Minister is right to warn against 'unsafe' home births

Dear Sir, 

I write on behalf of the Department of Health ­regarding an ­article in last week’s Bermuda Sun, War Of Words Breaks Out Over Home Births.

As a health care professional working under the Ministry of Health, I was very concerned about the unhelpful title and tone of the article, which framed the current community ­discussions about home birth in a negative and unhelpful fashion.

Articles that further ­polarise the various ­perspectives on this matter only detract from efforts to keep the community ­educated about the topic.

Worse, such articles delay respectful dialogue, mutual understanding and progress toward our ­common goal — safe, ­positive birth experiences for women and babies.

Risk 

In the article, Sophia Cannonier, who had a home birth, comments on a statement made in the House of Assemby by Health ­Minister Walter Roban, in which he said women should have ­babies in ­hospital rather than risk “unsafe” home births.

Ms Cannonier said: “To make such a blanket statement, absent of any ­supporting data didn’t make any sense and a man in his position should not allow himself to be used so obviously.”

Ms Cannonier’s personal attack on the ­Minister ­continues in the article in a way that validates it.  

She questions his motives and sincerity in a most ­inappropriate manner.  

These harsh opinions would be more appropriate in the context of an opinion editorial or letter to the ­editor, especially since they are inaccurate. First, the Minister ­receives his information in a ­formal collaboration with all ­programmes and professionals in the ­Department of Health.  

He is not to the tool of the ­“obstetrical lobby” as is printed in the article.  

Secondly, the Department of Health is comprised of registered health care ­professionals, many of whom have vast professional and personal experience in the area of midwifery.

My colleagues and I are insulted by the quote we “probably never witnessed (or supported) a woman in natural labour”. ­Nothing could be further from the truth. The facts of the Minister’s statement on safe motherhood is well ­supported by the World Health Organisation, the highly regarded global health authority.  

Here is what the WHO says about safe ­motherhood from a global perspective (www.who.int/ features/qa/12/en/index. html): “Every minute, at least one woman dies from complications related to pregnancy or childbirth — 529,000 women a year. In ­addition, for every woman who dies in childbirth, around 20 more suffer injury, infection or disease — approximately 10 million women each year. Five direct complications account for more than 70 per cent of maternal deaths — haemorrhage (25 per cent), infection (15 per cent), ­unsafe abortion (13 per cent), eclampsia (very high blood ­pressure leading to seizures, 12 per cent) and obstructed labour (eight per cent).

“While these are the main ­causes of maternal death, ­unavailable, inaccessible, ­unaffordable or poor quality care is fundamentally responsible. 

“They are detrimental to social ­development and wellbeing, as some one ­million children are left motherless each year. These ­children are 10 times more likely to die within two years of their mothers’ death.

“Women need not die in childbirth. We must give a young woman the information and ­support she needs to control her reproductive health, help her through a pregnancy and care for her and her newborn well into childhood.

“The vast majority of maternal deaths could be prevented if women had access to quality ­family planning services, skilled care during pregnancy, childbirth and the first month after delivery, or post-abortion care services and where permissible, safe abortion services.

“Fifteen per cent of pregnancies and childbirths need emergency obstetric care because of risks that are difficult to predict.

“A working health ­system with skilled personnel is key to saving these women’s lives.” 

Emergencies

So you see, concerns about keeping motherhood safe are ­universally ­expressed.  

We are fortunate in Bermuda to have easy ­access to qualified health care professionals to assist with childbirth and post-natal emergencies. Our good record on ­maternal and newborn health is proof of this.

The Ministry of Health simply wants this good record to be main- tained as we continue to ­explore ways to expand the options for families who wish to personalise their birth ­experience.  

Cheryl Peek-Ball

MD, MPH, senior medical officer, Department of Health