The Big Baby Trial - The Better Birth podcast

Listen to the first episode of season 11 of the Better Birth podcast, as I discuss the findings of the Big Baby trial with doula Samantha Gadsden.

S11 Ep 1 - The truth behind the Big Baby Trial

The Better Birth podcast with Erin Fung

0:04

Welcome to the Better Birth podcast.

My name is Erin and I'm a hypno birthing and antenatal instructor, birth activist and all round birth geek.

In this podcast, I chat to experts in the field of pregnancy and birth, debunking myths around birth, diving into the research around maternity care, and exploring what is it that means you're more likely to have a positive birthing experience.

0:28

If you enjoy this podcast, do feel free to buy me a coffee and fund my caffeine habit.

Link to my Buy me a coffee page is in the podcast info.

Enjoy this episode.

Welcome to the better birth podcast.

0:46

This is episode 1 of Season 11 and I am really, really excited to be talking about our topic today because my guest and I have been just ranting on this topic before we hit record.

And I think this is a really topical episode to go live now because it's really needed.

1:05

So I am very happy to welcome my lovely friend Samantha Gadsden on today.

Hi, Sam.

Hi, Erin and everyone.

And we are going to be talking about the Big Baby trial today, aren't we?

Well, we have lots to say before we start going off on a rant.

1:25

Because it's going to descend into a rant, I'm pretty sure.

Do you want to just introduce yourself to anybody that doesn't know who you are?

Hi, so I'm Samantha.

I run the Homebase support group UK, the Village, which is my life and parenting support group.

I have my free birth course.

1:42

I do lots of sort of hour chats on all things now, not just birth and turn together across a bit more really.

And yeah, a whole series of subgroups and things like that, that just kind of, yeah, that's me.

I think there's about 27,000 people in my Facebook groups.

2:00

Yeah, if you're, if, if you are pregnant, you need to be in Sam's Facebook groups because there is a wealth of information in there in her guides and there's tons of community support, everyone supporting each other.

It's a they are invaluable, like genuinely really, really useful groups to join.

2:18

So I'll make sure that I link those in the show notes.

Yeah, I could probably say that I'm a doola as well.

I can't forget that these days then.

Yeah.

And I think that the power of the groups is just the peer-to-peer support.

I really, you just touched on that.

It's the it's the support of other people who aren't going through what you're going through.

2:36

So the purpose of of today's episode is to discuss the Big Baby trial.

And I'm going to say that if you follow me on Instagram, you know, most people will know that I love reading a research study.

2:52

And it's something that I think over the years, I've become known as, you know, some person who's.

Like the research?

Queen, I don't like using.

It makes me quench when I say that other people have called me that I do.

Not call myself that.

But the Big Baby trial, I'm going to say it was, it was hard to read through that because it is a rambling mess of a study in my opinion.

3:15

So before we start analyzing and picking holes in the study, which is what I plan to do, I just want to talk a little bit about what the Big Baby trial is and what they were aiming to show.

So this is a study looking at suspected big babies.

3:35

Suspected big babies not confirmed.

OK, because we can't confirm the size of the baby until the baby is born and they wanted to see if performing an earlier induction at 30, what, 38 weeks between 38 and 38 + 4 helped reduce the chances of brachial plexus palsy and shoulder dystoia compared to what they called the standard care group.

4:03

I'm doing air quotes here because standard care is is is laughable as the term.

The standard care group was either waiting for spontaneous labour or induction, OK, just induction later than 38 + 4.

So there were people induced in both groups in this study.

4:21

So we're not looking at induction versus no induction, we're looking at earlier induction versus later induction, OK.

So this is what the study was was trying to to look at basically to see whether the incidence of shoulder dyslation was reduced by performing an earlier induction.

4:42

And one thing I think that's really important is to understand with this is that people who have pre-existing diabetes were excluded.

Anybody who had a pre planned C-section were excluded.

Anyone had a pre planned induction of labour was excluded.

5:00

We also need to mention that there is the study was was closed early I think from interpreting and again they go really round the houses with this, but I think they stopped the study because it wasn't showing what they wanted it to show.

5:19

So they didn't actually recruit the amount of people that they wanted to and I.

