Disgraceful behaviour by the Ministry of Health

Michelle Duff at Stuff reports:

In the months leading up to the release of a study which asked how safe it is to give birth in New Zealand, health officials were busy.
As a courtesy, researchers from Otago University had advised the Ministry of Health well in advance the study looking into maternity care outcomes would be coming out. Closer to the date, they provided an advance copy to the department.
The study found evidence to suggest all babies were not being born equal. Those in midwife-led care were at risk of poorer outcomes than babies in doctor-led care. The authors, Diana Sarfati and Ellie Wernham, were careful to point out their support for a midwifery-led system.

However, their conclusions were clear: the current way maternity care is provided in New Zealand is not as good as it could be.

So this research found inferior outcomes for babies (on average, not all) in midwife-led care than doctor-led care. And what did the Ministry of Health do? Did they work hard to identify the issues to make childbirth safer for women and babies?

Instead, an investigation by Stuff has found the ministry actively worked to try and obscure the results. Communications in the months before the study’s release show staffers worked on how to avoid “fallout,” and in one case shared plans to discredit the study ahead of its release with industry body the College of Midwives.

Heads should roll for this. The Ministry of Health colluded with an industry body to discredit independent research saying health outcomes were not as good as they should be.

Wernham and Sarfati’s study was the first ever to take an overarching look at the safety of babies within the current system. The differences she and Sarfati found were not small; across the five-year study of more than 244,000 babies, they found those in doctor-led care had lower chances of poor birth outcomes.
This included 55 per cent less chance of oxygen deprivation during delivery, 39 per cent lower odds of neonatal encephalopathy, and 48 per cent less chance of a low Apgar score, a measure of a baby’s wellbeing after delivery.
There was also a lower rate of stillbirth and newborn babies dying under medical-led care. This link was statistically weak due to the small number of baby deaths in the five years covered – 1.84 per 1000 births for midwife-led care (410 total deaths, from 20 weeks gestation to the first 27 days of life) and 1.31 per 1000 births for doctor-led care (27 total deaths) – but it was there.

They are very significant differences.

Of course, comparing women with midwives as their lead maternity carer to those who have doctors is not necessarily fair.
After all, doctors – counting GPs and obstetricians – look after less than ten per cent of mums. It is very possible the types of mothers they see are different – mums who smoke might be more likely to see a midwife, while healthier mums might pay for a private obstetrician, for example.

Correlation may not be causation. But you damn well expect further research to investigate this, not a campaign to undermine it.