My Top 5 Twitter Feeds Of 2019

Social Media is a funny thing. I’ve been on Twitter for years, but I didn’t really ‘get it’ until recently. Maybe it’s since they upped the character limit; I struggled to compress my thoughts into 140 characters! I still often have difficulty with 280, to be honest. But lately, I’m finding Twitter really useful, so I thought I’d share BigBirthas Top 5 Twitter Feeds of 2019.

#1 of Big Birthas Top 5 Twitter Feeds of 2019 = @justsayinmice

If I had to pick just one Twitter feed to tell you about it would be @justsayinmice.

Tweet from @justsayinmice pointing out (yet again) a news article quoting research as if factually correct for humans is based only on mice.
Big Birthas Top 5 Twitter Feeds of 2019

It’s the Twitter feed I didn’t know I needed, until it existed.

If you’ve ever read a long article about a research project which seemed super important and relevant, only to be irritated when a small paragraph near the end mentions it was a rodent study, this is for you.

It’s brilliantly simple. When a report’s title implies a study is about humans, but is actually on mice @justsayinmice retweets saying “IN MICE”. It’s international too; if it’s a Spanish study they write “EN RATONES” etc. instead. Saves a lot of time and frustration. Now I know which studies to ignore, and it’s having a positive impact by encouraging more responsible reporting too!

If you want to read a bit more about how the Twitter account came into being, it’s here: https://medium.com/@jamesheathers/in-mice-explained-77b61b598218. And yes, before you say it, the profile picture is a rat, because that’s funny.

Recommendation #2 – @justsayrisks

Following on from @justsayinmice, @justsayrisks takes on the reports which love to misrepresent statistics. You know the ones – “being obese TRIPLES your risk of [insert undesirable outcome here]”. Often these risks are very tiny, and so the increase in risk is negligible, but sounds really bad.

The author has written more about this here: https://medium.com/swlh/relative-vs-absolute-risk-e80efd68fa5

Human beings are, by and large, terrible at understanding risk. But that’s mostly because no one has ever explained it properly.

Author of @justsayrisks Gid M-K

I’ve only just found this one, but it’s already saved me wasting my time on some clickbait headlines!

@ObesityUK_org

Obesity UK is a relatively new charity (set up in 2014). It doesn’t even have a functioning website at the moment, just a landing page at https://obesityuk.org.uk/. But it is fighting the good fight against obesity stigma, and tweets and retweets are positive, useful, and relevant.

@millihill

Often I’m reading an article about pregnancy or labour, nodding along, only to discover it was written by Milli Hill. She’s a freelance writer penning articles for The Guardian, Telegraph, Independent etc.

Milli is also the founder of the Positive Birth Movement, whose aim I wholeheartedly agree with:

We aim to challenge the epidemic of negativity and fear that surrounds modern birth, and help change birth for the better. 

Positive Birth Movement

Milli is good to follow as she tweets and retweets about all sorts of pregnancy related issues.

@WRISK_project

Lastly I wanted to mention a project Big Birthas is involved with that I’m really excited about.

The WRISK project is interested in the way that risk messages are communicated in pregnancy, particularly to marginalised groups. It’s a collaboration between the British Pregnancy Advisory Service and Cardiff University. The WRISK Twitter feed is great because they’re very quick to notice any relevant news stories and comment on them.

And of course, don’t forget to follow @BigBirthas on Twitter too!

Who do you follow? Feel free to comment and share below!

Why hospitals need to grant pool access to bigger women

Anyone who has followed this blog for a while will know that I strongly believe hospitals need to grant pool access to women with higher BMIs.

My being denied access with my first-born is one of the reasons this blog even exists! I’d discussed it at every appointment, was promised a pool birth in the hospital (so long as the pool in the delivery suite wasn’t occupied when I needed it), taken on a tour of the pool room, but then repeatedly denied access to the pool while I was in labour until someone finally told me at 8cm dilated that I would not be allowed to use it after all. It’s also the reason I chose to have my second baby at home!

Hospitals need to grant pool access to bigger women - Big Birtha's Home Water Birth

My second labour and birth, where I did have access to a pool, confirmed everything I had suspected. The warm water was incredible at helping me manage the pain of contractions! Coupled with that, the buoyancy provided by the water meant that I could move around with ease. I was so much more comfortable and relaxed – even during contractions!