Just want to add, are you going to lose your train of thought if I?

Add.

Anyone having a home birth, they were not looking to look at what happens if we leave it alone or they were supposed to exclude home birth in women, but that's we'll talk about that later.

5:40

Yeah, so this is what they were aiming to show, aiming to show.

And I've already had in my DMS student midwives who have said that the midwives they work with have said that the study was closed early because it was it didn't need any more participants because it, you know, it was such a good study.

6:00

Wrong.

I've already had somebody in my comments section being quoted the big baby trial justifying an earlier induction because she has a suspected.

So we know.

And this study only came out, you know, was it a week ago or two weeks ago?

6:17

So this is a really recent study.

It's already being used to justify induction for a suspected big baby.

And this is an issue because the study did not show what they wanted it to show, despite them spinning it right.

And what it did show is that 60% of the babies that they labeled big.

6:36

And let's not forget that when I started as a doula, which was only 12 years ago, big babies were over 10 lbs.

They also changed the definition of big baby.

Didn't they change it to 9 lbs in this study?

60% of those babies weren't big anyway.

Yeah, it's, I think that's one of the biggest findings, right, Which is just swept under the carpet and no one shouting about that from the from the, you know, from the people that conducted the research study, 60% of suspected big babies weren't big and were actually under the 90th centile, which screams that growth scans are not accurate.

7:11

OK.

So I think that's one of the biggest takeaways that we'd need to take away from this, from this study, is that if you're being told you're having a big baby, statistically they're probably not.

And even if they are, it's not necessarily an issue.

They found that 96% of suspected big babies did not experience shoulder dysstasia, and that's in induction, even in induction.

7:36

And I think this is a really important point which Sam, I mentioned to you before we started recording because I had to go back and check what I'd written because I thought I was wrong and I'm not wrong because I've just checked it.

There were two cases of brachial plexus palsy in the again air quotes, a standard care group.

7:56

So people that were offered an induction later or maybe had spontaneous birth.

So that's nought .1% OK in the standard care group had brachial plexus palsy and four cases of brachial plexus palsy in the people that were induced early that's 0.3.

8:14

So either way, statistically really small chance of brachial plexus palsy.

And actually the rates were higher in the earlier induction group than they were in the standard care group.

So just just, if anyone that's listening doesn't know what brachial plexus palsy is, because I'm just conscious that we're, we're talking potentially talking about things people don't understand.

8:34

Brachial plexus palsy is where a baby's shoulder gets potentially stuck and it can cause nerve damage in that area.

In most cases it's not permanent.

And what Shelly explained the other day is they keep saying to people, or we'll have to, we'll have to break your baby's shoulder.

8:53

And Shelley was explaining that actually, nerve damage can be longer lasting than breaking the baby's shoulder.

So they're kind of using a motive frightening language.

And obviously you don't want either to happen.

But of the two options, it can be not the best thing to be doing anyway.

9:09

Yeah.

Yeah.

So.

Yeah, I know.

I'm throwing her hands up in the air.

She's like.

I'm horrified by this trial.

This trial is is the most horrifying thing that I have come across in the entire time I've been running the home birth group.

9:30

And you've and you've this I, I know because we're, we, you know, we chat regularly, like on a practically daily basis, right?

I know that you've been shouting about this for ages.

Like way before, yeah, way before this study actually got published.

You've been saying how unethical this study is.

9:47

Do you want to talk a little bit about that?

So this this study first came to my attention through the Home Birth Support Group UK, where home birthday members were supposed to be excluded from this trial.

So they weren't supposed to be coerced into induction for Big Baby.

They were supposed to be left alone.

And I was beginning to hear from members that they were being, you know, told that their babies were enormous, told that they were needed to be induced, frightened into induction, consultants banging on at them about induction and then asked to join this trial.

10:18

Not before it wasn't.

There's this trial going on.

Let's have a rational discussion.

It was big baby, big baby, big baby, big baby.

Risk risk, risk, risk, risk, risk, risk.

Would you like to be on this trail often after induction had been agreed?

So to me, this is supposed to be a randomized control trial.

10:36

I'm no researcher and I don't pretend to be.

I don't like stats.

