Book review by Margherita Drago
Informed is Best: How to spot fake news about your pregnancy, birth and baby by Amy Brown is available from Pinter and Martin as a printed book, or on Kindle, for £12.99: https://www.pinterandmartin.com/informed-is-best
How many times are we being told that we should do our own research?
With so much information at our fingertips, it’s probably like asking someone to look for a needle in a haystack. Professor Brown’s book “Informed is Best” is a must-read for anyone who wants to know how to look for the right information, where to find it and how to spot the thousands of fake/alarmist pieces of information we are exposed to every day. The final goal is to feel more confident in making decisions for ourselves.
We have also all come across social media users who claim to be “experts” on a particular subject (usually because of anecdotal experience). So why are we all more inclined to believe these people while dismissing scientific researchers? Of course, our unconscious bias plays a big part in our choices as we are more likely to trust our friends & family than researchers.
The first part of Informed is Best delves into how the media and social media shapes our views. It cites a very interesting study on how the UK’s newspapers are linked to political views and reiterates a certain world-view (confirmation bias anyone?).
Informed is Best also looks at the role of the Internet, and how this is changing even the way we (skim) read everything. Focus is put on checking where we are getting our information from. Professor Brown uses the example of Nestlé’s website which has many scientific articles talking about infant nutrition (breastfeeding included) and looks very formal. However, is this really the best un-biased source for information on infant nutrition? Probably not.
The section regarding academia will bring you back to blatant underlying sexism, classism and racism. It’s a very sad state of affairs where there are fewer women in academia, undertaking research. The book states that “women end up (still) doing less research and not getting taken as seriously for it. And because women predominantly do the research about pregnancy, birth and babies, this means that research in this area is still underfunded and not taken seriously” (p. 114, 115).
The world of research funding is another world that we all know is not fully transparent. However, after reading Prof. Brown’s examples I would say it’s even murkier than I expected. The extent of corporations’ gains and the amount of money spent to fund self-interested (or downright dangerous) research is so enraging. The truth is that “normal birth does not benefit the industry” (p128)and therefore there’s not much money spent on funding research benefitting mothers having normal births. If this doesn’t enrage you, I don’t know what will.
Partnerships between industry and health organisations have always been there, but because of current general lack of research funding these have become even more entrenched and condoned in the academic world. Reading of the effects of said partnerships on public health policies and individual health choices is, again, very sad. One interesting example is the increased rate of prescription for specialist formula (for cow’s milk allergy), which quadrupled between 2006-2016. The authors who published guidelines around Milk Allergy in Primary Care (MAP) all had ties with formula companies (p. 131-133).
Because the book was written in 2019, the picture becomes scarier when put in the 2020/2021 pandemic context where scientific research is now largely privately funded, sometimes with impressive results, but often at the expense of other research sectors.
To avoid getting sucked into scary headlines and misleading research, the author’s advice is:
1) Always read the label: check who has funded the research and you will always have your answer.
2) Look at the bigger picture. It’s important to understand that we, as individuals, don’t all have the same risks. Our individual risk is based on multiple factors (i.e. social, genetics, even luck). Public health guidelines are created with a very large group in mind, and their objective is to statistically minimise a risk. Guidelines on, for instance, keeping the baby in your same room, will lower the risk of SIDS. “It’s important to remember that this is NOT the same as saying that if you don’t follow this guideline something WILL cause harm, or has caused harm to all babies” (p. 153).
3) Be aware that each type of research (quantitative or qualitative) has its limitations.
4) Socio-cultural / economic / ethnic factors and geographical location are at play in every example of human research.
5) Some issues cannot be ethically researched, thankfully. Therefore, we will never know the scientific answer to many questions such as randomising women to breast or formula feeding.
Chapter 17 is incredibly interesting because it brings home all of the previous information.
Let’s be honest, what everyone really wants to know is “what’s the actual risk to me”. This chapter is a great insight on how we perceive risk and how our behaviour is affected by it. The author takes the example of co-sleeping. The public perception is that co-sleeping is unsafe, so we are told to avoid it completely (risk elimination p. 317-319). However, many parents will decide to co-sleep anyway (through conscious choice or necessity) but will often avoid disclosing it and will therefore lack the education on safe co-sleeping. Lucky things are changing and safe co-sleeping measures are now more widely publicised.
In the final chapter, the author describes the always useful BRAIN acronym (p. 336), which makes for a great final chapter considering how we make decisions, as individuals, according to our personal reasons, experiences, preferences, and familial/cultural background. Finally, it stresses how important it is to validate feelings if things don’t go according to our plans because it’s always important to keep in mind that, like everything else in life, birth has some degree of risk and unpredictability. A list of great resources is included in the final chapter as well.
My only partial criticism to this book is that it goes in great depth explaining how scientific research is conducted, randomised controlled trials and other specific examples on how research papers are actually produced. I completely understand the need to clearly explain this, as a preamble to the final chapters. However, chapters 8 to 12 probably go to unnecessary lengths into specific scientific research most of us are probably never really going to see again. That doesn’t mean we shouldn’t read about it or skip them. But just be aware it’s presented in detail.
Finally, after reading the book, I would definitely suggest always using a parachute when jumping out of a plane (inside joke – read the book to find out more!)