Flawed bed-sharing studies need to stop.

So today I went online, had a browse at the news... and what jumped out at me straight away?

Headlines such as 'Cot deaths Risks of Bed Sharing' - The title in itself doesn't even make sense! Now, that's a paradox if ever I saw one!

What other headlines were there? 

Bed-sharing increases SIDS risk, Bed-sharing 'raises cot death risk fivefold' and many more...

I have to be honest here, I can't even work out where to begin with this horrendous 'study' and awful media reporting of it. Link to article

Whilst reading the article, the first thing that jumped out at me was this "In this combined dataset, 22% (n=323) of the deaths occurred while bed sharing" - So wait, 88% of the deaths occurred while NOT bed sharing. Ok.

Not only that but Out of the 323 SIDS cases that died whilst bedsharing only 87.7% were attributable to bed sharing (assuming that they would otherwise have been placed on their back on a cot in the parents’ room).

So 283 deaths were attributed to bed-sharing. Out of 1472 deaths. Which means 1149 deaths were not attributed to bed-sharing.

Moving on from that strange bit of logic.

Notes on variables. These two really struck a chord with me.

 

Bed sharing was defined as when one or both parents slept with the baby in their bed so that they woke to find the baby dead in bed with them. 

Breastfed—infant was being partially or completely breastfed at the time of death or interview. 

 

So what do we notice about these variables? Well there are safe ways to bed-share, just as there are safe ways to put a baby to sleep in a cot. 

The first rule of safe bedsharing is that the baby should be exclusively, not partially breastfed.

Although bed-sharing often includes partners, and potentially siblings, the safest way to bed-share is with the mother and the infant only. If a partner is in the bed, the safest place for baby to sleep is not between them, but next to the mum. Other studies have found that there was no increased SIDS risk for babies who shared their beds with just one person - their mothers (Hauck and Herman 2006).

 

Why bother to do a study about bed-sharing, without factoring in variables that make the practice unsafe?

To study bed-sharing with regards to SIDS there needs to be studies that encompass only safe bed-sharing principles.

This study managed to leave out:

The type of mattress - soft or firm?

Whether the bed had a headboard, how close mattress was to the floor.

What baby slept with - duvet, blankets, pillows, toys?

Where baby was placed in the bed - by the edge, against the wall, between parents?

The temperature of the rooms

Whether the parents were known heavy or restless sleepers

Whether the baby was born premature

Whether the mother was on legal medication

Was the bed-sharing planned in advance?

etc.

And the final thing I noticed, right near the end, in amongst a large paragraph:

"Bias is also possible due to the selection of the studies"

So when will we get to see a large study, without so much missing data, with more variables...

When will we see a study showing only habits of safe bed-sharing compared with safe cot-sleeping? to determine the real risks of SIDS?

International Day of the Midwife 2013

Just a quick note to say happy International Day of the Midwife 2013! What a wonderful day to celebrate one of the most amazing jobs in the world! Not that it feels very much like a job sometimes....

One thing I really feel the need to write today is how thankful I am.

How thankful I am that I live in a country where midwifery is in general a respected profession. Where the maternal mortality rate is (last time i checked) around 12 women in 100,000. Which isn't good enough - I know; but it sure beats living in places such as Somalia where the maternal mortality rate is into the thousands.

We complain about the shortage of midwives in the UK. We compaign, rally and write petitions to try to urge the government to start training and hiring more midwives. In some areas over 40% of the midwives are coming up to retirement age, and no provisions have been made to train enough midwives to cover even half of that, which means soon the shortage will be worse than ever.

But to put it into perspective - WHO have estimated that worldwide there is an urgent shortage of over 350,000 midwives.

In 2011, UNFPA published a report on 58 countries that together account for 91% of maternal deaths in the world. They worked out that over 3 million lives could be saved each year if there were 112,000 more midwives or skilled birth attendants practicing in these countries. Over 60,000 of these midwives are needed in just 8 countries that account for 56% of all maternal deaths.

And although many people think of attending births when they think of midwives, midwifery is so much more. Midwives have a unique position working with women and their families to make a real impact on public health. Many women we meet here in the UK have had barely any contact with health care professionals before becoming pregnant, especially those coming from deprived backgrounds.

We often have the privilege of supporting women to take control over their own health, women who may not have cared about their own wellbeing before a baby was part of the equation - or women who wanted help but didn't know how or where to find it. Midwives can become a bit of a one stop shop - supporting, advising, counselling or referring to other healthcare professionals - on topics ranging from diet, mental health, employment rights, contraception. You name it, if we can't help you we will find you somebody who can.

And speaking of contraception - one last thing before I finish. Something I'm interested in, and keen to learn more about, is how we can improve family planning throughout the globe. Here we are lucky, contraception is something not too many people worry about. We have a lot of options and trained healthcare professionals to support us through our choices. We have clinics we can attend, or we can use the internet to find out what type of contraception is available. We have the morning after pill and termination is legal. Women in many developing countries who don't want, or literally cannot afford another baby do not have access to contraception and nearly a third of maternal deaths in the world are due to unsafe terminations and complications that arise from them.

I openly admit that I am quite ignorant about these issues - I suppose it isn't something you have to think about whilst working here. It is however something I'm deeply interested in and passionate about so I intend to change that. My plan for the next year is to learn more about the problems faced worldwide for mothers and babies, so hopefully by International Day of the Midwife 2014 I will be a bit more knowledgeable about this. I have to understand the worlds problems before I try to help them :)

So I've started a blog.

I have started a blog, as you can see.

I've thought about it for a while, but I keep thinking that I will have no time to write posts. I figured who would want to follow a blog that never gets updated?

But then I thought, who cares about followers? I'm not doing this to have a mass of followers. In fact it will probably be easier with less followers! I'm doing this to expand upon my facebook page, a page I originally started to share photos, quotes and information with women and other people passionate about birth. A page that was quickly targeted by somebody who didn't like the pictures I was posting and sharing, which ultimately led to facebook deleting and repeatedly banning me for 'obscene' pictures such as breastfeeding and waterbirth. Really.

For a while that put me off even posting. I was warned by facebook that I was ignoring their requests to remove all further pictures that break their rules and if I posted more I could be permanently banned. I can't find one picture that I honestly feels breaks their rules, and I have never posted a picture intentionally to upset or disgust anybody. I guess my feeling is that if you're so disgusted by a natural act - then don't look at photos of it online only in order to report them?

Anyway, moving past that. There are things I'd like to post on facebook, things I'd like to write and share and I guess I will be able to do that here instead.

I've begun to continue sharing pictures through facebook, but I'm a lot more careful about what I post now, which is a shame. Some of the best photographs I've ever seen are ones that facebook believe to be 'obscene' (I think that was the word they used? I'm trying to remember.)

So just to summarise: Welcome to my new blog :)