My brain goes off on a completely, but what I can see quite clearly and my friend tells me it's like neurozoverse pattern recognition because I can see when patterns are developing in my group and I could see from my group that the way that this trial was being implemented and this trial run into 75 dresss, maybe even more, 75 hospitals.

10:58

How can a new controller trial that is actually that big?

And I could see and I don't, and I still don't understand and nobody's able to give me an answer.

If you frighten somebody into being induced, how is that a randomized control trial?

Because the induction is already decided.

And when you've terrified somebody, how is anything, how is the impact of you terrorizing that person being measured?

11:21

Because if that person is already frightened when they're walking into the birth room and we're excluding normal birth.

So I, I have been screaming about this trial and then covert happened.

And then we know what the birth world is like.

There's always something to be worried about, but it's always been in my radar.

11:37

And I have said since this trial came out that whatever the results of this trial were, I believe that this trial has been fundamentally flawed.

I spoke to consultants.

I spoke to consultant midwives.

I got invited to go in and talk to them.

And I was like, it doesn't matter what you say to me about this trial.

11:53

I am hearing enough from people that I think your trial is flawed.

And also, we talked about this the other day in the sonographer's rooms in where you go in to have your scans.

There was posters, big baby trial, pastel pink, pastel blue, big baby in, in big letters.

12:11

Why don't you?

Just being scant.

It was so coercive.

I went in with one of my clients.

She was being induced necessarily.

Yeah, because my clients don't get induced unnecessarily.

Very few of them do get induced.

And, you know, all over the induction wards is these big baby posters everywhere.

12:28

You turned on the wall in the room.

And then it was just all, and then there was the induction party on Twitter.

So they were giving his wives Amazon vouchers and they was, it's been pulled.

And I, I've been looking for the photos, but I've changed laptops and I can't find them.

12:44

And on Twitter there was this 50 participants, 50 recruited, however they worded it.

And you know, it was an induction party, Their Twitter feed was an induction party.

And then when people noticed it and so they just pulled it, you know, and it was the the recruitment to this trial was just abysmal.

13:03

Before we even look at what these, you know, what they've done to the interpretation of the the results.

There is nothing wrong in my non medical, extremely experienced opinion in having a chunky baby.

Now, some of these babies are not big.

13:20

Well, we know that 60% of them aren't big, but we see regularly in the home birth group people birthing babies over 10 lbs over with no issues.

They avoid sweeps, they don't go along with what people want, and they have babies.

Yeah, because when you have somebody with a suspected or a confirmed, you know, big or baby turns out to be big, we know that there is a whole load of other factors other than just the size of the baby that impacts whether potentially you have complications, right.

13:53

You know what position with if everyone's birthing on their backs in a hospital bed, then that's going to increase the chances potentially of issues of birthing any size baby, right.

But you know, like there, there is a whole lot of other other factors which they have not they've not looked at in this study.

14:15

And I think that's it's an issue because it again, you these these, the outcomes of this study are being twisted to fit a narrative to justify induction.

And which form of induction?

Yeah, it's not induction.

You know, people talk about induction as if it's one thing.

14:32

Let's have an induction.

But what?

A sweep, A pessary, a balloon, the dilation rod, you know, where, where are we going with this?

Where are we in the induction process?

And you can't it's, it's one of my bugbears about induction is people talk about it and they don't, they don't.

14:49

Women go to hospital.

People go to hospital.

They don't even know what they're going in for.

They don't even understand that they're going in for a step.

There can be 6 or 7 processes.

So how can you have an induction trial that's not even looking at what form of induction was used?

Yeah, and.

15:06

There was an induction trial, nearly everybody on this trial was it 70% in the standard care.

And, and you know, I find the term standard care offensive because there was nothing standard about what they were doing to the people in this trial.

And yes, I know there are women who are really pleased with the outcome of what happens to them on this trial, but there are many who weren't.

15:25

Yeah, yeah.

So I just, I'm going to read some of the, some, some, some quotes from the study, OK, And we can talk about them because I think it's interesting that what I'm going to read is not what's being banded about, you know, in, in, in clinics and, you know, up and down the country.

