Dear Dr. Cheyney,
Homebirth midwifery organizations have repeatedly called for transparency in American maternity care. Therefore, it is more than a bit ironic that the Midwives Alliance of North America refuses to make public its own statistics on the safety of homebirth with a certified professional midwife (CPM).
Just last year, your predecessor as Director of Research Peggy Garland notified homebirth midwives:
I am pleased to announce the availability of data from the MANA Statistics Project. We have completed review of almost 13,000 records from late 2004 through the end of 2007. This data was collected through the online version of the data form (referred to as the 2.0 version) initially used for the CPM 2000 study, published in the BMJ in 2005.
The form was extensively revised with input from a distinguished panel of advisors. The resulting 3.0 form version went online in May 2009. From that date, all new pregnancies were prospectively logged on the new form. Data on those pregnancies that were not completed by May will be completed on the 2.0 form, the last of which is expected by the spring of 2010. Once those records are completed by the midwives, we expect another 10,000 records will become available for research, spanning 2008-2009. Data is transferred to approved researchers as .sav files, but other formats are possible.
Applications will now be accepted for research access to 2004-2007 data. We are also accepting applications for access to 3.0 form data to be collected for prospective studies. To view and download a Handbook describing the data, the data forms, data review procedures, the policies and procedures governing access, as well as application materials, please go to: http://mana. org/statform. html
As you know, that Handbook details copious restrictions for accessing the data including a legal non-disclosure agreement. If homebirth midwives are truly committed to transparency in maternity care, MANA should immediately release its data to the general public.
I call upon you, in your role as Director of Research to release the MANA data on the safety of homebirth with a CPM. Specifically, please release information on the death rates of both babies and mothers who undertook care with a CPM. There is no possible ethical justification for withholding this data. As long as MANA insists on hiding the data, we have no choice but to assume that MANA’s data shows that homebirth with a CPM increases the risk of perinatal death.
Sincerely,
Amy Tuteur, MD
