What a headline! What medical reporter could resist rushing to the news editor on sighting an academic article which packs such a quotable punch in its conclusions? No wonder Lachlan de Crespigny and Julian Savulescu, authors of "Homebirth and the Future Child" in the Journal of Medical Ethics in January 2014, have achieved a degree of publicity beyond the dreams of most childbirth researchers. Since dozens of midwives and obstetricians every year would give their eye teeth for such coverage, I was interested to find out who these chaps are.
Lachlan de Crespigny is an obstetrician and senior research associate at the University of Oxford's Centre for Practical Ethics. His biography on the Centre's website does not reveal how much experience of home birth he has, but it does make clear that he works "exclusively in prenatal testing and gynaecologic ultrasound".
Julian Savalescu is an expert in prenatal testing as well, especially in the ethics of embryonic research, genetic research and the like. His biography does not tell us of his experience of home birth and like his colleague, it would not appear to be close to his field of expertise.
The article opens by declaring that "debate around home birth typically focuses on the risk of maternal and perinatal mortality and morbidity — the primary focus is on deaths". The authors assert: "there is little discussion on the risk of long-term disability to the future child". I have spent much of the past ten years debating the relative wellbeing and safety of mother and child in different birth settings and hearing mothers thinking aloud as they laboriously weighed up the various risks to their precious babies at home or in hospital — yet apparently none of the discussions I've taken part in have taken place.
The authors quote the utilitarian philosopher John Stuart Mill to the effect that someone who brings a child into existence "irresponsibly" is a criminal, and move swiftly on to a case of a mother dying within hours of giving birth at home. Let not be said that our Oxford ethicists allow dry academic style to get in their way; even scholars of their status are not above rampant sensationalism.
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