Recent Studies Show Homebirth Is Safe, Episiotomy Is Harmful
Coalition for Improving Maternity Services (CIMS)
This research summary highlights two landmark peer-reviewed studies demonstrating that planned homebirth for low-risk families is associated with comparable safety and significantly lower rates of medical intervention than hospital birth, and that routine episiotomy offers no benefit and causes harm.
Drawing on large prospective data and systematic review, the article reinforces the Mother-Friendly Childbirth Initiative’s core principles: that birth is a normal physiological process, that multiple birth settings can be safe when appropriately supported, and that unnecessary surgical interventions should be avoided.
The Assault on Normal Birth: The OB Disinformation
Campaign by Henci Goer
Henci Goer’s investigation exposes how obstetric research and professional guidelines are often manipulated to serve the interests of hospitals and OBs rather than the well-being of mothers and babies.
Rising cesarean rates, skewed interpretations of VBAC data, and selective reporting of induction risks aren’t just oversights—they’re part of a systematic campaign that prioritizes liability protection and professional power over evidence-based care.
This article is essential reading for anyone who wants to see past the spin and understand how “safety” statistics can be used to justify unnecessary interventions.
Is Current Management of Neonatal Jaundice Evidence Based?
M S Skae, J Moise, P Clarke
This article surveys neonatal units in the UK to examine how jaundice is managed and whether practices align with evidence. It highlights wide variation in protocols, a lack of standardization, and the potential for overtreatment, while also pointing to emerging research on mechanisms of neonatal analgesia such as endocannabinoid-mediated effects from non-nutritive sucking.
Neonatal Signs Following Exposure to SSRIs
Moses-Kolko
This article reviews research on the effects of maternal use of selective serotonin reuptake inhibitors (SSRIs) during late pregnancy on newborns. The authors highlight an increased risk of neonatal behavioral and withdrawal syndromes, particularly associated with paroxetine, and discuss potential pharmacological mechanisms involving sigma-1 receptors. The findings raise important safety considerations for prescribing SSRIs in the third trimester and emphasize the need for careful risk–benefit assessment and dosing strategies to minimize neonatal complications.
Infant and Neonatal Mortality for Primary Cesarean and Vaginal Births to Women with "No Indicated Risk"
MacDorman, Declercq, Menacker & Malloy, 2006
This study analyzes over 5.7 million U.S. births from 1998–2001 and finds that even among women with no medical risk factors, primary cesarean delivery is associated with significantly higher neonatal mortality compared with vaginal birth (1.77 vs. 0.62 per 1,000 live births). The mortality difference persists across causes of death and is only moderately reduced after accounting for demographic and medical factors. These findings challenge the rising trend of elective cesareans and underscore that cesarean birth is not inherently safer for low-risk infants—highlighting the need for careful, evidence-based decision-making regarding delivery method.
Perinatal and Maternal Outcomes by Planned Place of Birth for Healthy Women with Low-Risk Pregnancies: The Birthplace in England National Prospective Cohort Study
Birthplace in England Collaborative Group
This study looks at how the planned birth setting—home, midwifery unit, or hospital—can influence outcomes for healthy women with low-risk pregnancies. It compares maternal experiences, newborn health, interventions, and hospital transfers. The results show that non-hospital settings often involve fewer interventions, though first-time mothers planning home birth may face slightly higher perinatal risks.
NEONATAL OXYGEN USE AND SAFETY
The following studies examine the effects of oxygen administration in newborns, highlighting potential risks of hyperoxia, neurological injury, and long-term outcomes. Evidence increasingly suggests that resuscitation with room air—or carefully monitored oxygen—may reduce mortality, oxidative stress, and other complications compared with routine use of 100% oxygen. Collectively, this body of research calls for critical evaluation of standard neonatal oxygen protocols to optimize safety.
Room Air Appears To Do Less Brain Damage Than Pure Oxygen
Fiskum & Rosenthal
Contrary to long-standing practice, this study suggests that resuscitation with 100% oxygen may cause more neurological damage than standard room air (21% oxygen) after cardiac arrest. Using animal models, the researchers found higher levels of harmful free radicals and worse brain outcomes in subjects treated with pure oxygen, implicating oxygen-induced reperfusion injury. These findings challenge the assumption that more oxygen is always safer, highlighting the importance of carefully monitoring blood oxygen levels during and after resuscitation to minimize potential metabolic and neurological harm.
Resuscitation of Newborn Infants with 100% Oxygen or Air: A Systematic Review and Meta-Analysis
Davis et al.
This meta-analysis of five trials (1,302 newborns) demonstrates that initial resuscitation with room air, rather than 100% oxygen, reduces mortality in term and near-term infants. While individual trials were inconclusive, pooled data showed a clear survival benefit for air, likely reflecting lower oxidative stress and reperfusion injury. The authors recommend using air initially, reserving pure oxygen as a backup for infants who do not respond, and call for further research on intermediate oxygen concentrations and premature infants. This challenges the long-standing convention of automatically using 100% oxygen and underscores the need for evidence-based neonatal resuscitation practices.
The Evidence Mounts Against Use of Pure Oxygen in Newborn Resuscitation
Paneth
Paneth examines growing evidence that exposure to 100% oxygen during neonatal resuscitation may carry unforeseen risks, including a potential link to childhood cancer. Using data from large cohort studies, he highlights that even brief exposures are not entirely benign and emphasizes the importance of using room air as the initial resuscitation strategy. Oxygen remains essential in certain high-risk scenarios, but this analysis underscores the need for careful, evidence-based management to minimize harm.
Hyperoxia May Depress Breathing in Newborns
Lofaso et al.
Lofaso and colleagues report that repeated exposure to 100% oxygen can depress breathing in newborn mice, suggesting potential risks for premature infants receiving oxygen therapy. The study found that hyperoxia slowed respiratory rate and prolonged apnea, though these effects reversed after brief periods of room air. The authors stress the importance of careful monitoring and control of oxygen administration in the neonatal period to avoid unintended respiratory suppression.
ULTRASOUND
This long-form review critically examines the routine use of prenatal ultrasound, questioning both its benefits and its assumed safety when used as universal screening. Drawing on decades of research, Buckley outlines limits in diagnostic accuracy, the psychological and systemic impacts of screening, and emerging concerns about biological effects—particularly with Doppler and repeated exposure.
The piece argues for selective, indication-based use rather than default scanning, and centers informed consent, maternal intuition, and proportional risk in prenatal decision-making.
Ultrasound Scans: Cause for Concern
Dr. Sarah J. Buckley
Screening for Ultrasonography in Pregnancy
U.S. Preventive Services Task Force
This recommendation from the U.S. Preventive Services Task Force concludes that routine ultrasound screening—particularly in the third trimester—does not improve meaningful health outcomes in low-risk pregnancies, and that evidence for benefit in the second trimester is insufficient.
Despite its widespread adoption in U.S. obstetric care, the USPSTF found no compelling reason to support routine use and declined to update the recommendation due to the continued lack of outcome-changing evidence. This resource underscores the gap between common practice and evidence-based medicine in prenatal screening.