My comments to this were part of a conversation I had with my colleague Nick Fogelson in South Carolina and were as follows:
So much to say but will summarize. Everyone has bias. I do feel comfortable, however, with Wax's contention that he had none when setting out to do his study. His last point, that most criticism comes from birth choice advocates, is a bit silly as not much criticism would be expected from hospital birth advocates in a paper that is not critical of hospital births. That Wax concludes there is an increased risk of neonatal mortality of 1 in 1,333 in home vs. hospital birthing does not seem worthy of all the hullabaloo. Most people would not consider this number to be a reason to or not to have a home birth. So, even if we were to accept his paper as flawless, is this number so substantial as to base an entire ACOG committee opinion on? Not being adept in statistics I cannot comment on the science of his calculations. But if we give Wax credit for being truthful we do have to put some credence in the knowledge and science of those authors of some of the papers he uses who disagree with him as well.
When a headline says a 2-3 fold increase in neonatal death it looks scary. When you see the increased risk is really less than 1 in 1000 its not so bad to many. when I counsel patients on interpreting statistics I often use the example of disease X. Say it has a frequency of 1:1,000,000 last year and this year there were 2 cases or 1:500.000. Both very small numbers. However, advocates for funding of research into disease X can say the rate doubled. Very misleading.
Do you agree that the increased risk is still very small and, if so, why do you think organized medicine is so vehemently against informed choice? The risk of c/section in hospitals surpasses 1 in 3 and yet does not draw close to this much finger pointing from ACOG.
I thought it very important to point out the manipulation of statistics by ACOG to make a point and another way to look at the numbers it deems so impressive in its argument against home birth. Lies, damn lies and statistics! Dr. F