Anyone who has a basic understanding of Bayes' Theorem can tell you that testing all new mothers for X (where X is relatively rare among new mothers) will lead to a large number of false positives even if the test has high specificity and sensitivity, simply because the prior probability for X is so low.
According to Healthcare Triage, home births have an overall lower risk of complications. It's only in the cases of things going spectacularly wrong that being in the hospital helps.
https://www.youtube.com/watch?v=xHWvSPhENtk
It fits with my view of things: If there's something really broken, go to the hospital to get it fixed. However, if you're fine, you're better off avoiding the place. (Do get checkups from a doctor you have a good relationship with.)
Also, the overall chance of pregnancy with unprotected sex involving a man and a woman of childbearing age is 1 in 4. So, would you engage in such sex knowing that there was a 1 in 40 chance it would lead directly to your own death? (Or your partners? Bees be Krayton!)
I wonder if that's where some of our cognitive biases around risk come from? It benefits our genes that we're cavalier about certain kinds of risk.
Also unprotected sex does not necessarily equal procreative sex, which I realize is a somewhat controversial statement, but nonetheless true.
[0] https://www.plannedparenthood.org/learn/birth-control/withdr... (there's no fragment, it's under the effectiveness section of the accordion)
[1] https://www.plannedparenthood.org/learn/birth-control/condom...
I knew that when I posted it. When I posted it, I thought I had clearly indicated it, but looking at it again, that must have been forgotten before it could be enacted. My intention was to play with the two wildly inaccurate figures together.
1 in 20 (~50 in 1000) in the UK until 1940/1950. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1633559/
and lots of interesting reading here: https://www.google.co.uk/webhp?sourceid=chrome-instant&ion=1...
but 1/180 times your baby got a Staph Infection they would not have gotten at home and died?
The numbers are obviously bogus, but there are dangers to anyplace you choose to give birth... As long as people are well informed, seems they should be able to choose their own adventure.
Drinking a hot beverage is much more dangerous than drinking a cold beverage.
Life is full of dangers and risks. Why should birth be any different?
I could post many stories of people who had their first kid in a hospital and had a horrible experience, ends up getting a C section when not really needed, etc (See american C-section rates vs European for example). Then they chose to have a kid at home and had a 100x better experience and a more healthy baby (due to lack of C section and all the problems that leads to).
What you are doing here, is glossing over the underlying logic and falsely reasoning by resemblances. I find this sort of false reasoning flat-out stupid. It needs to be called out so others do not imitate it. (Which is a more meaningful resemblance to anti-vaxxers your comment is exhibiting.)
I'd be very surprised if that was a controlled study accounting for people who are at risk of complications making sure to deliver in a hospital.
> It's only in the cases of things going spectacularly wrong that being in the hospital helps.
Which you wouldn't really know in advance as it comes up during the delivery itself.
Yep. My wife had a perfectly normal pregnancy, and everything went perfectly until something went spectacularly wrong. When my daughter was born, and didn't breath on her own for the first 3 minutes. If she hadn't been in a hospital, it would have gone down as still born. She was in the hospital, immediately received resuscitation and numerous other treatments which maintained her blood oxygen level sufficient to prevent brain damage, and now at the age of 4 is ahead of every developmental measure.
"It's only in the case of things going spectacularly wrong" that any risk mitigation activity actually provides value, and in every other case is essentially worthless. YMMV, but I tell everyone I can the story of my daughter whenever they talk about home birth.
One of my daughters too didn't breathe when she was born. The midwives grew very very ernest very very quickly, and the little child was rushed off to hospital in an ambulance. All went fine. I was a little shaky that first night.
Yes, midwives (in some jurisdictions) are trained, qualified practitioners. That said, they are not equipped to deal with many, many complications other than by calling an ambulance and hoping for the best.
Choosing to have my daughter born in a hospital instead of a home birth was most likely the difference between having a healthy baby girl and something in the range of severe mental handicap to stillbirth.
Having a child is a huge risk and investment (by every measure, emotionally, financially, socially, economically, etc). Why would you risk having a stillborn child, life with a mentally or physically handicapped child (this is not a shot against handicapped children - it's a shot against people who refuse to apply critical thinking skills to emotionally charged high risk decisions) so that you can satisfy some foolish ideal that being born at home is better than being born around people who have trained for much of their adult lives to keep your kid alive in its first few days?
It ranks right up there with the foolish parents who refuse to vaccinate children against common ailments or choose naturopathy or homeopathy because of "toxic western medicine".
by whom? That's an easy claim to make if you don't have to test it.
Just doesn't seem worth the risk to me.
EDIT: And for the record, there was zero prior indication that something was wrong. The first sign was when the water broke and was green.
(not that it gets used much -- your case is far from the norm -- but they DO actually come prepared)
Is this not commonplace in the larger hospital markets (where I would assume most HN'ers live)?
"Complications" is a broad categories and includes many things that may not lead to adverse outcomes if managed appropriately, and which hospitals may be more prepared to manage.
According to this study of Oregon births in the NEJM, planned out-of-hospital births studied have substantially higher rates of infant death and neonatal seizures than planned in-hospital births (and these results are, per the study, in line with other studies of out-of-hospital vs. in-hospital births.)
Where things went wrong and bad in the story is the attitude of the nurses.
The social worker who initially responded was no presumptive and did the smart thing of not escalating the issue.
More screwed up is the fact that it took weeks to get the correct result, and that innocent people have to live in fear of CPS coming and taking away their newborn.
That pretty clearly depends on the prior probability, P(M).
It doesn't matter what the prior probability is of a random person having used meth (or whatever you are testing for); it only matters how likely it is that someone who has not used meth will be given a positive result.
If that test is performed only on women, the false positive rate will be 100% regardless of accuracy. All positive results would be false positives.
If the test is preformed on any man leaving or entering the oval office, then the false positive rate will likely be significantly less then 100%, as there will be a president tested multiple times in that group, and when we test positive on him, it's not a false positive.
If we test the population at large, most positive results are going to be false positives, simply because we're unlikely to actually have a former president get tested. But in theory the false positive rate could be slightly less then 100% if we got lucky.
As the probability of an actual occurrence in the test group drops to zero, the rate of false positives approaches 100%, regardless of the accuracy of the testing method.
I think you might be talking about the rate relative to all positive trials. I think I am talking about the rate relative to all trials that don't meet the conditions of the test.
So, you survey 100 women and your test tells me that 10 of them have been president, I say that your test has an observed false positive rate of 10%.
If we test a group comprised of only former presidents, all positives must be true positives. So our false positive rate will be 0% while our female test set has been observed to have a false positive rate of 10%. This illustrates that the sample set effects the observed false positive rate.
As the rate of occurrence of what we are testing for approaches 100% in the sample set, the false positive rate drops to zero. Inversely, as the incidence of what we are testing for in a (sufficiently large) sample set decreases from 100%, the false positive rate will eventually increase to some non-zero percentage unless the test is perfect.
So if we only test meth addicts for meth, our false positive rate will be lower then if we test the population at large.