A lesson in being wary of health articles in the news

I recently read a news article about a new study on the safety of home birth. Later, I wanted to find the article again. All I remembered was that it was from the Huffington Post, so I navigated back to that site, and what did I see in the pregnancy section? I saw this unintentionally hilarious juxtaposition of articles:

They really are right next to each other like that. See for yourself here (at least until new stories push it off the front page).


One of these articles is about how home birth is basically safe. The other is about how it's really risky for first-time mothers.


The best part? Both articles are based on the exact same study - this one that was recently published in the British Journal of Medicine.


And it's not just that each article is highlighting a different aspect of the study. They each pull out different figures to talk about the risk to first-time mothers to make it sound more or less safe, according to the article's mission.


The pro-home birth article says: "... researchers found a higher risk for first-time mothers planning a home birth. Among those women, there were 9.3 adverse events per 1,000 births, including babies with brain damage due to labor problems and stillbirth. That compared to 5.3 adverse events per 1,000 births for those planning a hospital birth."


The second article, the one highlighting risk, says: "Serious adverse outcomes for the baby are rare - occurring just 3.5 times for every 1,000 babies whose birth was planned in an obstetric unit. But the research, carried out at Oxford University, shows this figure rises to 9.5 per 1,000 babies if the mother chooses a home birth."


These articles are actually using two different figures for the risk of adverse outcomes for babies born in a hospital! So what's the truth? Is a home birth, according to this study, less than twice as dangerous to the baby, or almost three times as dangerous? Because one article says one thing, and the other article says another.


Fortunately, the BMJ study is available online, so we can find out. First of all, a summary website for the study uses the 5.3 vs. 9.5 per 1000 figure. Doing a quick skim and a text search of the article itself, I couldn't even find that 3.5 adverse outcomes per 1000 births figure, but I did find a statement that the study overall had 4.3 adverse outcomes per 1000 births. That number includes both first-time mothers and mothers who have had children before. Knowing that, I'm guessing that the 3.5 per 1000 figure must be multiparas (women who have had at least one child before).


Thus, it seems clear that the second article cherry-picked its numbers, and compares multiparas giving birth in the hospital to nulliparas giving birth at home in order to make the risk sound greater than it is. On the other hand, the first article definitely downplays the risk and glosses over it.


This highlights the importance of always being wary when we read health news in popular media. Authors often misinterpret, misrepresent, and misconstrue the data, and almost everyone has some bias toward one side or the other. This may be deliberate, unconscious, or accidental, but it's still very common.

Sorry for the funky formatting in this post. I messed it up and can't figure out how to fix it.

Doula training

Oh my goodness. Doula training was amazing. Just amazing. 50 women, every one so passionate about birth, together for four intensive, wonderful days of education and training. There was just so much energy and joy in the room.

I'm going to compromise my anonymity here, because I think it could be valuable to others for me to say what class I took. So, it was at the Simkin Center at Bastyr University near Seattle, and one of the instructors was the legendary Penny Simkin. I know, how lucky am I, to live in this area and have that opportunity?

Demographics-wise, I was expecting the class to be fairly small - say, 20ish people; and I was expecting to be perhaps the only woman without children. I had the impression that many women get interested in birthwork after having a birth experience, so I expected it to be a crowd of mothers.

Instead, the class was a full 50 women! An unusually large group, I've since heard. The vast majority of the class was under the age of 35; there was even at least one high schooler, which I thought was neat. Slightly over half of the women did not have children. There were actually quite a lot of the early-to-mid-20s, childless women, like myself. I found that very reassuring. In a way, I'm glad that we had such a big class, because there was such a diversity of experiences. We had college students, we had a few ladies in their 50s, mothers and non-mothers; women who wanted to be doulas, women who were already doulas, women who wanted to be midwives; nurses, lactation consultants... oh, and quite a few pregnant ladies, too!

As far as the course material, it was quite comprehensive. There were some basic overviews of pregnancy, the stages of labor, complications, etc. - stuff that we were expected to know, but it was reviewed. Probably the most useful thing was our discussions and practice on how to be active listeners. That made me realize that I very rarely practice active listening. My main goal in a conversation is just to keep it going; I often want to hear information from the other person, but I want to give information from them, too. Sometimes I just want to hear or tell an entertaining story. The give and take is important. But in doula work, the doula's role as a conversation partner is much more as a listener, and much less as a teller, than in an everyday conversation.

Overall, I found the training to be incredibly inspiring and encouraging, as well as very informative and educational. It was a very supportive environment that gave me a lot of confidence that this is work that I can do. I am very lucky to be starting out in a region where doulas are very supportive and collaborative, not isolated and competitive as they can be in some other places.

Big steps

I signed up for a doula training course.

On one hand, it's not much. Just training. I'm not quittin' my day job and I'm not committed to anything more.

On the other hand, it feels huge.