15:48

No significant difference in incidents of shoulder dysphasia was found between trial groups in the intention to treat analysis.

No statistically significant differences were found in neonatal secondary outcomes.

The number of adverse events was the same in both groups.

16:08

Comparison of maternal and neonatal outcomes at two months and six months showed no differences between the two groups.

So basically, there's no there's no difference.

But that's a really interesting start on its own, particularly two and six months because what are the long term implications, not the two and six month implications of inducing this many babies, many of whom ended up on antibiotics.

16:35

There were higher rates of Niku readmission.

One of the reasons the trial was more costly, I think it was Shelley who identified it might have been Charlotte's, is because the Niku on costs went up.

So it made this more.

And why did Niku on costs go go up?

Because there's not more need for Niku care for neonatal care.

16:54

It's just playing with numbers and figures I think.

If I remember rightly the PPH rates were high and so excessive.

Leading for those listening.

Postpartum home Ridge.

Yeah, this is the thing.

There's there's so many outcomes that have just been shoved onto the carpet, ignored because that's not what they want to look at and that's not what they want to acknowledge.

17:17

And again, they try to fudge the numbers because the study, you know, quotes that they did find a very small reduction in shoulder distosia with early induction, but only when they reanalyzed the results and they took out certain groups to make it fit their narrative.

17:35

I just got my hands over my face.

That's the stat.

That's the stat that's being that, that, that's the key take away.

That's being taken away and, and, and talked about with this study that, oh, it did, it did, it did reduce shoulder dysstosia, but it didn't.

It's because you've taken a subset of the data out to make it fit the narrative that you want.

17:54

Could you sit compared to what Could you sit compared to inducing later on or induce it compared to just leaving People have babies they do not know.

The study has told us absolutely sorry, fuck all about big baby birth.

18:11

Nothing.

And they weren't big.

No, I keep going back to you know, and when you when you terrorize women all of the time.

I'm just this this trial has been well, you all know and we've said it already.

18:27

I don't understand how this trial was ethical.

It didn't properly list the risks of induction, at least not on the original early patient leaflet because I have a copy.

It didn't really discuss the ongoing implications of induction.

It didn't discuss the fact that when you induce a 38 week baby because of the two week and, you know, there's an estimated due dates can be two weeks out, you are potentially bringing your baby out 36 weeks.

18:54

You are potentially causing a medically premature baby, a baby who needs more help with feeding.

What were the implications in terms of ongoing formula cost and use?

Who knows?

Yeah.

And many women do not know that they've been birth traumatized.

19:10

I did not know that I had birth trauma until 13 years later when I was having my second child.

If you just said to me at the time was I traumatized by my birth, I would have said no.

But my first birth and I've had three children since then and they've been amazing, Traumatized me so much.

19:28

I cannot have a smear test, right?

And I am 55, he is nearly 30.

So yes, I had birth trauma.

Was I aware?

Completely oblivious?

Yeah, Yeah, I think you're and I think your point about forcing babies out early is a really important one.

19:50

You know, we we're saying that they're in the study, they're inducing people at between 38 weeks and 38 + 4.

But we know that due dates are a guess, they're inaccurate.

We don't know.

20:06

You know, you don't know what damage you're going to be doing by forcing that baby out early when they potentially could have another four weeks of development still needed.

We are, we are forcing babies out before they are ready to be born for a reason.

You know, they if they, if they need longer, they need more development.

20:24

What's that impact on that baby's?

Like you said, the feeding impact, the impact on the baby's brain development, their nervous system.

I think, I keep saying this, I think that we are causing neurological damage in birth and it is presenting as neurodiversity.

20:43

So both Erin and I, I want to be really clear here because I think there is genetic neurodiversity that has always been there and will always be there.

And I think from what I'm reading, and this is just my own personal theory, I think that there is something that looks like neurodiversity mimics neurodiversity and so is being presented as autism, ADHD and things like that, but it's actually being caused by the amount of medical intervention in the birthroom.

21:09

Now that's just a theory of mine.

It's not.

And I don't want anybody who's neurodiverse to go sounds trying to face autism because I'm not.

I absolutely adore my children in every in every, even when they're being the biggest pains in the arse.

