Another quick look at home-based births and this is a study that recently came out that a lot of people had been quoting earlier in the month and it was looking at the fact that while it was claiming that there were fewer interventions affecting the mother in a planned home birth, it was also stating that it was not as safe for the infants, that the infant mortality rate for the newborns was higher.
This was the study that was brought up in a recent Insights in Nursing episode where we had Amy Romano on from the Science and Sensibility blog to talk to us about reading science effectively and understanding methodology and she pointed out some major flaws in this particular study. It is a combined meta analysis study where several different research pieces are put together and analyzed as a group and of course that is meant to alleviate issues with the study of small patient populations in a lot of research and medical and nursing field. However, if you pull a giant study such as this one did and pool it with a bunch of smaller studies, you can really end up with skewed numbers and if you have a large, well-designed study, you don’t need to provide a meta analysis of multiple studies because you have a large patient population study involved.
You can look at the numbers there in that study and extrapolate appropriately. Then when you use different criteria from different studies and don’t boil down to a similar criteria point such as when is neonatal mortality measured? At 7 days? At 30 days? Well, if you have a study that measures neonatal mortality all the way out to 30 days, infants past a certain point, is it really related to a birth trauma or related to a birth-related problem? So obviously, there can be a lot of issues when you start combining studies that are using different criteria for examining their data. So I just wanted to point out this article that has been talked about quite a bit and yet there’s a lot of issues with it follow up on the link to the Insights in Nursing episode so you can listen to Amy’s great analysis of this study and her confusion about why this is used as a better representation of infant mortality rates in planned home birth when there is at least one other well designed study that stands on its own and doesn’t need to be combined in a meta analysis situation.
Research can boggle many of us and we often don’t read the information appropriately. So we just kind of read the author’s conclusions and assume that their methodology is good. I think that it is incumbent upon us as nurses to be able to critically read some of this research and understand what’s going on there so that we can provide correct information when people ask us about that latest headline they heard about. That maybe it’s not safe to have a home birth, and these can be medical professionals asking this question as well as the lay public. So I urge you to really follow up and stay on top of the researches that come out. I’ll try to do my best to talk a little bit about the research itself and tell you what’s coming along but it is incumbent upon you to follow up on these articles and if you have a different point of view, if you think there’s a problem with that research, get back in touch with me. Again always, you can leave a comment and you can also reach me of course by sending in an email in to nursingshow@gmail.com.
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This article has been featured in the news segment of the Nursing Show podcast episode Patient Communication and Episode 142
