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Midwife Talks

Navigating Pregnancy and Birth with Informed Choices

- Sep 8th, 2023

Bringing a new life into the world is a profound journey, and for the parents, it's filled with a multitude of choices to make along the way. From prenatal care options to labor and birthing plans, the decisions you make during pregnancy can significantly impact your experience. As a midwife, I'm passionate about helping you make informed choices, and one crucial aspect of this is understanding the difference between relative risk and absolute risk when reading studies related to pregnancy and childbirth.

The Power of Informed Decision-Making

In the digital age, information is at our fingertips like never before, which can be both a blessing and a challenge. While the internet offers a wealth of information about pregnancy, labor, and childbirth, it's crucial to sift through it carefully. It is important to first learn the source of the information and how reliable it is. After diving in beyond the surface and understanding the information presented in front of you, then you can see how this aligns with your values, needs and circumstances.

In previous generations, where access to information that we have now was hard to come by, people leaned on their healthcare providers more than anything else to provide them with a plan of action. A lot of power was given away and a loss of autonomy occurred. This type of care was normalized, as the doctor knows best and thus they will undoubtedly make the decision that’s right for their patient/client. My intentions here are NOT to bash anybody who has worked very hard to receive their medical degree, but just to point out that not everyone that received a medical degree (or any healthcare provider degree, including midwives for that matter) will provide you with completely unbiased information. It’s hard to compartmentalize previous clinical experiences, personal history, personal experiences and unwillingness to change practices due to convenience. In a world that is highly litigious as well, sometimes options are presented in a way that will sway the decision maker to take a certain direction. That’s not really giving people the option of true informed decision making and in time, people realized that they have to advocate for themselves.

For someone to make an informed decision that will be their unique choice or plan of action, the following need to occur:

  • Ask Questions: When your healthcare provider discusses interventions or options with you, don't hesitate to ask about both the relative and absolute risks. This will help you make choices that align with your preferences.
  • Consult Reliable Sources: Rely on reputable sources, such as healthcare professionals, medical organizations, and peer-reviewed research, to gather information.
  • Consider Your Unique Situation: Remember that your pregnancy is unique, and what might be the right choice for one person may not be the best for you. Weigh the potential risks and benefits in the context of your health, values, and goals.
  • Seek Support: Don't hesitate to seek support from a midwife, doula, or other trusted professionals who can help you navigate the decision-making process.

Understanding Relative Risk vs. Absolute Risk

To make informed decisions during pregnancy and childbirth, it's vital to grasp the difference between relative risk and absolute risk. These terms are often used interchangeably, but they have distinct meanings and implications.

  • Relative Risk (RR): Relative risk compares the likelihood of an event happening in one group to its likelihood in another group. For example, a study might report that the relative risk of a certain complication is 1.5 in group A compared to group B. This means that group A has a 50% higher risk of experiencing the complication compared to group B.
  • Absolute Risk (AR): Absolute risk provides the actual likelihood of an event occurring within a specific group. It expresses the probability as a percentage or a fraction. In the context of pregnancy, it could be the chance of a particular complication happening to a woman of a certain age or with specific medical conditions. Meaning an absolute risk may be 0.5% or 5 in 1000, for example.

Why This Matters

Understanding the distinction between relative and absolute risk is crucial because it helps you interpret research findings accurately. Misinterpreting these values can lead to unnecessary anxiety or unwarranted decisions. Here's why it matters:

  • Context Matters: Studies often report relative risk to highlight the potential impact of a particular factor. However, without knowing the absolute risk, it's challenging to assess the real-world significance of this increased risk.
  • Individual Variability: Every pregnancy is unique, and your individual circumstances may differ significantly from those in a study. Absolute risk helps you relate the study findings to your personal situation.
  • Balancing Benefits and Risks: Absolute risk allows you to weigh the potential benefits of an intervention against its actual risks. This is particularly important when considering medical procedures during pregnancy or labor.

So, the bottom line is that informed decision-making is a powerful tool that empowers birthing people to take charge of their pregnancy and birth experiences. By understanding the research, asking questions, and considering your individual circumstances, you can make choices that align with your values and contribute to a safer and more fulfilling pregnancy and childbirth journey. Remember, it's your body, your baby, and your choice!