So, you’re pregnant? Wonderful, isn’t it, how you’re suddenly surrounded by friends, family and professionals, all giving you the benefit of their sage advice? Anecdotes and opinions about being pregnant and giving birth abound. How much of what you hear is actually evidence-based, though – and does it matter?
Childbirth advice based on other peoples birth experiences, hearsay, urban myths or old wives tales may be interesting or even funny (“I laughed so hard, my waters broke”) to read but may also do nothing to support you in your own decisions and help you in choices that feel right for you and your baby. To help us make good choices about giving birth, we need to be able to trust the information we get.
The next time you read a childbirth or pregnancy related article ask yourself a few questions. For example –
- Who is the author?
- What are their qualifications?
- What gives them any authority to be able to offer this information?
Perhaps a quick Google on the writer will reveal more about them. For example you probably shouldn’t base your decision to use pain relief in labour on the “have you ever tried to poo a bowling ball” types of article written by one woman based on her one birth experience, however well written it is and however touching it may be. It’s better to find something that is more evidence based (ie backed by good science )and written by someone who has a better chance of knowing what they are talking about” (scientist, midwife, obstetrician, doula, professional journalist etc).
Is the article fully referenced? How relevant are those references? Beware generalised statements like “Most women find pain relief during labour makes life easier” unless it is backed up by good evidence and references that you can verify. If the research is based on 5000 women giving birth for the first time at a range of hospitals across the UK in 2006 then you know it is more relevant than something from Scandinavia in 1933!
Is the evidence trustworthy? We’ve already mentioned relevance but what about the source of the evidence? Who funded it? Much health research is funded by private companies who’s interests lie more in profit than health; that doesn’t mean you can’t rely on the evidence, just that you need to be aware of it’s provenance and possibly look for further studies that my come at things from a different angle.
However, some information we find as parents will not be, and is unlikely to be, evidence-based. For example, there are few studies on the effectiveness of using cabbage leaves in the bra to help early postnatal breast engorgement but many women find it soothing. (It is unlikely that anyone will ever fund research into cabbage leaves) In this situation you are left to follow your own instincts – cabbage leaves are unlikely to hurt anyone but other unsupported suggestions could be riskier. The point is that you need to check the research you can and trust your instincts the rest of the time; some Old Wive’s Tales are more helpful than others.>
Birth and baby-related research publicised in the media may prompt questions and anxieties and may even seem to back up views of childbirth that you may personally disagree with. It maybe that new research requires us to readjust our stance on something, but hopefully reading of this kind can help us make our own decisions and take responsibility for our own births.
Sometimes, one set of research can appear to debunk another – but this does not mean much; just statistics! Often, neither research, personal experience nor opinion are all the answer; as mothers, we frequently use our gut instincts to help us find our unique way through the pregnancy and childbirth maze.
Here is a checklist for evaluating reseach:
- Is the study recent, or a few years old
- have more recent studies come to different conclusions?
- Whose health is being studied?
- Is it culturally relevant? Were woman included in a study that may flaw the study (eg were vbacs included in a study of first time vaginal births)?
- What is the treatment or intervention being studied and how are the outcomes measured?
- Who funded the research? Is there anyone involved who has an axe to grind, or a conflict of interest?
- re there any side effects or risks involved?
- How many were involved in the trial. How many dropped out?
- Was it a <a href=”http://en.wikipedia.org/wiki/Randomized%20controlled%20trials” id=”aptureLink_ptj2VUqPKp”>Randomised Controlled Trial</a>, or would this have been unethical?
- Are the groups being studied clearly defined?
- Is there a true ‘control’ group so the researchers can make accurate comparisons?
- Does the abstract (or summary of the research) back up or contradict the actual findings?
- Who carried out the study? What did they probably expect to find?
A last tip – if you find yourself having to assess the evidence ‘on the spot’ during pregnancy or labour, you might try using the <strong>BRAIN</strong> analysis:
B=What are the Benefits of the course of action advised?
R=What are the risks of said course of action?
A=What are the alternatives?
I=What do my Instincts say?
N=What if I do Nothing?
Questions and comments welcome below.