Every so often, the media launch an attack on women, midwives, home birth, straightforward birth and/or the low-tech tools that we have used to support each other for tens and sometimes hundreds or thousands of years.
Usually, such pieces are very one-sided. Relevant facts are left out. Data are cherry picked to suit the journalist’s or editor’s own views.
Frequently, there’s no consideration of nuance, the bigger picture, or the downsides of interventions.
And that’s a huge problem for those who need to make decisions about their pregnancy and birth journeys, as well as for anyone who works in or around pregnancy and childbirth.
We all know it’s happening
We all need to be able to look critically at information. To understand the importance of not taking stories at face value. To know the importance of looking at things more deeply, so we can make the decisions that are right for us.
And I think that these things are now commonly understood. Irresponsible and unhelpful reporting of birth related research, news and issues isn’t a new problem, and several commentators (including myself) have raised concerns about this for many years now (e.g. Newman 2003, Romano et al 2010, Newburn et al 2011, Wickham 2011).
But it’s sometimes hard to remember, when we’re glancing at the millions of pieces of information that pass us during the course of a day, that there are different perspectives on birth and that some people benefit from fearmongering and trying to make us focus on risk. I’ve written more about that here.
The denigration of the female body
A common tactic is to denigrate female physiology and attack a low-tech approach by claiming that there’s “no evidence of benefit.”
Sometimes that’s true. But it’s not necessarily because there’s anything wrong or harmful with the approach.
It’s important to remember and remind people that we need evidence to justify intervening, not to justify things that our bodies will do if left alone. The latter is a ridiculous suggestion, and yet some people use gaslighting to try and convince us otherwise.
Would it be good to have better evidence?
In an ideal world, would we have better evidence for the low-tech interventions, such as hypnobirthing and some holistic therapies?
Absolutely. They are still interventions. It would be a double standard to expect otherwise. And if things don’t work, or work only as a placebo, then people should be able to find that out. They might still want to use them, because effectiveness isn’t everything, but we can at least offer information on which people can base their decisions.
But it’s important to understand why we sometimes don’t have that evidence.
Often, there’s a lack of evidence because it’s hard to get funding for research into things that don’t make big profits for private companies.
It’s also important to understand that the research methods favoured and valued by western medicine are the methods which are based on a western medical approach. As I explain here, they aren’t necessarily the right methods to measure the effectiveness of more individualised therapies. The key is to match the research method to the thing being researched and to explore better and more diverse ways of carrying out research, not to try to make everything fit into the very narrow western medical box and then attack it if it doesn’t.
It’s also ridiculous to suggest that we need evidence to prove that common sense things we have done for millennia are beneficial. There’s no actual evidence that offering a cold, damp washcloth to someone who is hot from hard work is beneficial. That doesn’t mean that we should stop doing it.
Another important question
It’s also useful to turn the question around, and to put the spotlight on the interventions and approaches that form the status quo.
Where’s the evidence which shows that the drugs, technologies, tests and interventions that are increasingly pushed as routine are beneficial?
Why, for instance, are so many women being ‘offered’ induction of labour when there often isn’t evidence that this will make a positive difference, and there IS evidence that it carries risks?
Why is it that midwives and midwifery services are being denigrated, cut, and stretched beyond measure when we have so much evidence that a midwifery-led approach is the most beneficial thing that we can offer women, babies and families?
Sadly, the answer is again about politics and economics. If you’ve read my book ‘In Your Own Time,’ you’ll know that the current situation has a long and sad history which is all about certain groups seeking power, and using ideas like risk in order to scare others into complying.
Is it any coincidence that fear and risk are some of the main tools that the media still uses to try and get our attention and scare us into reading their stories, and clicking on their links?
The good news
But all isn’t lost.
There are a couple of things that we can all do which will help us as individuals, and which will help us to help others and to address the wider problem.
The first is to understand that this situation exists, by reading and thinking about how the media (and social media) works to try to get our attention.
We can also be open to thinking more deeply about how information is presented, and by questioning what we’re told, and what we have grown up believing, rather than taking it at face value.
I won’t pretend that’s always comfortable. It isn’t. But help, support and tens of thousands of other people who have been on the same journey are available.
And third, we can all get better at understanding how research works, which means that we are less likely to be fooled by other people presenting research findings in a way that suits them, or that sells their particular story, service or status.
You can learn how to approach stories and ask the right questions to make sure you’re not taken in by someone else’s presentation of research findings and statistics, or swayed by their interpretation of risk.
If you’d like to know more, some of my books help people understand the research in certain areas of pregnancy and birth, such as induction of labour, Anti-D (RhoGAM), vitamin K and group B strep.
I also highly recommend Informed is Best for anyone who wants to deepen their understanding of research and how it can be misrepresented. I loved this book so much that I wrote the foreword for it.
But whether or not you’re ready want to know more, I have one simple message:
Don’t believe everything you read. There’s always a bigger picture.
Newburn M, Gyte G, Macfarlane A (2011). Why do medical journals get so het up about home birth? EM 1(4):17-22.
Newman RB (2003). Our unrequited love for simple explanation. Journal of Perinatology 23(6):504-6.
Romano AM, Lythgoe A, Goer H (2010). They said so on the news: parsing media reports about birth. Journal of Perinatal Education 19(1):47-52.
Wickham S (2011). Media Mayhem. EM 2(8): 50-51.
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