Born in the USA by Marsden Wagner

Author:Marsden Wagner
Language: eng
Format: epub
Publisher: University of California Press
Published: 2006-09-22T04:00:00+00:00

When a study is published with scientifically valid evidence against an important position of a clinical group, clinicians have two common reactions: ignore the study and hope it goes away; torture the data until it confesses to what they want it to say.

It is instructive to observe who has and who has not responded to date to the study of planned home birth by Johnson and Daviss. The largest group of responders consists of midwives and other supporters of the demedicalization of birth. This group recognizes the excellence of the methodology, the importance of the findings, and the consistency with the existing weight of evidence. The second largest group of responders is primary care physicians, some of whom are generally positive about the findings while others try to torture the data to justify running away from the heresy of agreeing to health care which is not in some kind of medical setting: “this information does not change my practice.”

Then we have the silence of the lions: why are the obstetricians not responding? With one possible exception, there are no obstetrician responders to a study with major implications for obstetric practice. And the one physician responder, who may or may not be an obstetrician, rejects supporting planned home birth, even if safe, because of the “pernicious legal system.” Fear of litigation is a highly selective excuse used by some obstetricians when there is something which is not obstetrician-friendly such as planned home birth (over which they have no control and no profit). . . .

It is doubtful there will be obstetrician responders to this study because of their hope that by ignoring it, this study will go away. . . . And their silence in the face of the present outstanding study by Johnson and Daviss of the safety of home birth is to be expected.37

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