The frustrating thing is there’s no evidence to support restricting access!!

To be honest, there’s not a lot of good-quality evidence about the use of birth pools full stop. But because so few women get access to water birth there’s no data to show it’s safe for larger mums. But because there’s no data to show it’s safe, we’re denied access! Anyone see a problem here?

I’m not alone in thinking this!

It turns out that Health Care Professionals are beginning to notice this. So I’m delighted to report that the Association for Improvements in the Maternity Services asked me to write an article for their journal, complete with oodles of references for you to wave in the faces of healthcare naysayers you may meet. Enjoy!

AIMS Journal Article featuring Big Birtha

https://www.aims.org.uk/journal/item/waterbirth-high-bmi

Why I’m Never Again Donating To Cancer Research UK

Well, this probably seems uncharitable, but here are my reasons why I will never again be donating to Cancer Research UK (CRUK).

Don’t get me wrong, if you’re a friend of mine, and you’re planning on running, swimming, knitting in a bath of custard etc in future and need sponsorship, I will happily donate to a charity in recognition of your efforts. But not to CRUK. You can pick another charity. You can choose one doing great work in cancer treatment or care or awareness or research; Macmillan, Marie Curie, Breast Cancer Now, there are hundreds! Just not Cancer Research UK/Race For Life/Stand Up To Cancer, which are many faces of the same charity.

Why? What’s wrong with Cancer Research UK?

Maybe it’s just me, but I’d hope that a charity which puts research at the forefront of its identity (it’s in the name, for heavens’ sake!) would understand the need to not make wild claims. I’d hope they understood the difference between causation and correlation – it’s usually taught in secondary schools! Here’s a really useful TED talk explaining the danger of mixing correlation with causation:

So we can see from the example given in the video (if you’re reading this on mobile data and don’t want to watch it!) is that just because the incidence of drownings increases when the sales of ice creams increase (a correlation), does not mean that we can infer ice creams are responsible for drownings (causation). Or conversely, decide that drownings are responsible for ice-cream sales!

We can suspect one leads to the other. We can theorise what might cause this, but without further evidence it is merely a theory. It may be difficult to prove. That doesn’t mean you can ignore the lack of proof and state it as fact for the sake of convenience. Furthermore we must not forget to look for other influencing factors which might explain both results, like the weather, in the TED example.

So, where does Cancer Research UK come into this?

CRUKs 2018 OB_S__Y is a cause of cancer ad campaign.

When CRUK released their ad campaign last year stating, quite categorically, that obesity causes cancer, I was a bit concerned. I knew of the link between being of higher weight and increased risk of certain cancers (and decreased risk of others that we rarely hear about!), but there has never been proven causation. Yet CRUK were happy to state it.

Wait, obesity isn’t a cause of cancer?

No one (and there’s been plenty of research!) has yet proven that obesity causes cancer. It is possible that there is a causal link, of course. The theories may be spot on. I don’t deny that. But you’d hope a charity spending hard-won donations, and with ‘research’ in their name, would be a bit more responsible and careful not to overstate a theory as fact? It’s an important distinction.

As with the TED analogy, research has suggested that common factors could be responsible for the connection. Genetics are particularly suspect. Did you know tall people are more likely to get cancer than short people? Don’t see them putting that on a bus shelter, or claiming that height causes cancer. It’s an accepted correlation. Strangely CRUK don’t feel the need to make anyone feel crap about being tall…

But being fat’s not the same as being tall!

“But people can’t help their height!” I hear the virtue-signallers cry! “It’s not the same! Fat people can lose weight!” (with a in implied side-order of “they’re just lazy/stupid/lack willpower!”).

Except if you’re overweight, and have always been overweight, come from a line of people who are and have always been overweight, and have repeatedly watch them try and fail to lose weight, you know that while the maxims of ‘just lose weight’, ‘just eat less’, ‘just exercise more’ sound so deceptively simple in theory, they’re incredibly difficult in practice.

