Wax 2010 Meta-Analysis: The Debunking
The main anti-home-birth study was debunked for bad methodology
The most cited anti-home-birth study was formally investigated. Statistical errors found. Failed to distinguish planned from unplanned home births. Only 64 deaths in dataset (200-400 needed). Despite debunking, ACOG still cites it.
The 2010 Wax meta-analysis became the most-cited anti-home-birth study in US obstetrics because it reported a tripled neonatal mortality rate for planned home birth. The paper was formally investigated and found to have serious methodological flaws.
It failed to distinguish planned home birth from unplanned home birth (women who delivered at home accidentally), included only 64 neonatal deaths when 200 to 400 would have been needed for the conclusions to hold statistical power, included studies the authors had already reported as having data errors, and counted breech and twin births in the home-birth arm even though those would have been hospital-transferred in any actual home birth system. Despite the formal critique, the American College of Obstetricians and Gynecologists continues to cite the study in its position papers.
64
Neonatal deaths in dataset
200-400
Needed for statistical power
Debunked
Methodology formally critiqued
Still cited
By ACOG in policy
Why it matters
The single study most often used to argue against home birth in the US was found to be methodologically broken by independent reviewers. The professional bodies that cite it have not retracted that citation.
This is one finding from the research library behind How to Birth a Mother. Everything here traces back to a study, a dataset, or a systematic review.