Musings on research, international development and other stuff

The arrival of mini-evidence!


pregnantReaders, I have to confess that I have been keeping a secret from you; for the last nine months, in my spare time, I have been growing a human!

I didn’t want to mention it before because I was feeling superstitious (yes, yes, I get the irony) – but I am now happy to announce the safe arrival of my son last week.

OLYMPUS DIGITAL CAMERANow, the perceptive amongst you will recognise that this post is just a poorly-disguised excuse for a proud new mum to show off a picture of her offspring (see right).

However, in an attempt to shoe-horn my news into the theme of my blog, I hereby present five things that pregnancy and childbirth have taught me about evidence-informed decision making:

1. Pregnancy is open-season for pseudo-science. I have been amazed at how otherwise sensible sources of information seem to be completely happy to promote dodgy quackery when talking about pregnancy. It is difficult to find a book or article about pregnancy problems which doesn’t eventually advocate trying homeopathy, reiki or some other daft treatment plan, while the pronouncements about what you can and cannot do while pregnant are often arbitrary and non-fact based. This article in the Guardian on this topic is great.

2. The best pseudo-scientific ‘fact’ I heard was the idea that foot massage could be dangerous during pregnancy since there is apparently an accupressure point on your foot that can induce early labour – which made me imagine a horde of reflexologists-gone-bad moonlighting as backstreet, alternative therapy abortionists.

3. The ubiquity of bad science in pregnancy-related advice is particularly disappointing considering the rich history of good research on pregnancy and childbirth. In fact, the Cochrane Collaboration was originally started in the 1980s in order to produce objective reviews of research in perinatal medicine.

4. Just as in policy making, lived experience can trump statistics. This is demonstrated by the number of mums who will assume that your experience will be the same as theirs despite the massive variation in ‘normal’ pregnancy and childbirth.

5. Those of you who work in the field of evidence-informed policy making may think you know a lot about the competing influences of evidence, beliefs, politics, prejudice, vested interests and so on in decision making. But you have not seen anything until you have spent some time browsing a mums’ online discussion forum…

The only thing that remains for me to say is that my blog posts might be a bit infrequent over the coming months – please bear with me as I might be a bit preoccupied. And, what’s that I hear you say? You would like to see another photo? Oh OK then, here you go!


12 thoughts on “The arrival of mini-evidence!

  1. Many, many congratulations! Ignore all the doom-mongers, motherhood is the most glorious fun and just gets better and better.

    But if you think the pregnancy lot is mad, wait until you meet the anti-vaccination lot. One of my proudest achievements was walking into my health visitor’s office and demanding the MMR vaccine for my eldest, just after the autism scare had happened. When I said that you couldn’t base a clinical decision on a self-selected sample of 8 and what was the Lancet doing publishing such nonsense, she nearly hugged me.

    Coffee in about 6 months or so? Don’t rush back…


  2. Congratulations! I totally agree and remember the frustration late at night, browsing the internet for decent evidence and not the usual waffle.

    I applaud the recent link up between Mumsnet and Sense about Science but the fact is that there are some v bonkers advice online on various discussion groups – and you can only really moderate things that are downright dangerous, libelous etc

    One thing that you will come across is the old chestnut of ethics and trials. You can’t, so they say, experiment or do an RCT with babies on say different approaches to getting them to sleep. The ‘controlled crying approach’ worked for us, but there are some fierce critics and it’s really all anecdotal whether it works or not (we had to do it as nothing else was working). But this surely this is important enough for some more robust research (parents’ sanity is not to be sniffed at).

    The self help books are woeful. I think you should set up a new campaign?

    I recall finding some of the content on the Royal college of paediatrics and child health website helpful, but the focus was still on ‘disease, extreme and acute issues , not the day-to-day madness of looking after kids. But at least it was trustworthy and most of it intelligible to a non-clinician like me.

    I also recommend putting the childs cot at a 260 degrees angle to a full Moon is beneficial for longer term sleeping

  3. Your posts are great Kirsty but this one is the best by far. More pictures please!

  4. Congrats! He’s beautiful! And I think the question of evidence-based policymaking around pregnancy is actually a great one. Beyond the pseudo-science, there seems to also be a bad problem about misinterpretation of otherwise valid studies. For instance, the study that “proved” pregnant women shouldn’t drink caffeine was apparently done with a sample of women with unusually high rates of cocaine use. Helloooo, confounding variable. It’s an important reminder that while researchers might think the results of their work are unambiguous, there’s no guarantee policymakers will view them as such.

  5. Congrats Kirsty! Considering how important pregnancy is, there should be more focus on good information.

  6. Congratulations! Your take on the evidence around pregnancy was wonderful. As the mother of four and having worked in public health for over fifteen years and currently in reproductive health it is also very relevant to me, especially the statement about lived experience trumping population evidence. And I wholehearted agree about the vaccination debate raised in a previous comment.

    There is a huge amount of work to do to line practise with evidence in women’s reproductive issues from conception – both trying and not to (apparently you can’t get pregnant if the woman doesn’t orgasm – my favourite story from our service this year), through the stigma and religious dogma attached to abortion, through birthing and breastfeeding and parenthood.

  7. Congratulations! You are so right about those parenting forums. Try to stay objective and/or away. (That advice is definitely evidence-informed.)

  8. Huge congratulations Kirsty, hope you’re both doing well.

  9. Congratulations Kirsty! Super cute!! And, yes, completely agree about the contradictions in pregnancy and parenting advice (especially living in the US)

  10. Pingback: Does public (mis)understanding of science actually matter? | kirstyevidence

  11. Pingback: Guest post: Louise Shaxson on advising governments… and ugly babies | kirstyevidence

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