Posts Tagged ‘pregnancy’

I’m pleased to announce the launch of my new book, Skeptic’s Guide to Pregnancy. Here is the blurb:

“Are you tired of reading pseudoscientific nonsense in pregnancy and parenthood books? If so, this book is for you. In it, author Chris Worfolk offers his frank assessment of preparing for parenthood with research references to back it up.

In this short book, you will find a mixture of cold hard, evidence-based facts, mixed with Worfolk’s brand of sarcastic humour and a collection of anecdotes to help you remember it.

Invest a few hours in reading this and avoid nine months of tedious and unnecessary planning, worrying and spending on things you don’t need. And, if all else fails, you will have enjoyed the ride.”

It has been two years in the writing as I have been documenting since we started Project Venla. This month, I’ve put the final touches to it. In some ways, it’s a victory for sunk cost fallacy. But I prefer to think of it as using Darren Hardy’s time/reward matrix.

In any case, it is officially out today and will be appearing in in eBook and print, via Amazon and iBooks, in the next few days.

Sleeping might seem like the last thing you should be doing when your wife has gone into labour. But there is a good reason to get some rest.

She has gone into labour, while you are snoring your head off in the bed next to her. Something wrong? You might think you should be awake to support her, but there is a good reason for you to be asleep.

Millions of years of evolution have made mammals pretty good at giving birth. Like breathing, most of it happens automatically. Hormones pulse around your body, directing your emotions and subtlety controlling your behaviour.

One of the hardest things about labour is not the pain itself, it is the sheer exhaustion of the whole thing. You can be in labour for days, with little or no sleep, and yet somehow women find the strength to go on. They do so because their body makes sure they do, injecting careful amounts of oxytocin and adrenaline at the required times.

Birth partners do not have the benefit of this of course. Things have changed a lot in the past 50 years. We are no longer in the waiting room with a cigar; now we are at our partner’s side helping her through the birth. Mother Nature has not cottoned on to this, though, and leaves us with a few vicarious hormones at best.

So, after 72 hours of sleep deprivation, exactly how helpful are you going to be as a birth partner? This is an important question because when your partner reaches transition, she is going to rely on your support to get through it. If you are barely functioning because you have had no sleep, you are not going to be in a great shape to do that.

Sleeping through half of the labour might seem a selfish thing to do. In reality, though, a somewhat rested birth partner is going be to able to offer far more support than one who is utterly exhausted.

Waiting for the labour pains with a well-timed “I told you so” might seem like a good idea, but turns out not to be if you like your balls attached to your body.

The active birth movement has now been going for 50 years and is almost certainly here to stay. That makes sense. Research suggests that active birth reduces the number of complications and interventions, and allows the mother to recover quicker.

As with everything in pregnancy, though, there are benefits and there are also drawbacks.

First, labour can be really painful. It varies from person to person and from birth to birth, but often the amount of pain management required is going to be dictated by the situation.

Second, not everything goes to plan. So you may be planning to have an active birth but the situation could change quickly if there are any issues with labour. Therefore it is important to go in with a mindset of being ready to adapt to the changes required.

How should you handle it? The most important step is to be supportive. Active birth offers a lot more chance for the father to be involved, supporting your partner through the process and helping with non-drug based pain relief (such as massage, and helping her in and out of the bath).

It is also important to be supportive if things to not go to plan. If she decides she does need pain relief after all, remember to reassure her that almost everyone does, and there is no “failure” in resorting to it.

Overall, active birth is a great decision, especially for dads. The advantage is the reduced chance of intervention, and the disadvantages of additional pain are only felt by the father vicariously.

In July, We bought a pram from Mamas amp; Papas. Now it seems we’re in some kind of cult, like when you buy an Apple product and then get invited down for a personal setup. They invited us down to their Parents To Be evening to see what it was like. Their claim of “impartial advice” seemed a bit dubious for a chain that sells baby products.

We almost missed it. Having booked for the Leeds store, it was only when I printed out the invite as we were about to set off that I noticed their “Leeds” store was in fact their Birstall store, not their LS1-based store in Leeds Trinity.

