The title âChildbirth: why I take the scientific approach to having a babyâ is interesting given the topic. Is âthe scientific approachâ having a baby in a hospital, or is it reading the research carefully and making whatever decision the research supports (both of which the author did, by the sound of it)? Having read the article, Iâm still not 100% sure which way the author would answer that question.
We had our baby at home with midwives, based on reading comparable research in the Canadian (i.e. our) context, which found the opposite results from what she describes - that midwife-led home births were the safest option, followed by midwife-led hospital births, followed by obstetrician-led hospital births (the fourth combination, obstetrician-led home births, had a sample size of zero). I think what we did was âthe scientific approachâ but Iâm not sure if the author would agree with us or not.
At my last job I did data analytic work for the stateâs Medicaid and Medicare programs.
Since high cost childbirths can be extraordinarily expensive I had a few requests for ad-hoc work on the topic and had to do two more extensive analyses (including setting up a dataset for others to use).
I was given birth location/type as one of the possible targets and sure, if I focused on that and ignored the other factors I could end up with various arguments supporting one side or another. . . but the more I factored in other data points (demographic information, specific conditions, etc.) the less it seemed to matter in the grand scheme of things.
Instead things like âhow much access to healthcare did they have before the child was bornâ and âdid anybody even know who they were?â and âdid the mother have access to good nutrition at the beginning of pregnancyâ were pretty much the strongest drivers . . .beating out classics like prior c-sections and high or low age bands by a significant margin.
Even after those were filtered out (because at the time the idea of making sure everybody was insured wasnât terribly popular with the new director) how/where the child was born was only a factor in emergency births (being birthed at the scene of a car accident), once we had the consistent care factored in it didnât seem to matter much what sort of care they got, just so people were paying attention.
I suspect thatâs why people arenât agreeing on this, because it doesnât matter terribly much and because weâve advanced our technology enough that we can see the complications enough in advance.
Of course Iâm not an obstetrician or anything, but I had some good people advising me and Iâm pretty sure we didnât miss anything obvious.
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