Response to Amy Tuteur

A recent blog post of mine titled “’If I were at home, I would have died’ – The trouble with extrapolating hospital birth events to homebirth” received a lot of attention. One blogger, Amy Tuteur, published a scathing response to my piece on her personal blog.

I am stunned and saddened by Ms.Tuteur’s hate-filled critique. Rather than commenting directly on my blog, where I welcome sensible debate and where we could have engaged in a meaningful discussion, she deliberately exploited my statements out of context in what amounts to a personal assault on me and on the greater body of midwives in the US.

I use hemorrhage to illustrate the larger point that events in typical hospital births — and their outcomes — cannot automatically be extrapolated to out-of-hospital settings. Missing this point entirely, Ms.Tuteur cites maternal death from hemorrhage in impoverished nations where women are malnourished and do not have access to skilled prenatal or intrapartum care as evidence that I do not understand the gravity of hemorrhage, or the international causes of maternal death.

To be clear, I did not state nor imply that women do not hemorrhage at homebirths. Hemorrhage can occur in all settings and midwives are trained and equipped to manage them. However, for the record: published evidence from medical studies on homebirth in the US, Canada, UK, and Netherlands shows a 0% rate of maternal death from hemorrhage at home, and of the studies that compared hemorrhage rates between homebirth and hospital births, all showed a lower incidence of hemorrhage at home.

I welcome substantive discussion on my blog, that is how birth change is happening in this country — with open and honest discussion. Until now, I have not removed or censored any genuinely critical comments from readers. I will not, however, publish vindictive comments that reflect more of a personal attack than honest questioning or critical discourse. These kinds of comments do not serve me, my readers, or women seeking to learn more about their choices in childbirth.

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