Letter to the Editor
of the
Irish Medical Journal

Dear Sir

As midwives in clinical practice in the Eastern Regional Health Authority area, we are gravely concerned by your publication of a "study" on the purported safety of home versus hospital birth in the Region.

This deeply flawed and fundamentally biased article conveys a view of independent midwifery practice in the Region which is at best aberrant and at worst, unsafe.

We demand that you publish a critique of this wholly defective research in the next edition of your Journal by reviewers to be nominated by us. Defective methodology yields skewed results, generating mortality rates that are grossly inaccurate and dangerously misleading.

We will confine ourselves to drawing your attention to just one of the many methodological weaknesses invalidating this research. It claims to be based, in part, on the "Regional Interactive Child Health system in the Southern Health Board". Authoritative sources within the Board have stated that no such system exists. While this per se indicates a degree of carelessness on the part of the authors that many would find unacceptable, the possibility that this database might exist within the South-Western Area Health Board of the Eastern Regional Health Authority was investigated, lest this lacuna be merely an error of nomenclature. However, no such system exists either within the South-Western Area Health Board, according to highly placed sources. The "study" is therefore based on a non-existent database.

To have published an article so groundless and so opaque that most reputable peer-reviewed journals would reject it reflects very poorly on you, and on the reviewers who allegedly vetted it.

Apart from its potentially damaging consequences for independent midwifery, you owe it to your readership, the wider scientific community and the Irish public not to allow such statistically worthless work go unchallenged.

Yours faithfully,

Philomena Canning MSc., RM, RN
Catherine Spillane RM, RN
Dolores Staunton RM, RN