We read with some alarm the article by Wax et al entitled, “Maternal and newborn outcomes in planned home births vs planned hospital birth: a metaanalysis.” We agree with several researchers who point out that the method used to select studies for inclusion in this metaanalysis requires serious scrutiny.

But even if we accept the authors’ flawed data, their main argument remains highly misleading. Of greatest concern is the conclusion that home birth is associated with a greater risk of neonatal death. This conclusion is an artifact of the authors’ study design, in that the home birth data used for comparison include births not attended by a certified midwife.

The authors do inform us that when these studies are excluded from the analysis, the odds ratio for neonatal death between home and hospital births is no longer statistically significant. However, this information appears only in a complex sentence at the end of Results , opening the door to the publication of false reports on the safety of birth at home by the mass media. A more honest title for this study would be “Outcomes of unattended birth vs births attended by trained professionals.” The misleading presentation of data begins in the title and continues in the abstract and virtually throughout the article.

This misrepresentation of data is contrary to what the public rightly expects from science.