BMJ Home Birth Study: Questions and Answers

Answers to Questions About:
Outcomes of planned home births with certified professional midwives: large prospective study in North America
British Medical Journal 330, 1416. June 18th, 2005

Kenneth C. Johnson, PhD and Betty-Anne Daviss, MA, RM

SUMMARY

This piece responds to questions that have been posed about our study and provides additional details that could not be accommodated in the original BMJ article which had a 2,000 word limit.

The 8 questions concern the following:
1) The choice of the BMJ for publication;
2) The choice of intrapartum and neonatal mortality rate as the key risk measure;
3) The basis for concluding that planned home birth and low-risk hospital birth have similar safety but homebirth has much lower intervention;
4) Why did the Washington home birth study have different conclusions?
5) Are you comparing apples to oranges?
6) Why there are no confidence intervals for mortality rates?
7) What about reporting on other outcomes? and
8) Could the funders have biased the study?

Clearly understanding the article and its history is useful because it has attracted enormous attention not just in North America but worldwide, partly due to the fact that it is the largest prospective home birth study done to date, possibly because it is largely based in the U.S, and contextually because the debate over home birth and hospital birth has grown in sophistication since the early eighties and the article captures the best available methodology for a national study of the U.S. (with a glimpse of Canadians who have the same certification.)

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