Of course, there’s always surgery, the one reliable intervention to lose weight – but if that’s so desirable, why wouldn’t we suggest tall people lop off a couple of inches to reduce their cancer risk? (I’m not suggesting that either!) There are significant risks associated with surgery, and significant downsides. It is not a one-size-fits-all solution. Yes. Pun intended. Let’s not lose sight of the fact that there’s a lot more to being healthy than merely a BMI.

But obesity IS preventable! You just don’t want to hear the truth!

Many overweight people struggle with their weight their entire life. Many lose weight, only to put it all back on again and more, often over and over, getting bigger with every cycle. We know this, and we don’t fully understand why. But we’re beginning to understand that willpower and behaviour are probably only a small part of the puzzle, maybe as little as 5%, with many other factors coming into play .

If it was so easy, Slimming World and Weight Watchers would have gone out of business years ago. The fact of the matter is that their business model works precisely because most people don’t and can’t lose the weight and keep it off long term in our modern society. We know this. It’s a problem we’ve been trying to solve for years, and CRUK campaigning that obesity is a ‘preventable’ cause of cancer completely ignores this.

Every time I drove past one of the CRUK adverts last year it irritated me. I knew it was inaccurate, felt it was irresponsible, and I was frustrated that they were choosing to oversimplify a complex problem as a personal failing. I, and many others felt it insidiously feeds the narrative of blame and shame that is so common with obesity.

It allows those who don’t have a high BMI to feel just that bit more smug, just that bit more superior; safe in the knowledge that their predominantly genetic disposition to not be overweight is saving them from cancer, with the added implication that us fat people should really do something about it for the sake of our health…

Maybe they didn’t realise…?

Not everyone reacted as mildly as I did, of course…

But those ads didn’t quite push me to the point of saying never again will I be donating to Cancer Research UK. That only happened this week…

I decided to give them the benefit of the doubt last year. Maybe they didn’t realise? Perhaps they felt the shock factor they wanted to use outweighed the risks of that approach and misjudged it? Maybe in wanting to keep the message simple they went further than they should have in overstating the point, but have learned from it?

So, what happened next?

Firstly, don’t be tempted to read the responses Sofie Hagen received on Twitter. Let’s just say plenty of people decided to tell her she was wrong. Haters gonna hate and all that… We don’t need that kind of negativity!

The campaign garnered lots of attention, was widely accused of fat-shaming and stigmatising obesity, and lauded by others for ‘telling it like it is’ (or as we know, isn’t, but hey-ho). These comments mainly came from smug-thins who think it’s simple to solve the ‘obesity problem’; just regularly tell fat people how crap they are and they’re sure to take it on board…

It also prompted amusing but entirely predictable responses implying the only reason people are overweight is because they eat fast food… yawn. Never saw that one coming. Oh, wait. Yes we did. It’s exactly these kinds of lazy tropes and attitudes that such a campaign fuels and that we’re entirely sick of.

Didn’t anyone explain to CRUK where they’d gone wrong?

Of course! Aside from the discussions on Twitter and in the media, various organisations and experts connected to the study of obesity contacted CRUK to offer their services.

They told CRUK how the adverts were stigmatising and misleading. They explained how simply telling people with obesity that they’re at increased risk of cancer does nothing to help, but does everything to make people feel more marginalised. Experts met with CRUK to explain how a more useful and sensitive campaign could be launched in future…

So, what happened this week?

Cancer Research UK's latest ad campaign - comparing obesity to smoking.

This week, CRUK went one further with this ad campaign.

Cigarette packets branded with “Obesity is a cause of cancer too”. Eyecatching and emotive, certainly. Accurate and helpful? Not so much.

Marvellous. They’ve taken on board precisely …erm… nothing at all from last year’s campaign feedback!?

Or perhaps they enjoyed the publicity last time?

Good grief, I feel sorry for the people who gave up smoking and gained weight as a result. They must feel like they can’t do right for doing wrong! They’re probably having their nicotine addiction triggered by the enormous images of cigarette packets, all while wanting a cigarette to deal with the stress of finding out that they’re doomed to get cancer…

Of course, the media reported the release like this:

Google News search for 'cancer obesity' showing misleading headlines and the standard 'headless fat body' image

With the word ’cause’ prominently repeated, with images of fast food and headless fat bodies galore – despite organisations such as the European Association for the Study of Obesity and The World Obesity Federation campaigning widely against such reporting and providing and free usable non-stigmatising images… Here we go again. Entirely predictable. Blame and shame. Emotive stuff.

