Wednesday, March 25, 2009


MARIA PARLAPIANO responds to our post about home-birthing and mid-wife Cara Mulhallan (posted below):

Do people really believe that having their baby in a hospital guarantees the baby won't die??

In the US about 7-8 babies out of a thousand
die every year in hospital births, despite being surrounded with the latest, best medical technology.

Midwife-assisted home birth is a lot closer to our biological norm than an OB-directed birth in a strange place. So the comparisons need to be made that way.

Is home birth safer?

The real question is whether hospital births are safe enough to risk all that tampering with normal.

Maria Parlapiano is the owner of Postpartum Place, formerly the Lactation Resource Center, in Chatham, NJ, an invaluable center for new and nursing mothers for support, equipment and information. Go to, OR call her TOLL FREE, twenty-fours hours, seven days a week, at 1-800-801-MILK.

TO: Letter to the Editor, NY Magazine
RE: "Extreme Birth" by Andrew Goldman
NY Magazine 3/30/09

"Extreme Birth"?

Giving birth naturally is now 'extreme'? So, should we start labeling medically unassisted (non Viagra induced) ejaculations "extreme jerk-offs"?

Mr. Goldman, it’s clear you entered into this piece with a deeply conditioned, cultural bias that prevented you from properly completing your job as a journalist — but you’re in good company. Even The American College of Obstetricians and Gynecologists (ACOG) allows standards of practice to be dictated by economics and fear of litigation, rather than evidence-based medicine.

I wish you had presented a truer picture of the real choice(s) available to US women in childbirth, rather than a poorly disguised warning to women who might think outside the box, so to speak.

You might have thought to ask Dr. Moritz about his personal history of infant mortality and morbidity when he observed that, “Muhlhahn should go easy on herself; if a clinician hasn’t lost a baby, she just hasn’t done enough births.” Or, you could have simply reported the number of infant deaths for the average obstetrician practicing in the US:

“...the typical obstetrician performing 140 deliveries a year could encounter nearly two dozen women with a miscarriage and one to two with stillbirth or infant death.” [University of Michigan Health System survey, June 2008.]

To translate, that would be 1 or 2 deaths in 140 births or 1.07 to 1.42%, versus Ms. Muhlhahn’s 1 in 700 deaths, or .14% — less than one-quarter percent.

You might have included in your article the US’s abysmal national birth statistics, reporting that we rank 29th in the world in infant mortality, tied with Poland and Slovakia. This despite the fact that nearly 97% of American women give birth in a hospital setting.

You could have highlighted the fact that although the US caesarean delivery rate rose 4 percent in 2005, to a record high of 30.2 percent of all births, the;

“...U.S. infant mortality rate was 6.86 infant deaths per 1,000 live births [in 2005], not significantly different than the rate of 6.89 in 2000.”

That's right. Thousands of more c-section deliveries in five years’ time, but no positive change in infant mortality rates for the same period.

You might have reported, as the March of Dimes recently has, with alarm, on the rising number of infants being induced pre-term by caesarean section, and that pre-maturity, in itself, is a significant risk factor for infant death [The March of Dimes 2008 Petition for Preemies].

Instead, you anoint Ms. Muhlhahn as the “high-priestess of home-births” — a catchy headline for sure — and another indication of our culture’s predilection to deify anyone with medical training (for better or worse).

What is extreme about Cara’s methods? Her ability to successfully deliver, again and again, truly informed consent to birthing women and better-than-national-average outcomes for babies and mothers. It is a testament to both her solid skills as a clinician, as well as her deep commitment to preserving a woman’s civil right to give birth as naturally, as safely, and as humanely as possible.

Lisa Duggan, Publisher
The MotherHood Magazine

*All data obtained from the CDC’s National Center for Health Statistics, unless otherwise noted.



  1. Amazing response. I find it disheartening how the mainstream media marginalizes and demonizes anything out of the norm. Are we surprised the author is male? Does it remind anyone of the Salem witch hunts? Does anyone read NY Mag for the hard-hitting articles?
    - Gregg Valentine

  2. MP writes:

    "In the US about 7-8 babies out of a thousand die every year in hospital births, despite being surrounded with the latest, best medical technology."

    and LD writes:

    "U.S. infant mortality rate was 6.86 infant deaths per 1,000 live births [in 2005], not significantly different than the rate of 6.89 in 2000."

    Seems to me that the total infant mortality rate can't be lower than the death rate for hospital births, or am I missing something?

  3. I'm not sure what source Maria used, I'll ask her. Here's the link to the full report I used:

    (I wonder how the government counts/ keep track of non-hospital births? I'm assuming it's by birth certificate, right? Irregardless of where a birth takes place, a certificate is required by law for all births.)

  4. Maria Parlapiano says:
    "...I stand corrected... obviously it is lower....(I was using notes from a conference which I should have checked). In looking at the CDC Wonder site under Linked Birth/Infant Death Records you can calculate based on specific parameters. Overall, the numbers of reported in-hospital infant deaths in the first week - all causes, are more like 1 per 1000."

    Thanks John, for keeping us honest. But hey man, what did you think of the NY Mag article????

  5. Sorry, haven't read it yet, but I'll put it on the list.

    So, what's the out-of-hospital death rate?

  6. I dunno. I have the "Vital Stats 2007" PDF on my desktop. 20+ pages. A search for homebirth yields nada, so far. I'll keep looking and perhaps we'll include this in our upcoming BIRTH IN AMERICA week in April.
    PS Say hi to Chris for me!