Tuesday 18 December 2012

Galway Skeptics Meeting 17 DEC 2012

So we had a very fine get-together last night in McSwiggans. If the world ends on Friday, at least we spent some of our time well, discussing Science and Skepticism in the pub (btw, Phil Plait has a great blog on why nothing is going to happen on Friday).

Yolande, Podge and Charles all presented great mini-talks on failed Apocalypse predictions - Harold Camping, Apocalypse Predictions as a resource and Y2K respectively.

You can find their presentations here. Give me a heads-up if the link doesn't work.

Huge shout out to the Galway Humanists from NUI,G- their Auditor, Peter, came to join us and start a process of linking up between us and them.

As part of revitalizing the blog, we'll do our best to put up a summary of every meeting we have. Keep an eye out for more blog updates and synopsises on our fortnightly meetings! Any feedback as to how to present/the content for these updates would also be hugely appreciated.

Our next regular day would be on the 31st of December, so there's no way we'ld have peace and quiet in our regular to discuss Science in a sensible fashion, so our next actual meeting is on the 14th of January, 2013.

Thanks,

donalfall

Saturday 8 December 2012

Ireland abortion debate and a particular dubious claim

I don’t often blog, but I was recently given cause to do so, and thus here we are. While I’m sure most people have, by now, heard of the sad case of the death of Savita Halappanavar, the summary found here should be reasonably clear and current. This case has very much been at the forefront of Irish political discourse for the last few weeks and rightly so, as it seems that due to a long standing lack of clarity on the law regarding abortion in Ireland a woman may have needlessly died. Abortion has long been a fiercely debated topic in Ireland, with most politicians trying desperately to avoid ever having to address the issue. Indeed it is only after a ruling by the EU court of Human Rights, several high profile cases in the Irish courts and the death of a woman in an Irish hospital that legislation seems to be imminent. However, this has all been covered in depth elsewhere, and with greater clarity than I could manage. That said, there is one specific claim which I would like to address, and that is the oft repeated nugget on social networks and elsewhere, and which has again surfaced as part of the current Irish debate; that having an abortion makes one six times more likely to commit suicide. This claim is supposedly backed up by a pair of Finish papers, the most recent of which covers maternal deaths from 1987-2000. I intend to examine this claim briefly, and provide some commentary on the same. Firstly, the data itself. The paper indicates the following; Image The first thing you should notice is that the mortality due to suicide after induced abortion (31.9 / 100,000 women) is not six times that of the general population of women (age adjusted 11.8 / 100,000 women) as is implied, but rather a little less than three times that figure. It is around six times the suicide rate of women who are pregnant, but being pregnant and giving birth is in fact a protective factor for suicide; that is, becoming pregnant is generally associated with being less likely to die by suicide than in the general population of women. Should you become pregnant and choose an abortion, you may be at a higher risk of suicide, but that risk has not increased six fold compared to your risk before becoming pregnant. It is misleading to compare these two statistics side by side without explanation - after all, given that a pregnant woman is less than half as likely to commit suicide as she normally would be, one could just as easily say that giving birth double’s your risk of suicide as you are no longer benefiting from being pregnant! Both of these statements misrepresent what is shown in the data. There is nevertheless an increase in the rate of suicide among women who have had an abortion when compared to the general population of women. To put this risk in context, it is worth nothing that Finnish women included in this study and who have had an abortion are still less likely to commit suicide than Finnish people who suffer from the debilitating condition of being male. (Suicide rate of Finnish men c.45 / 100,000 at the midpoint of the period when this data was gathered.) I assume that we’re not going to see the people willing to make this rather alarming claim proceed to suggest that we should take action to curtail the number of males in society, so perhaps they might also take a moment to consider if it is reasonable to use this data to suggest that the number of abortions should be similarly curtailed.

 That said, I have no intention of ignoring this statistic; lets take a further look at the data provided in this study and perhaps come to some understanding of what it means. Helpfully recorded along with the number of suicides per 100,000 we also find the number of deaths by homicide and unintentional injuries. In both cases, the risk to women who have had an abortion is higher - in the case of injury almost twice as high as the risk to the general population of women (20.4 vs 10.8 / 100,000) and more than five times higher than the population of pregnant women (20.4 vs 3.9 / 100,000). The risk of homicide displays a similar pattern; women who have had an abortion are more than three times as likely to be killed violently than a women in the general population (7.7 vs 2.1 / 100,000) and eleven times more likely to be murdered than a pregnant women (7.7 vs 0.7 / 100,000). Eleven times more likely! I wonder why those making these claims decided to focus on the comparatively paltry six times increase in the number of suicides among women who have had an abortion when there existed a much larger and more shocking increase in the rate of homicide occurring to the same group? Could it perhaps be that it is much harder and more taxing on one’s credulity to draw a link between abortion and homicide rates than it is to draw a link between abortion and suicide rates? The data doesn't show a causative abortion-suicide link specifically; rather, those making this claim rely on the reader's presumption that there must be an intrinsic, common sense and causative link between abortion, guilt and suicide. What this data in fact shows is not that there is a cause and effect relationship between abortion and suicide, but rather that women who are more likely to have an abortion are also more likely to be killed by accident or violence, including suicide, than those who do not have one. To take it a step further - women who in their day to day life are more likely to suffer a fatal injury, become suicidal or be murdered are also more likely to have an unwanted pregnancy, and thus choose to have an abortion. Rather than being a causative factor, an abortion is much more likely to be a symptom of whatever underlying cause is also making these women more likely to be murdered or suffer a fatal accident. While this is in some sense shocking, it is not exactly surprising. Such data was sadly not gathered in this study, but I would not be terribly surprised to find that those women who choose to have an abortion may also be more likely to come from abusive homes or be economically disadvantaged, both factors associated with a higher incidence of violence, mental illness and abortion. While this data does not show that there is no causative link between abortion and suicide, neither does it demonstrate that there is; much like a tasty but ultimately irrelevant sponge cake, it informs us very little in this matter. Rather than being an argument against abortion, this data is instead an argument for greater post abortion support services, and perhaps follow up investigations to look at the social and economic situations of women who choose to have abortions and determine if some form of assistance is appropriate. In summary, while I do not doubt that the notion of a causative link between abortion and suicide will continue to be bandied about, if you feel the urge to perpetuate such a hypothesis please note that the above studies support for your claim is dubious at best.