There was a swift backlash. The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (what a title!) wrote this great article:

Only this time there’s no room for the benefit of doubt; CRUK know these campaigns are hurtful, and they clearly don’t care.

And then, despite the complaints, CRUK continued the narrative this morning by tweeting this:

What, are we just pointing out random statistics we observe now? No. Clearly CRUK has decided this is the hill they want to die on; might as well be hung for a sheep as a lamb. If you don’t like it, go chew some obesity gum or puff on your obesity inhaler… Oh, wait…

Cancer Research UK Budget

Here’s how much CRUK spends in a year.

Caner Research UK's 2017/18 Budget spend by sector (total £652m)

It’s a lot. A sizeable amount is spent on research. So far so good. But when £43 million pounds in 2017/18 was spent on ‘information and policy’ (admittedly, it’s only half of what they spend on raising the cash in the first place…), and when that information and policy is based around misrepresenting that research, enough is enough.

What does CRUKs CEO have to say?

Luckily not all media outlets have responded to CRUKs latest campaign by parroting it blindly… Sky News at least have responded by reporting some of the criticisms the new campaign has received:

https://news.sky.com/story/cancer-research-advert-criticised-for-comparing-smoking-to-obesity

They even quote CRUK chief executive Michelle Mitchell:

“We have a responsibility to tell people about what might increase the risk of cancer.”

Yes, Michelle. Might. So why are you so ready to be certain that it does cause cancer when you’re plastering it on a poster?

I might never again donate to Cancer Research UK. Oh, actually sorry, no. I’m never again donating to Cancer Research UK. Put that on a poster, Michelle.

Pregnant in the last 5 years? Make your voice heard!

A new, massive survey run by the WRISK Project wants to hear from anyone who is or has been pregnant in the last 5 years. https://www.surveymonkey.co.uk/r/WRISK

We need your voice!

Pregnancy is a time of information and advice overload. But is that information always delivered in the best and most helpful way? Are the messages consistent? Have you ever left a meeting with a health care professional feeling confused, or frustrated, or upset? Our voices and our experiences matter, so please, if you have a few minutes, follow the survey link and tell your story.

It’s great that we’re seeing so many researchers and surveys asking for our perspective lately; it’s the first step to making ourselves heard.

WRISK Recruitment advert - A woman is climbing onto a set of scales - text alongside asks to hear your experiences if you've been pregnant in the last 5 years

To take part, you need to be:

  • Over 16
  • Living in the UK
  • Have been pregnant in the last 5 years (or are currently pregnant)

What The WRISK Project/Survey Hopes To Achieve

This survey hopes to learn more about women’s experiences of advice and information given before and during pregnancy. It’s open to anyone who has been pregnant in the last 5 years, irrespective of how that pregnancy ended.

Women who are planning a pregnancy or who are pregnant receive many public health messages that are intended to guide their decision making. For example, they receive advice about what to eat, drink, how much they should weigh, and what medications they should or shouldn’t take. These messages are intended to improve outcomes for babies and mothers.

However, there is growing concern that messages do not always fully reflect or explain the evidence base underpinning them, and that negotiating the risk landscape can sometimes feel confusing, overwhelming, and disempowering. This may negatively affect women’s experiences of pregnancy and motherhood, and be exacerbated by a wider culture of parenting that tends to blame mothers for all less-than-ideal outcomes in their children.

WRISK Project

The survey is particularly keen to capture the experiences of women whose voices often go unheard; including BAME women, those receiving welfare benefits, and younger/older women.

The project will draw on your insights to understand and suggest improvements for the communication of risk messages in pregnancy.

Please share this survey amongst your networks and across all of your social media platforms. We want to reach as many people as possible!

Who Is/Are WRISK?

The WRISK Project is led by the British Pregnancy Advisory Service (BPAS), in conjunction with Cardiff University, funded by Wellcome. Membership of the project oversight group includes representation from many different organisations involved with pregnancy, which includes Big Birthas.

And remember, when making decisions about your care – always use your BRAIN (acronym explanation here!)

WRISK recruitment advert - have you been pregnant in the last 5 years?