Pregnancy, childbirth, correlation, causation and small samples

When you’re pregnant, or just given birth, people think it’s pertinent to give you unsolicited advice. Most of this advice is couches in the garb ob “traditional wisdom” and as you might expect, the older the advisor the higher the likelihood of them proffering such advice. 

The interesting thing about this advice is the use of fear. “If you don’t do this you’ll forever remain fat”, some will say. Others will forbid you from eating some thing else because it can “chill the body”. 

If you politely listen to such advice the advice will stop. But if you make a counter argument, these “elders” (for the lack of a better word) make what I call the long-term argument. “Now you might think this might all be fine, but don’t tell me I didn’t advice you when you get osteoporosis at the age of 50”, they say. 

While most of this advice is well intentioned, the problem with most such advice is that it’s based on evidence from fairly small samples, and are prone to the error of mistaking correlation for causation. 

 While it is true that it was fairly common to have dozens of children even two generations ago in india, the problem is that most of the advisors would have seen only a small number of babies based on which they form their theories – even with a dozen it’s not large enough to confirm the theory to any decent level of statistical significance. 

The other problem is that we haven’t had the culture of scientific temperament and reasoning for long enough in india for people to trust scientific methods and results – people a generation or two older are highly likely to dismiss results that don’t confirm their priors. 

And add to this confirmation bias – where cases of people violating “traditional wisdom” and then having some kind of problem are more likely to be noticed rather than those that had issues despite following “traditional wisdom” and you can imagine the level of non-science that can creep into so-called conventional wisdom. 
We’re at a hospital that explicitly tries to reverse these pre existing biases (I’m told that at a lactation class yesterday they firmly reinforced why traditional ways of holding babies while breastfeeding are incorrect) and that, in the face of “elders”‘ advice, can lead to potential conflict. 

On the one hand we have scientific evidence given by people who you aren’t likely to encounter too many more times in life. On the other you have unscientific “traditional” wisdom that comes with all kinds of logical inconsistencies given by people you encounter on a daily basis. 

Given this (im)balance, is there a surprise at all that scientific evidence gets abandoned in favour of adoption and propagation of all the logical inconsistencies? 

PS: recently I was cleaning out some old shelves and found a copy of this book called “science, non science and the paranormal”. The book belonged to my father, and it makes me realise now that he was a so-called “rationalist”. 

At every opportunity he would encourage me to question things, and not take them at face value. And ever so often he’d say “you are a science student. So how can you accept this without questioning”. This would annoy some of my other relatives to no end (since they would end up having to answer lots of questions by me) but this might also explain why I’m less trusting of “traditional wisdom” than others of my generation. 

One thought on “Pregnancy, childbirth, correlation, causation and small samples”

  1. There is also a problem of ‘invented traditions’ with older people’s advice about pregnancy, baaNantana, etc. I’ve had relatives recommend giving gripe water (invented c. 1850s) to my kid, like it is ancient wisdom.

    Unfortunately, I wasn’t good at choosing my battles wisely when my mother-in-law was staying with during the postpartum phase leading to a lot of fights. Same old unscientific bullshit: galactogogues, random hitherto unheard of herbs and spices, dietary restrictions, etc. The dietary restrictions are especially dangerous bullshit, since they promote unhealthy eating when the body really needs more nutrition. Felt good making breakfasts of pancakes, bacon, and sausage in opposition to recommended curdrice-type bullshit. A good part of my irritation was also physical because I’m mildly allergic to dill/sabsige soppu which was added to every dish as it is supposed to help breast milk ‘production’ according to supposed-traditions. Even seemingly benign unscientific advice can be harmful because endless repetition of such advice distracts you from following scientifically correct practices.

    I think in Indian families, the largest amount of unscientific garbage traditional knowledge and invented traditions exist under the categories of pregnancy, postpartum, and infant care.

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