Public Health science communication has for the past years been my field of interest. I have studied it, I have taught it, I have networked over it. But have I actually been a user of it – like I was before I started studying it? Well, over the past nine months I actually have. At least one particular field within public health communication has had my special attention. Not for the sake of how it is communicated, but the actually public health knowledge. The field relates to pregnancy, which coincidentally for the past nine months (and still is as I write these words) have been a part of my life.
A circus of information
When you become pregnant not only do a lot of questions pop up in your head, but a lot of information relating to the health and wellbeing of yourself and the baby is communicated to you, whether you like it or not. Doctors, midwives, health authorities, friends, relatives – all have information to share with you. It can be quite a circus of information and you quickly discover that the science of pregnancy is full of science AND of urban legends, gossip, personal narratives and experiences, and culturally imbedded practices. The later become especially obvious when you as I choose to have a child with someone from a different country than your own and go through your pregnancy in neither’s of yours home countries.
To do or not to do?
As a public health professional I have of course been interested in doing what is best for the baby, and with an academic background I lean towards following advice which is based on scientific research rather than word of mouth or traditional practices in the country I happen to be. I quickly realised however that the two often get mixed up. Even in official guidance and pamphlets are you sometimes left to wonder what the advice is based on. In the wine country Spain for example you can drink alcohol (in moderation that is) while in Denmark your are advised not to. As my iron level dropped my German doctor advised me to start taking iron tablets and continue throughout the entire pregnancy. My midwife has, for reasons I have yet to understand, advised me to stop some weeks before my due date. The argumentation for all these different recommendations is very often: “It’s better for the baby”. But says who? Based on what? What is the evidence? All theses questions arise all the time and it seems like way to big a task to investigate the scientific background behind all of them. I was therefore happy to learn that I didn’t have to! Thus, my cousin told me about this book she had read a review of, which basically did what I felt like doing with every piece of advice and recommendation I was presented with: Learn about the basis or science behind the recommendation and based on that make my own decision on what to do and how to act.
Emily Oster, an associate professor of economics, decided, upon becoming pregnant, to test the facts of medical advice she was given by using the methodologies she knew best: an economist tools. The outcome of her struggles not only resulted in her making informed decisions right for her and her husband but also in the book “Expecting Better – why the conventional pregnancy wisdom is wrong and what you really need to know”. I have with joy been reading this book. Both for the content but as I was reading it I realised also for its public health science communication value. Emily Oster manages to explain medical research without oversimplifying it and in a manner that most people without a health (or economist) background can understand. For a public health savvy person it is perhaps sometimes a bit too pedagogical and one can quickly become tired of having explained what a cross control study and a randomised trial is, but as public health professionals are not necessarily the target audience of this book this it not necessarily a bad thing. In addition, if one uses the book as a tool for looking up specific topics rather than reading it from A to Z the repetition is of course fine.
Facts and personal decision-making
One of the reasons I find the book to be an interesting example of public health science communication is that it manages to find a good balance between communicating scientific studies, findings and facts and at the same show how these can be used for decision-making – or in some cases are super difficult to drawn conclusions from and thus challenging to make decision upon. By sharing her own reflections and ultimate decisions with the reader, Emily Oster exemplifies that scientific findings and statistics take on a new meaning when they are to be applied to an individual person. Indirectly, it also illustrates how difficult it can be to make general recommendations when science doesn’t give clearcut answers (which is very often the case in public health research). Granted, at times you do become a bit tired of hearing about Penelope (Emily Oster’s daughter), but at the same time the book really wouldn’t have the same communicative value without it. Putting a human face and a name on science just makes it more relevant to read – at least when you are targeting a wider audience. And as mentioned it illustrates what happens to science when it moves from the laboratory, the statistical programme, the conference presentation etc. and meets real people.
“Expecting Better” was reviewed by Zoe Williams im the Guardian. I find her review of the book to be spot on, so instead of making more comments on the book, I’ll let you read her reflections, praise and critic.