Saturday, January 30, 2010

Independent: 'A bad case of bias against Caesareans'

...says Nigel Hawkes, director of Straight Statistics, writing in The Independent today. More fallout from the WHO survey, 'Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08'; this time published by a national newspaper, so hopefully it might reach a wider readership.

Article highlightsOn cesarean maternal mortality and morbidity
"So how many women died? None. How many suffered complications? Eight: five needed treatment in an intensive care unit (ICU), and three needed a blood transfusion. The risks for women who completed a normal birth were significantly higher. One in a thousand died, five times as many required a blood transfusion, and twice as many were admitted to an ICU.

Overall, if deaths and complications are added up to make a "Maternal mortality and morbidity index", risks to mothers in the Caesarean group were 60 per cent lower than in the normal birth group.

So how, from this, does the team conclude that risks to mothers who have Caesareans are actually 2.7 times greater? There's a hefty difference between 60 per cent smaller and 270 per cent greater, but statistical manipulation is a powerful tool."

On babies born by planned cesarean..."And what about the babies? Those born by elective Caesarean without medical indications were seven times less likely to suffer death or complications (raw data) or less than half as likely if you believe the corrected data. Understandably, the authors don't make much of this."

On the WHO's final conclusion and The Lancet's role as publisher"Did none of the 23 think this an odd conclusion to have reached? Did no one check the arithmetic in the tables, which are full of errors? The Lancet is a distinguished journal - were its referees asleep?"

1 comment:

S Griffiths said...

I don't think The Lancet was asleep.... On the contrary, it's always towing the line of the medical establishment in the UK i.e. keen to play deny a c-section as a legitimate birth plan for women. Shame on them.