 P.S. In this post I have focused mainly on debunking a specific claim, which in fairness to the authors of the paper they did not themselves make without qualification: the conclusion surmized that "The increased risk of suicide after an induced abortion indicates either common risk factors for both or harmful effects of induced abortion on mental health." As I'm sure is clear, I tend toward the former suggestion, as the evidence does not goes as far as supporting the latter. In general, the literature has shown either no or little difference in mental health outcomes for unwanted pregnancies which end in abortion or are carried to term. Regardless, the practice of shaming such women should be roundly condemned, as studies have shown a causative relationship between social exclusion and suicide risk. For those interested in more recent and broader ranging studies that specifically address the relationship between abortion and mental health, I would direct you towards a 2011 systematic study by the National Collaborating Centre for Mental Health as a good starting point.

Note: This is a crosspost from my own blog, From Which We Sping.

Tuesday 13 March 2012

Swaddling

Okay, it's a weird topic I know, but I was browsing independent.ie and I came across this article which says that swaddling has come back into fashion and is causing an increase in hip dysplasia which we haven't seen in 25 years. Presumably women are being advised to do this at childcare classes or websites, so I decided to look up what it involved and why it's come back in to fashion.

I didn't really know anything about it, other than that it's mentioned in the bible story, but it involves binding the baby tightly in a blanket in order to sooth it and help it sleep more soundly by eliminating it's startle reflex. It's also said to reduce SIDS and colic. It was formerly believed that it was necessary in order to ensure that the limbs grew straight.

Throughout the 17th and 18th centuries, philosophers and doctors realised that it was not necessary for straight limbs and was in fact overly restrictive for muscle development. Jean Jacques Rousseau (who I suspect didn't much like women) said that women despised their duty to nurse their own children and entrusted them to mercenary wetnurses who would have to pay less attention to a swaddled baby than one who could move freely.

Modern swaddling seems to be less restrictive and its advocates say that it simulates the closeness of the womb and calms the baby. It is believed to reduce SIDS because it keeps the baby in a supine position which reduces the risk of SIDS. But if the baby does end up on it's front, there is no way to roll over again as the arms are bound within the blanket. Recent studies actually suggest that it could contribute to SIDS. Of babies who died of SIDS, 24% were swaddled, while only 6% of the control group were.

So that's a brief version of what I learned from Wikipedia. Then I went to see what the rest of the internet said. Most of what comes up does say to be careful to leave room for the hips and legs, because of the risk of dysplasia. A lot of sites also recommend to stop swaddling at about one month old, presumably because the baby will want to start moving around at that time. That all sounds okay.

But I did find some video tutorials that said nothing about dysplasia, and a suspicious number of deleted comments. My guess is someone criticised the technique and it proved easier to delete the comments than to engage them. There was also a comment saying that more SIDS victims were unswaddled than swaddled. But that is simply a corruption of the actual statistics seen above as the control group had far more unswaddled babies who didn't suffer from SIDS.

Also, try doing an image search on google for swaddling. It does not look comfortable.

I'm inclined to think that the ideal way to mimic the womb to sooth the baby is to hold it closely. Hugging soothes the huggee and the skin on skin contact is a major part of the mother and child forming a bond. Binding it up just seems to be the lazy solution so you can go do something else. And I wonder if it is inadvisable to swaddle in order that the child will wake less. It seems like a good way of making sure everybody knows baby is still alive. Plus it's how they realise they need a feeding, a change, or maybe even can help prevent SIDS.

So anyway, back to where I started with hip dysplasia. Although some conscientious advocates of swaddling stress to be careful of the hips, not all sources do. And I have no idea what goes on at childcare classes or what hippy alternative women think is better than what the doctors say. I don't doubt that lots of people are shown a safe way to do it and mess it up.

It's really best to drop the practice altogether - when we weigh up the benefits, they turn out to be erroneous, or achievable in another way. It doesn't make for straight limbs, it doesn't prevent SIDS and if it does mimic the womb, a hug is better.

Again, I know it was an unusual topic for a post here, but it piqued my interest and I thought the re-emergence of a traditional method despite despite warnings of its danger might interest a few of you too. Especially when you throw in the misinterpretation of statistics. :)