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Planned home and hospital births in South Australia, 1991–2006: differences in outcomes

Marc J N C Keirse, Robyn M Kennare, Graeme R Tucker and Annabelle C Chan
Med J Aust 2010; 192 (12): 726-727.
Published online: 21 June 2010

In reply: Dahlen and colleagues overlooked that we excluded births without professional antenatal care (n = 1217), ensuring that all 1141 planned home births in our study were cared for by registered midwives.1 Nonetheless, we appreciate their acknowledgement that our article contains useful recommendations. Yet, they failed to endorse these recommendations in their letter and in the earlier critique to which they refer. They instead draw attention to a lack of difference in total mortality, but dismiss large differences in intrapartum and asphyxia-attributed mortality through their misinterpretation of confidence intervals. Rare outcomes, such as these, inevitably have wide confidence intervals. However, it is wrong and misleading to use the lack of precision in how much more frequent they are as an argument to dismiss their significantly much higher frequency.

  • Marc J N C Keirse1
  • Robyn M Kennare2
  • Graeme R Tucker2
  • Annabelle C Chan2

  • 1 Department of Obstetrics, Gynaecology and Reproductive Medicine, Flinders University, Adelaide, SA.
  • 2 Epidemiology Branch, SA Health, Adelaide, SA.


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