth doesn’t have to be a dangerous and deadly proposition–but in the United States, it often is
Kat Eschner
May 5, 2017
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Many women who choose midwife-assisted birth do so because it's associated with fewer medical interventions like caesarean sections. iStock
Home birth is on the rise in the United States and other countries, although less than one percent of all U.S births take place at home.
In Canada and many other developed nations, it can be as safe as birth in a hospital for some women. But in the United States, it’s very dangerous compared with hospital birth. That isn’t because home birth is always more dangerous in all cases—it’s because home birth in the United States isn’t part of the medical system, and not all midwives are equal in terms of their medical education.
A 2016 study found that child mortality in Oregon—the place with the best records in the United States on this matter—was stunningly high compared to hospital birth.
Children were seven times more likely to die during planned home births, according to Amy Tuteur for The New York Times, and the perinatal death rate—the rate of death in the weeks just before and after birth—of babies for whom home birth was planned was three times that of hospital births.
“Could racial or economic differences, or poor prenatal care, explain this deadly difference between home births here and in Canada,” she asked? “No.”
The problem is that there are two types of midwives in the United States. The first, certified nurse midwives, called C.N.M.s, are perhaps the best-educated, best-trained midwives in the world, exceeding standards set by the International Confederation of Midwives. Their qualifications, similar to those of midwives in Canada, include a university degree in midwifery and extensive training in a hospital diagnosing and managing complications.
The other, certified professional midwives, or C.P.M.s, fall far short of international standards. One 2010 study of midwives published in The Journal of Perinatology found that home births attended by nurse midwives had double the neonatal mortality rate of hospital births attended by nurse midwives, while home births attended by C.P.M.s and other midwives had nearly four times that rate.
This second class of poorly trained midwives attend the majority of American home births. And yet they are legal in only 28 states; in the rest of the country, many practice outside the law."
When we study to be midwives here, we discuss how terrible your maternity system is and how poorly educated your staff are. We have placements from American students who learn how to conduct births safely outside of an operating theatre because they don't know how to. Im not defensive, i am right.