But I think if we are causing neurological damage in the birthroom, it needs, people need to start looking at, I might be completely, completely wrong.

21:28

I would be happy to be wrong, but I don't think that I'm wrong.

I don't think that we can do this amount of things to babies at the end of pregnancy and in the birth room and it not have an impact considering we are now looking at population level harm.

We are harming people at such a great degree and this trial, if it becomes common practice, which is why we were so eager to get this out so early, is going to cause harm.

21:54

It's not going to help people to have more and more inductions.

Yeah.

Yeah, you know, induction in itself is a whole nother podcast episode, which I think I've recorded before, but maybe I'll do it again because I feel like it needs shouting about even louder.

But you know, the fact that an induction can cause a cascade of intervention can cause AC section can mean, you know, all of these synthetic hormones, pain relief drugs, you know, the impact on, on breastfeeding, the impact on the baby's gut microbiome because of all the antibiotics that you get given.

22:26

You know, the, the increase in asthma, eczema, food allergies, you know, all of these things stem from unnecessary interventions like induction.

And a lot of those babies, you know, 60% of those babies in that big baby trial arguably were intervened with unnecessarily.

22:49

Now if we, if we apply that 60% to the entire population, you know, that's, that's a huge number of unnecessary inductions that are potentially going to happen because of a suspected big baby, because they fudged the numbers on this trial, which I think is criminal.

23:05

You know my understanding I've I only heard from like 2 healthcare professionals who were at their presentations that I couldn't get my hands on any slides.

But my understanding is they weren't presenting this.

I might be wrong again because this is the third time is they weren't presenting this as an outstanding success and all of a sudden it seems to have gone into look at this amazing trial when very clearly by their own published paper it wasn't.

23:29

I don't understand how you can take something that clearly shows one thing and then try to get the narrative out there that this is amazing life saving intervention for two big babies.

And they were tragic small, you know, and I want to put my my sympathies into those families.

23:46

There were tragic outcomes on this trial.

Yeah, yeah, because they were, they were some, some tragic outcomes on this child.

You're right to acknowledge that as well.

It's just I don't understand.

I've been a birth worker, trained birth worker for 12 years, and all I see is things getting worse.

24:08

Yeah.

Why are we not driving?

We know that one to 1K.

Why are they not trying that?

Why?

Why is this trial?

How much many?

I'd love to know.

I don't know enough about research to know how much did this trial cost?

And not just the cost of the trial, how much did it cost in hospital time, midwife time, You know that it's out there.

24:30

I know the information's out there, but a lot of many when we are, you know, my thoughts.

I think that all, all hospitals who aren't created excellent should be banned in taking part in research anyway.

Because if you're not providing an excellent service and you're not meeting basics like goods, quality care, if your home birth services are closed, if your MMM use are being closed, how can you be participating in research that is being used to drive policy when we want a failing trust and we know from CQC reports just a failing left, right and centre.

25:05

Yeah, yeah.

So there's so many things about this trial.

And then let's look a small baby because the paranatal institutes are also behind gap grow for small baby.

So if we know that 60% of scans are inaccurate for big baby, where do we sit on small baby?

25:22

Yeah.

If it's usually the same.

Yeah, I think, I think one thing I think it's important to point out for anybody that is pregnant and has a suspected big baby is that, and again I'm reiterating, but I think it's because it's important.

25:41

A, we don't know the size of your baby.

Statistically probably you are not having a MOHUSIF baby.

Even if your baby is big, in most cases that's not an issue, right?

It's not an issue.

We generally are designed to birth babies appropriate to our size.

26:03

You know, and again, I've had clients who, you know, one of my current, my couples, the person that was pregnant, she was like 5 foot 9/10.

Her husband was over 6 foot.

And they're like, we've been told we have to have an induction because we're having a big baby.

26:19

Of course you're having a big baby.

You're both tall genetics.

And then there's also the issue that they get told they're going to have a big baby because their husbands are massive, but they don't calculate the husband's size in the growth charts.

26:35

So we're.

Yeah, I know.

Make it make sense.

Genetics plays a big part, right?