It was actually very good. They had talks on baby and child first aid, sleep and car seats. Nobody else seemed too bothered about the free refreshments, so I worked my way through three pastries, three muffins and a cupcake.

Having so many sales people on hand was also a bonus. We have sometimes struggled to find someone to speak to on our prior visits so getting one-to-one attention was great. I had them help me try on practically every baby carrier they stocked.

We also received a goody bag and a £10 discount on the car seat we bought. We actually bought a Cybex car seat but it would seem to come Mamas & Papas branded if you buy it from their store.

Overall, this event was well worth attending. They were true to their word in offering advice and talks, and if you are planning on buying anything you can cash in on the discount too.

Expecting Better: Why the Conventional Pregnancy Wisdom is Wrong and What You Really Need to Know is a book on pregnancy by economist Emily Oster. Oster is known for applying her economics to other fields having given a TED talk on re-thinking AIDs in Africa. During the pregnancy of her first child she got sick of uncited recommendations and decided to look at what the evidence really said.

Take alcohol for example. I wrote about alcohol and pregnancy last month. Oster’s review of the available evidence and theory behind alcohol use during pregnancy is that having up to one drink per day is fine after the first three months. Coffee gets the green light too.

There is no evidence that bed rest is beneficial for pregnant women. In fact, it is quite the opposite: laying around for weeks or even months on end is likely to have a negative impact on the mother’s health. Aromatherapy provides no benefit either, but not everything is out the door: having a doula at the birth produces much better health outcomes.

With each topic, each stage of the pregnancy and each taboo, Oster reviews the available evidence and produces a short summary at the end of each chapter explaining what is safe and what is not. This is by far the most important book on pregnancy I have read.

While in Mothercare a few weeks ago, I picked up a leaflet on alcohol. It has the Leeds City Council and NHS logo on the front and is entitled “No thanks, I’m pregnant”. The message is that the best amount of alcohol to drink while pregnant, is none.

The problem with this statement, is that it may not be true.

For years it has been widely believed that you should cut out alcohol while you are pregnant. All the pregnancy books I read recommended staying away from alcohol. Though they also said that if you had been drinking before you found out, it didn’t matter. How does that stack up? The answer is because there is a lack of evidence that alcohol is harmful after three months.

Do not mistake me: heavy drinking while pregnant is dangerous of the baby and could result in foetal alcohol syndrome. It is serious and if you drink heavily you will do serious damage to your baby. However the evidence for moderate alcohol consumption is less clear.

Advice published by The Royal College of Obstetricians and Gynaecologists says…

Drinking small amounts of alcohol after three months of pregnancy (not more than one or two units, not more than once or twice a week) does not appear to be harmful.

Similarly, in 2010 University College London published research that concluded…

Light drinking during pregnancy does not harm a young child’s behavioural or intellectual development.

Alcohol is not beneficial to the foetus. However, small amounts are not harmful either. Given that it does provide health benefits to adults, it could be useful for the mother. In light of all of this, it may be time to re-think our public health advice on drinking while pregnant.

The Expectant Dad’s Survival Guide is a pregnancy book by Rom Kemp.

It cuts a nice channel between the super-factual but not very engaging What To Expect, and the highly engaging but far less informative Fatherhood: The Truth.

It covers the practical stuff that you need, what to expect during labour and the first few months after the birth. As with other books, he has surveyed his friends to back each point up with a range of anecdotes. More interestingly, there is also advice from a midwife (who is also a father himself), The book does a far-better-than-average job of not patronising (no “oh wow, you want to be involved with your baby – but you’re a man!” that is common with pregnancy books).

Five Star Babies was a two part BBC documentary looking at Portland Hospital, a private maternity hospital in London. No expense is spared. The dining is gourmet, you get your own private consultant, and the birthing suites come with a lounge area for guests.

Having not been through the process myself, it’s hard to judge some aspects. For example, sending your baby off to the nursery for the first few days. If that was an option, I think I might take them up on that. As a new parent, I imagine I am going to want all the help I can get.

