Interesting Links for 25-11-2011

[andrewducker]

• IPv6 for consumers on DSL at last
  (tags: ipv6 adsl isp uk internet broadband )
• Apple is the UK's second most popular shopping site (after Amazon)
  (tags: apple shopping uk )
• Google and Samsung confirm Galaxy Nexus volume bugs - glad I'm not upgrading until January!
  (tags: google samsung android )
• Badoo - the billion pound social network you've

Comments

[andrewducker]

This is true for a first child (doubling of risk from 0.45% to 0.93%, but not even slightly true for further children, where the article states "For a second birth there was no difference in the risk to babies between home, a midwife-led unit or a doctor-led hospital unit."

[andrewducker]

This single study being the largest one carried out in the UK, covering tens of thousands of births. If you want to dispute its findings then feel free to point to opposing data.

Looking at the data for second children:
For multiparous women, there were no significant differences in adverse perinatal outcomes between planned home births or midwifery unit births and planned births in obstetric units.

For multiparous women, birth in a non-obstetric unit setting significantly and substantially reduced the odds of having an intrapartum caesarean section, instrumental delivery or episiotomy.

So your outcomes are as good at home, and the odds of you not being sliced open are better.

https://www.npeu.ox.ac.uk/birthplace/results

[laplor]

If we're going anecdotal, my son nearly died due to complications caused and worsened by hospital procedures and conditions. For one thing, the hospital had no air conditioning or hot water - I'm not kidding! I had both at home.

Then they saved him, then he had an 8 minute seizure. He's only marginally impaired.

I was very tempted to have my second baby at home, but lived more than an hour from hospital so decided it wasn't prudent. He was born with no doctor in the room because I had him so fast they didn't have time to get there from down the hall.

In light of my experience, I absolutely believe that, in the case of a healthy woman who has been screened for complications and attended by a midwife, home within reasonable range of a hospital is just as safe as hospital.

[anton_p_nym]

Apparently there's a saying going around Microsoft now; bowdlerized, it's, "the average person has one breast and one testicle." It's a caution against relying on statistical models without examining the context.

I strongly suspect that the reason second-child home-births have the same complication rate as hospital births is that those who were most prone to complications (as demonstrated the first time) went to the hospital. This skews the result heavily... indeed, I'm surprised that home-birth for second children doesn't show a greater safety rate because of that bias.

Of course I haven't seen the study design or how they controlled for this so perhaps I'm being unfair.

-- Steve's not a stats genius in any case.

[andrewducker]

Yup, that's what I'd expect.

Which means that the sensible thing to do is to have your first child in a hospital, and then make a decision about the second child based on the results of that experiment.

[del_c]

Because complications are rare, pulling complications out of the home birth pool is like pulling tokens out of a bag with a lot of tokens. So removing the mothers who had complications the first time shouldn't affect the home birth statistics positively enough to detect. Which is just what we observe: home births rise to the safety level of hospital births on and after second birth, but do not exceed it, despite the theoretical skew from first-birth complications electing hospital the second time around.

[andrewducker]

As the quote I left just above makes clear, there were no significant different in outcomes.

[andrewducker]

Of course a statistically insignificant outcome feels more important when you're in the middle of it.

This is why anecdotes make for awful recommendations, and the people who are mostly exposed to the things that go wrong have a more negative view on things.

(See, also, doctors who deal with people who have massive alcoholism problems, and thus want to ban everyone from drinking. If you only get involved once people have problems, of course that makes a bigger effect on you.)

[andrewducker]

Sadly, the general drinking populace are generally incapable of understanding 'in moderation' and come up with things like 'alcopops don't count'

I'm not convinced that a majority of people are like that. Certainly there's a loud cohort who make people's lives a misery on a Saturday night, but I don't think that's that many people out of the whole population.

The GMC aren't bad - but you end up with some doctors advocating tougher and tougher measures on alcohol pricing, because of the alcoholics they see, without seeming to realise that this is have a large affect on ordinary people, without making much of a difference to the actual alcoholics.

(Don't get me started on the "You shouldn't be allowed to smoke in your car..." stuff that came out a couple of weeks ago.)