Monday, December 14, 2015

Birth Apologetics: Does The Netherlands Really Have The Highest Newborn Mortality Rate?

Note: This post is part of a series called "Birth Apologetics". "Apologetics" comes from the Greek and means "to speak in defense". (Often used in relation to defense of a particular idea or viewpoint, such as "Christian Apologetics".) In these posts, I will be taking blog posts and articles that are critical of home birth and natural birth and doing a critical analysis on the data and arguments. The idea is that if natural birth and home birth are safe for most women, arguments against them will have serious flaws.
The Claims: The blog post we will be looking at today is here. The claims are that The Netherlands has higher rates of newborn mortality while having some of the highest rates of planned home births of any developed nation and that this shows how dangerous home birth is.
Analysis: It is true that the Netherlands has higher rates of newborn mortality than other European countries. However, this blog post comes from an American OB-GYN, and the Netherlands still has lower rates of newborn mortality than the United States of America! (3 neonatal deaths per 1,000 live births in the Netherlands vs. 4 neonatal deaths per 1,000 live births in America.)
The Netherlands has acknowledged their high newborn death rates in comparison to other European countries, but have found that these rates are due to high rates of very premature births and not term babies born at home. The rate of prematurity in the Netherlands is 8 per 100 live births. This is higher than most European nations. (But by comparison, note that the United States has far worse rates of prematurity at 12 per 100 live births.) Prior to 2010, Dutch hospitals were not required to offer treatment to very premature babies, which could be another contributing factor to high death rates from prematurity in the past. Since instituting a policy that babies born at 24 weeks or beyond receive care, deaths from prematurity have dropped in the Netherlands. However, even babies born before 24 weeks can still be saved with treatment, so infants born before this time who would receive care in other countries like Great Britain and survive could still be a contributing factor to newborn mortality in the Netherlands.
Conclusion: Dutch newborn mortality rates reflect issues with premature birth rates and care of premature babies rather than flaws inherent in home birth and are still better than the newborn mortality and prematurity rates in the United States. Arguments that the Netherlands' high rates of newborn mortality in comparison to those of other European countries reflect supposed dangers of birthing options are based superficial analysis and inaccuracies.

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