Tuesday, April 20, 2010

Funding Review Published!

The UBC Midwifery Program has finally received its funding review report. It is being studied and a decision regarding 2010/11 admissions will be made soon (how vague is that???!). Wow! That took forever. We shall see what happens! Good luck, me!

On a related bent, I recently read a large data analysis study published in the Canadian Medical Association journal in August of 2009 regarding Homebirth safety. It is called "Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician." It was conducted in BC. There were over 12,000 cases studied. The outcomes were astounding to me (even me!), given what I believed about birth attendants versus geography. In the US the home birth/midwifery vs. hospital birth/physician attendant is much more divisive than in Canada, and particularly in BC, because here midwives can, and in fact are required to, attend a percentage of their clients' births in hospital. So it has been difficult to accurately study midwifery care results in the US and then apply the results of that study, to our population here in BC. Plus we have universal health care, which also affects outcome percentages and access to midwifery care in the provinces which offer funded midwifery care.

Anyways, I had always figured that it was the attendant more than the geography that affected outcomes. This study shows a low perinatal mortality rate in all three subgroups (midwife attended home birth, midwife attended hospital birth, and physician attended hospital birth of a woman low risk enough to qualify for home birth), but the physician attended hospital mortality rate was TWICE that of the midwife attended home birth group! The rates were:
rate of perinatal death per 1000 births:
planned home births: 0.35
midwife hospital births: 0.57
physician hospital births: 0.64

(all had similar P values, for those research minded folks). Also, the rates of interventions and adverse maternal outcomes were studied and are enormously significant. The entire study can be read here, but I found it fascinating that geography had more of a role in birth outcomes than I had previously considered. The study does not attempt to expound on reasons for increased perinatal mortality in hospital, but results are pretty clear.

This would be interesting to have replicated in future studies. In the meantime, it is excellent food for thought.


Rachel Clear said...

Very interesting.

I'm gonna read that study right now.

And good luck, you, for sure!

Asheya said...

Yep, I came across that recently too. Pretty cool. I love homebirth.