- 4 years ago
- Wedding: July 2013 - UK
futureMrsHidalgo: If you read over my previous posts, I’ve tried to explain various things to clarify my own position (and this isn’t a personal attack.. honest!). But this is my reasoning:
– People don’t understand what “no amount has been proven to be safe” actually means, in relation to double blind clinical trial data, and how it relates to information on caffeine and various other substances. All it means is that it would be unethical to do double blind trials. It’s terminology which doesn’t actually mean very much. It sounds like an impressive statement, but it is pretty much meaningless, and could be applied to almost anything during pregnancy, from eating chocolate cake to hopping on one leg for long periods of time…
– I’ve also looked at the disagreement between (for example) the UK’s Department of Health and the National Institute for Clinical Excellence, and the importance of looking at who is recommending a particular course of action. I explained that I believe the NICE guidelines to be much more accurate than those of the DoH (a political body) because NICE is a clinical research organisation dedicated to the collection and dissemination of peer reviewed, scientific data, which sets the gold standard for British healthcare professionals. Likewise, the National Association on FAS is a campaign organisation with a specific agenda… to prevent FAS. That’s a very noble goal. But they are campaigning from a particular standpoint. It’s not their job to read all of the available clinical data and break it down systematically. It’s not what they do, or what they want to do. They want a short, quick, clear, easy to understand, mission statement for their work, and that statement = abstain. NICE, on the other hand, has no political goals other than the dissemination of public health data, which is why their guidelines on the subject are about half a page long, a lot more complicated, and state (amongst other things) that 1-2 units 1-2 times a week has no measurable effect on birth outcomes. This is based upon 40+ years of rigorous, scientific research as one of the most respected clinical research organisations in the world…. which is why I trust it more than I trust the other sources.
– When sources disagree, I reach for peer reviewed research from scientific journals. Going right to the source (if you have the time and the energy) is a great way to do it because studies are often misreported. There is a lot of academic research done on this. The agreement across the board is that drinking in larger quantities is harmful, and smaller quantities is not. The real debate lies in the definition of “smaller”. A few years ago, there were all of these gleeful newspaper articles in my country summarising the latest research, which showed that drinking in moderation does not cause any negative birth outcomes. The problem was that “moderation” during pregnancy is defined differently, in clinical terms, from moderation in non-pregnant women. Moderation in non-pregnant women works out at around one drink a day (NHS guidelines). However, moderation in pregnant women was defined as much less than that during these studies. That also angers me, because I feel that the newspapers were misleading women into thinking that drinking in larger amounts was proven to be safe… and that is not what the data says at all. So I think it is important to also state which measures are being used…. studies which repeatedly and consistently show that small amounts of alcohol are not harmful should absolutely NOT be used as some sort of an excuse to drink as much as you like. It’s not even an excuse to drink amounts of alcohol which many non-pregnant ladies would define as “small”. But equally, these research papers show that a specific, measured, and very small amount of alcohol has no impact.
The reason I get frustrated is because peer reviewed, scientific literature is of much more value to me when making a decision than the information given by many other groups. I know why the other groups present their data simplistically… it’s because the majority of the human beings on this planet are stupid, and don’t understand subtlety (evidence: Youtube. Jackass. Donald Trump’s political campaign. The inexplicable popularity of Tom Cruise.). They want to present a clear and easily understood message. But I don’t want a clear message if that message only gives me some of the facts. I want to know what the latest scientific research tells me, even if it’s messy and complicated.
There is no study out there which shows that one drink can cause FAS. Honest. If there were, it would be internationally famous. By all means, prove me wrong. If you show me the data, I will believe! Until then, I’m sticking with the opinion of the scientific research community rather than the opinion of organisations dedicated to pushing a particular political agenda.
Does that make sense? This is why I get frustrated. I know I’m an unusual case, because I’m an academic researcher completing a PhD (disclaimer: I am not a medical doctor), so I’m one of the few people who likes their data raw (as opposed to lightly cooked and presented in an easy to understand format designed for members of the public). But it frustrates me when people think that the opinion of a political campaign group has the same scientific value as years of research. That’s what makes me cross. That crossness is not aimed at you specifically… it’s just… frustration. In general. With life. Which is why I tried to explain my position with that GIF!
candy11: My issue with the “every pregnancy is different” line is that, if this were so, it would be impossible to formulate any sort of clinical guidelines at all. There are differences between individuals. But at the end of the day we all follow the basic rules of biology, and research is designed to minimise these differences. That’s not me criticising your caution, that’s me saying that at some stage I think you just have to believe in the data, or else no research has any value at all! The research so far does show that a very small amount of alcohol is harmless (in the sense it doesn’t have any measurable effect), and medium to large amounts of it are harmful. To me, that = fact. The debate is exactly where that cut off line between completely harmless and potentially harmful is (which is exactly where the “proven to be safe” line comes in). For example, some studies say that you can safely have up to 10 drinks a week… others, no more than 5. Well… I certainly wouldn’t risk having 10 with that discussion still going on! However, as I’ve never been able to find anything to contradict the NICE guidelines (and they certainly know a lot more than me about the subject), I feel comfortable following them, whilst exercising caution… because at the end of the day I am a believer in technocracy, and I feel the compulsive need to defend it to the hilt!
aprilanne: +1! Too weird.