The Culture of Risk

Pregnant person talking with doctor

“It’s just not worth the risk”
“I don’t want to expose my baby to ANY risk!”
“I’m not comfortable with any risks”

I hear these comments, and others like it, all the time. Unfortunately, they’re just not realistic. Risk is all around us, and it’s an unavoidable part of life. But in this culture of fear mongering and attention grabbing headlines, it can be hard to thin calmlu and realistically about risk.

Here are some ideas for ways you can check the anxiety about risk and think clearly:

Give up on the idea of avoiding risk and shift to thinking about minimizing risk. This can be much harder said than done, but shifting away from a knee-jerk running away from something someone says is risky can be very freeing. Otherwise you’re living in fear and ping-ponging your way around life at the mercy of headline writers. Sometimes you need to decide what level and type of risk you are okay with.

In addition to the risk of doing a thing, consider the risks of NOT doing the thing. I’ll use induction as an example. While I absolutely believe that in most cases waiting for labor to begin on its own is best, there are definitely times when choosing induction is the safe route. I have seen families so afraid of the risks of induction they let complications get quite scary before they were willing to choose induction. The end result was that the baby was exposed to much more risk.

Make sure you’re looking at absolute risk, not relative risk. In an effort to draw attention to their work, study authors and people writing articles about studies have a tendency to report the results in the most dramatic way possible. Headlines that scream things like “DOUBLES THE RISK!” etc can be very misleading. For example, people commonly hear that waiting for labor to begin past 41 weeks has (cue scary music) double the risk of stillbirth than when babies are born earlier in pregnancy. The rate of stillbirth is very low in either case, going from .004% to .006%. So *technically* it does go up, but the absolute risk isn’t changed much.

Make sure that you’re not comparing apples and oranges. Let’s take another look at the example above. If you are 41 weeks and trying to decide about induction, the risk of stillbirth at 40 weeks is totally irrelevant. Delivering at 40 weeks is no longer an option. When you’re evaluating the risks to make a decision, what you need to consider is not the risk of delivering at 40 weeks vs 41 weeks. What’s relevant is the risk of induction now compared to the risk of waiting for spontaneous labor. The only risks that matter are the comparative risks of the options available to you.

It can feel very overwhelming trying to figure out what’s safest for you and your baby. I hope these tips are helpful as you try to navigate the information out there. A trusted care provider who has a practice style similar to your birth plan can also help you navigate it.

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