Letters Respond to Lancet Home Birth Editorial With Feminist Perspective

In July, The Lancet published an editorial, “Home Births: Proceed with Caution,” in which the editors discussed the apparent safety of home birth for most low-risk women, contradictory or low-quality evidence on infant outcomes, and the recent, controversial Wax meta-analysis.

Perhaps most likely to cause feminist double-takes was the following comment:

Women have the right to choose how and where to give birth, but they do not have the right to put their baby at risk.

New letters to the editor in the October 16 issue take on this comment (alongside other letter-writers who describe their perspectives on the Wax methods and conclusions). Susan Bewley et al respond:

Why does The Lancet perpetuate the misuse of language, irresponsible reporting, and paternalism that dog the home birth debate? “Women have the right to choose how and where to give birth, but they do not have the right to put their baby at risk:” what humbug! There is no risk-free birth. Life and parenting consist of complex choices and tradeoffs, preferably made with impartial information. “Rights-talk”…becomes a stick to beat “non-compliant” women.

They go on to ask, “Even if home birth was objectively inadvisable, what remedy is proposed-barring the familiar guilt trip and cultural misogyny?”

Another writer comments that if improvements in home birth safety is desired,

The most effective solution would be a call to action for professional organizations and health-care institutions to remedy the problems for both hospital and home births, although it is not as headline-catching as a solution that suggests that women’s informed decision making, and indeed their rights, be curtailed.

For more information about the problems with the Wax meta-analysis, see Planned home birth and neonatal death: Who do we believe?, a post by Science and Sensibility’s Amy Romano.