Other things just seemed downright strange though. Sending your new-born off for a clean and a nappy before holding it for example. That seems like a weird rich-person thing. In fact one of the most interesting confessions on the show was when one of the nannies admitted that she almost always saw the baby’s first smile, but would never tell the parents that.

There is also something about private healthcare. My dad told about the time my granddad went private for something. He needed pain relief and the doctor, rather than recommended what would be best, just gave them a price list. The quotes for epidurals, which come in at just under £1,000 if you are interested, reminded me of that.

As the show goes on, it just becomes silly. People redecorating entire floors, bringing in their own designers, making secret entrances and spending up to £250,000 reveal a deep problem with the growing income inequality in the UK. Do you need all of that? The answer is almost certainly, no.

Last month, I wrote an article calling out companies that had started using the Finnish baby box tradition to sell their wares.

Specifically, my criticism was that the Finnish system lowers infant mortality by acting as a bribe to get people to neuvola, the centres that provide all the antenatal and postnatal care. That is where the evidence-based benefit is. On top of that, giving good quality stuff to poorer parents may also help.

However, the there is no evidence the cardboard boxes themselves do anything (obviously, because it is just a cardboard box) and so selling them from webpages that show infant mortality graphs feels like taking advantage of scared parents to me. In fact, the box matters so little that the Finnish government will just give you cash instead, if you wish. The box is worth more, so most people choose that, but the key to the Finnish success is the adoption of the medical care.

Anyway, recap over.

After the post went up, Jennifer Clary, CEO of US-based Baby Box Co offered to have a chat to fill me on what they are doing. I took her up on the offer.

She said she fully accepted the boxes were not magic, but that they were trying to use them as an engagement tool to get more of the good stuff done. So while they love selling direct to consumers, the real opportunities are selling to healthcare providers and governments so that the boxes can be used in a way that is more Finnish.

In addition to their actual box products, they’re developing what they call “Baby Box University”. The idea is that they can partner with authorities, who get people to complete online courses and come out of the end with a certificate and a free baby box.

This sounds super because it fills in the missing gap in replicating Finland’s success. Infant mortality is lowered by developing educated parents who engage with healthcare programmes, and it sounds like what Baby Box Co are doing supports that.

What to Expect When You’re Expecting is a book by Heidi Murkoff and Sharon Mazel. I read the forth edition.

It is packed full of information. Hundreds of pages arranged into several columns per page. Chapters take you through each month of the pregnancy, as well as things like diet and exercise, and what to do in special situations such as twins, complications and even loss.

It covers labour, delivery and the first six weeks after giving birth as well, though with increasing references to “you can read more about this in our next book” style advertising.

The chapter on diet is just intimidating. You get the usual list of foods to avoid. It also suggests a pregnancy diet to ensure mum is getting everything she needs, and the list is long: 3 servings of protein, 4 servings of calcium, 3 servings of vitamin C, 3-4 servings of salad, 1-2 servings of fruit, 6 servings of whole grains, 1 serving of iron-rich food, 4 servings of fat, 8 glasses of water and a vitamin pill.

All of that while monitoring your salt intake and avoiding all the food on the banned list. I spend quite a bit of time planning our diet and I have no idea of much of that we are hitting. This was a guilt trip I did not need.

It is targeted almost exclusively at mums. There are occasional references to the other partner, but these are few and far between. There is a chapter for expectant dads, but it contains almost no useful information. It felt like a short Q&A that gives obvious and patronising suggestions: have you considered helping out around the house? Why yes, yes I have, because it isn’t the 50’s anymore.

It is also tediously American. If this the “bestselling pregnancy manual” as the cover claims, you would think they could put out a UK edition. Everything from the language used, to the medical information and drugs referenced, is a bit off for the UK. You would think given how similar our cultures are they you would not get such a wide gap. However, it often felt like it when reading.

I did appreciate it’s tip to skip the chapter on complicated pregnancies. As the book says, I can read that if we run into a complication.

There is loads of information in this book. From that perspective, I am glad I have read it. However, my guess is that there is probably another book out there that gives you the information in a much better way.