When you are expecting, at least if you are anything like me, you want to be kept informed.  You are constantly drawn towards articles that discuss pregnancy and childbirth and, invariably, these articles are filled with the stuff of nightmares.  At just the time when you should be avoiding stress, you can find yourself bombarded with reasons to become more and more anxious.  I often find myself wondering of much of this reporting would more responsibly be kept away from the general public until it is backed up by a little more evidence.  Frequently, on closer inspection, it comes across as scare mongering.

An estimated 4-12% of women become anally incontinent after childbirth.  31% of obstetricians would opt for a caesarian, even though natural birth is currently regarded as the best option for mother and child.  Exposure to fertilisers (I live on a farm) increase your child’s risk of autism by 30%.  Still births are common.  SIDS is still the leading cause of infant mortality in babies under a year.  The list of horrors goes on.  Not to mention all the latest research suggesting that you should avoid strawberries,  plastics and paracetamol (paracetamol being the only medication, outside of gaviscon, that a pregnant woman is allowed to take and it’s ineffectiveness at treating a headache in the third trimester is a major warning sign for pre-eclampsia).

This wash of statistics is bewildering and can be overwhelming.  Even for someone like me who used to use maths everyday for her job and should know better than to be taken in by some of their assertions.

Let’s start with incontinence.  This one scares me to death.  I’m actually more worried about perineal tearing and it’s aftermath than I am about labour and birth.  The estimation comes from the fact that researchers believe that cases are underreported as women are too embarrassed to come forward.  Personally I would argue that most women would be too embarrassed to not come forward and seek treatment, of all the afflictions to just ignore, unless of course a large amount of the time faecal incontinence is just the passing of gas and the problem tends to pass within months of giving birth.  It may return in old age but there is no evidence to suggest that how you gave birth influences your chances of this happening,  incontinence is an indignity of old age brought on by loosening muscles.

31% of obstetricians would opt for a caesarian.  Let’s begin with the reality of being an obstetrician, you see the very worst of birth.  A normal and healthy pregnancy, labour and birth will be seen through, in this country, by a midwife.  I’m old and my lack of any other problematic symptoms means that I am still in midwifery lead care and unless something drastic changes will stay that way throughout the delivery.  The only reason that I will be referred to an obstetrician will be if I develop a condition that threatens my life or the life of the baby or if my labour is so long, drawn out and fraught with complication that the baby and I are exhausted by it and are forced into an emergency caesarian.  Under those circumstances it’s only natural that an obstetrician would develop a certain respect, if not fear, of birth and yet somehow 69% of them,  the vast majority, would still choose a natural birth.

Exposure to fertilisers will increase your child’s chance of autism by 30%.  First of all we need to consider the fact that recent British research suggests that, while the US are discussing an autism epidemic and fearing that as many as 1 in 50 children will be diagnosed with the condition, the same has not been found to be the case in the UK.  There was an increase in the cases of autism in the 1990s, thanks to greater recognition of the affliction and changes in diagnostic practices, but since 2000, the rates have stabilised and remain constant at 1 in a 100.  That means that the chances of any child developing autism as 99 to 1 against.  The increase of 30% when exposed to fertilisers sounds colossal…if you’re not gifted with the maths or you’re a pregnant lady who is not always capable of being rational as I was until I made myself sit down with a calculator.  For the rate of autism to increase from 1 in 100 to 2 in 100 there would have to be an increase of 100%.  A 30% increase is tiny in the grand scheme.

Still birth is common.  In much the same way that I was forced to deal with the fear of miscarriage by examining figures and verbiage I have dealt with fears over still birth in the same way.  Still birth is not common, it is not uncommon.  Of course any occurrence at all of still birth is horrific.  It is the most earth shattering and traumatic thing that could happen to an expectant mother, indeed to any parent, next to losing a child.  It should be taken seriously, but 1 in 200 babies are still born,  that means the chances are 199 to 1 against.  50% of still births also take place before 28, weeks so for one in my position, the risk is 1 in 400 or 399 to 1 against.  It’s not very likely.  As much as I have remained aware, I have been a lot less paranoid about counting my kicks since I made myself understand that.

SIDS.  Any new parent is terrified of SIDS.  There is no great certainty as to what causes it and the guidelines that you can follow to help prevent it are not a guarantee.  However, SIDS is rare.  Fewer than 1 in 2300 babies die of SIDS in any given year and as SIDS effects babies between 1 month and 1 year of life that figure will not escalate.  Of course even one in 1 in a 1,000,000 is too many but the risk is still not high.  It’s important to be careful and to make sure that all the safety precautions are followed but it is not a good reason to make yourself crazy (though I’m sure that I will).

When we look at any of these risk factors, it is worth remembering the risk factors for cancer.  It is claimed that anywhere between 1 in 6 and 1 in 2 people will develop cancer at some point in their lives.  This may be cancer that is easily treated but, let’s be honest, a cancer diagnosis is not something that any of us would be particularly calm about.  These odds are tremendously high when compared with any of the odds expressed above and yet very few of us will wake up everyday terrified that today is the day that we will find a lump.  If we did,  we would seek help, because that kind of crippling anxiety is not healthy.

Random studies that decry everything in the world as being a potential hazard to your unborn child.   Studies into pregnancy risk factors are very hard to conduct and harder still to gain a positive conclusion on.  Researchers cannot test directly on pregnant mothers,  such a thing would be unconscionable, as a result studies into pregnancy fall into two categories:  testing on laboratory animals and questionnaires that look for statistical correlations.  With regard to the former the issue always exists that we are human, not rats, and that something that has a detrimental effect on a rat is in no way guaranteed to have the same effect on a human.  Of equal concern to the veracity of such studies is the fact that the levels of toxin that the rats will be exposed to is hundreds, if not thousands, of times the dose that a human would be exposed to during the course of their day to day lives.  Laboratory testing therefore takes years to reach a conclusion that is applicable to real life situations and sometimes never does.  Statistical correlations are equally hard to prove.  For a start the sample group has to be large enough for the results to be clearly above that which could merely be attributed to chance but then we also have the issue that correlation is not the same thing as causation.  It could appear in the papers tomorrow that women who drink camomile tea have easier labours but how can a correlation be proven to be a causation?  The same women that drink camomile tea may also be more likely to perform pregnancy yoga, do their kegels, be of above average fitness,  massage their perineums or eat prunes.  Any one of these may be the true cause of the apparent pattern and the camomile tea may have nothing to do with it.  This is why a hundred different things may be reported in the papers that never make their way into the official NHS guidelines, they are simply not solid enough to become recognised risk factors.  Which is why, although I have followed the NHS guidelines to the letter, I ignored my parents when they sent me e-mails about avoiding strawberries and plastic.  They may think that the NHS guidelines are cuckoo but I know they have been rigorously tested.  The NHS guidelines may be a little over-cautious but they are protecting you against matters of genuine concern.

I understand that from the point of view of a journalist, any new discovery is something that the public has a right to know, but the conclusions of a study cannot always be promoted to the status of a breakthrough new discovery as rapidly as some newspapers would have us believe.  New studies are published everyday, they provide insight and food for thought but frequently far more study is needed to determine whether their findings will lead to any conclusions that can be used for the betterment of society.  I have learned the hard way that it is important to take them with a pinch of salt.  If we do not pregnant women will soon be living in isolation, protected from normal life for the sake of their babies,  eating the foods that are prescribed to them by experts, watching the television and reading the books that are deemed suitable and not being allowed to see their loved ones for fear of infection.



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