Monday, September 14, 2009

a letter to the Today show

Dear Today Show,
I'm writing today in response to your segment titled "The perils of Midwifery" (later changed to "Home Birth". I was extremely disappointed by the biased, incomplete, and exploitative reporting done in this segment.

I'm due to deliver my second baby at home in a few weeks. I chose this option because of my desire for the safest birth possible. Period. To represent my choice as "trendy", or foolhardy, is to insult my intelligence, and insult the hundreds of thousands of women around the globe who choose to be midwives, support homebirth, or give birth at home themselves.

While I sympathize with the couple who tragically lost their child, and can't comment on Cara Muhlhahn's competence, I do know that your report left out a multitude of facts:

1. Caesarian section increases the rate of maternal and infant death. Even in the best-case scenario, it combines major surgery with caring for a newborn and (for first-time mothers) learning to breast-feed. Avoiding an unneccessary caesarian is a completely rational, safe choice. It's not about pursuing a "hedonistic" spa treatment, or about imitating celebrities.

2. The WHO recommends that caesarian rates be at about 10% for all birth. Currently, the national average is 30% and rising. At some hospitals, it exceeds 50%. This means babies and mothers are _dying_ unnecessarily in the US. Perhaps this would be a good topic for a Today show expose.

3. Women have been giving birth without medication, at home, since the beginning of time. While I thank God for the advances in obstetrical care that save those mothers whose births are high-risk, and am happy for those mothers who chose pain medications without experiencing some of their possible side-effects, characterizing home birth as "extreme" is like saying sex in your bedroom at home is "extreme". In fact, this is the way we've done it for millennium.

4. Let's say, just for the sake of argument, that Ms. Muhlhahn's care was incompetent. That says nothing about the safety and efficacy of home birth. You might as well say that one bad obstetrician makes it unsafe to give birth in any hospital. If you did say this, I'm guessing the ACOG might sue for libel. Do you pick on midwives because they don't have the political clout and the $$ to keep you honest?

5. Just this year, two high-quality studies have come out, comparing home birth outcomes to low-risk hospital births. You can find the results summarized here: From the summary: "Consistent with many other studies comparing planned home with planned hospital birth, the results showed comparable perinatal mortality rates, less serious morbidity for both women and infants, and lower use of obstetric technology in planned home births."

6. Nowhere in your segment did you mention the ACOG's possible conflict of interest in speaking about home birth. By definition, a birth attended by a midwife is not attended by an ACOG member. Perhaps the organization's leadership might be biased?

7. In many other countries (the Netherlands and the UK, to name just two), midwifery care is the gold standard for birth. These countries have lower rates of infant mortality than we do. Even if that correlation isn't attributable to the midwifery model of care (which would surprise me), having midwives attend births sure isn't hurting anything.

Finally, and less factually, it irked me that the two journalists presenting and introducing the segment (Matt Lauer and the journalist himself) were both men. At least have someone actually qualified to speak about labor and delivery report about it.

For too long, women have been forced to shut up and submit passively to a system that does not value their voices, their intelligence, and their ability to choose wisely for themselves and their children. Your report just demonstrates how little headway our country has made.

Frankly, I am disgusted that you would exploit this couple's tragedy to present such a biased, incomplete report. You've used the loss of their child to sensationalize and twist a powerful, humane, and life-affirming experience. It shocks me that Today, which I've been watching since grade school, would have such low standards for their journalists. I urge you to apologize to the midwives and mothers throughout America that you have insulted and, frankly, libeled.

Heather Caliri


Idyllic Youth said...

My Today Show letter, not nearly as well worded as yours.

To whom it may concern:
I found your recent excerpt on homebirth to be very biased and a shame to journalism. Shows that only give one side of the story lose my respect. I don't know how The Today Show can regain this respect. There is much evidence that homebirth is equally as safe as hospital birth in America. In other countries midwife assisted birth is usually safer and has better maternal/infant mortality outcomes than the U.S. For some home birth fact check I would like to point you to to read up on how ACOG (American College of Obstetrics and Gynecology) states that OBs are more concerned with protecting themselves from litigation than concerning themselves with patients' safety. According to the 2009 CIA World Factbook the U.S. is number 46 in infant mortality trailing behind such countries as Cuba, Guam, and Solvenia. In a 2007 U.N. report the United States was ranked 41st in maternal mortality rates. Considering that in the U.S. 99% of all births are in hospitals these rates more accurately depict the danger of hospital birth and not home birth. I hope that in the future The Today Show will do stories with real evidence based research instead of sensationalizing biased information based on a few personal accounts. While personal experience is important, it is not the entire story. The Today Show holds a responsibility to its viewers to consider that what one home birthing mother experienced is not the whole story of home birth everywhere. Just as one c-section gone wrong does not represent all hospital birth everywhere. I am greatly disappointed in your program and hope to regain my trust in your journalistic integrity in the future.


Clarissa Jarem

Melissa said...

That's what I'm talking about. :)

Nicely done.

Heather said...

why thank you, ladies. Grr, Today show.

Diana said...

Well said!