There will be some people who have a suspected big baby and the baby is big and bigger than perhaps baby would be if you didn't have medical complications like, you know, undiagnosed, uncontrolled gestational diabetes and your baby is growing exponentially and you know that that's affecting baby's growth.

27:03

Yes, OK, potentially that's a different that's a different thing.

But if we have an uncomplicated pregnancy and you are either genetically predisposed to have a big baby.

Or.

You're not.

And we're just going for growth scans and you have one erroneous, you know, measurement.

27:21

It's probably not an issue.

You know, let's not, let's not neglect, you know, fundal height measurements as well, right?

Because it's not just growth scans that identify big babies, it's fundal height measurements.

So fundal height measurements is where the midwife gets the tape measure and she finds your peeval bone and she measures over your bump, right?

27:37

Do you want to talk a little bit about the issue of that sound because you've got your hands on your head.

It's an inaccurate measurement of anything.

Yeah, it's like trying to measure the amount of bath water in the bath from the outside.

But if there is no continuity and how many are having continuity T of care And my frontal height measurements are not worth the ink that they are used to plot on a piece of paper.

27:57

And I see hundreds of stories in the home birth group where people go, my midwife's done my frontal height measurements and she wants me to go for a growth scan.

And it's like off the scale, it's either dropped off the bottom or it's shot up.

And I say the first question I ask is, was it your usual midwife?

28:17

No, it's a different midwife.

Well, there you go.

No continuity.

And then I'll say, oh, particularly if it's one of the late ones, where were you when this funnel height measurement was done on the sofa?

So if it's done on the sofa, it's not worth the paper it's written on.

28:32

And when you start looking at funnel height measurements again, they're just inaccurate.

We know that the biggest thing that makes a difference is continuity of K for all of these things, and that includes your growth scans.

Because if your growth scans are done on different machines or even by different stenographers, then they're inaccurate.

28:50

They're not, they're not accurate.

There's a slight difference in measurement.

And my favorites are the ones that towards the end the lake scans and they go can't measure the baby's head.

So we've guessed and your baby's enormous or your baby's tiny because they've guessed.

29:05

Would you accept this from your builder?

Would you accept these inaccurate measurements if your builder came to the house and said OK, Mrs. I've measured 2 bits, that'll do, yeah.

I'll just can.

You be like what you know and frontal height measurements.

29:24

Do they have their place personally?

Actually, if I had my time again with my foot, I would never have bothered with them, you know?

But they certainly don't have their place.

If you don't have the same midwife in the same place, you're not in the same position.

Think about your abdomen when you need a wee or you're bloated because you've eaten something.

29:43

You know.

That changes the size of what's going to happen.

It's just basic, basic.

You know, I'm not very good at science.

I'm not very good at the medical.

I understand birth, do not understand science a lot of the time, but even I can tell when something's just not.

30:01

It's just not right.

Yeah.

And and I think you touched on this, but the timing, you know, where are you in your pregnancy, if you're being measured in your third trimester, it is inevitably harder to accurately measure that baby because the baby is bigger, their heads lower down, they can't get everything on the screen.

30:21

We know that there is a statistical margin of error with measuring babies in the third trimester.

You know, just as a Gen. in general, there's a 1520% margin of error with ultrasound scans, which actually doesn't, it doesn't sound like a very big, you know, margin of that's huge, that's huge.

30:39

That's, that's, that's having an 8 LB baby and being told you're having somewhere between a six and a nine pound.

That's that's, I mean, that's, that's massive, right?

I don't, I don't know, kilograms.

I'm old.

OK, I do pounds Oz.

I'm really sorry for anyone listening.

And then something else I read, I haven't fact checked it, but it makes sense to me.

30:57

Baby boys weigh more than baby girls as well.

So on average a pound difference at birth.

But I, as I said, I haven't checked that out, but I can imagine it's probably true.

It's like, if that's true, then does that not put everything into jeopardy?

Because it's another thing that these scans don't account for or the charts don't.

31:14

It's not the scans.

I'm just with or, or, or, or, you know, parity.

Like I, I mean, in my personal, this is just me personally, but my first child was 6 lbs.

My second child was 6 lbs seven, and my third child who's a boy was 7 lbs seven.

31:31

And they got progressively bigger.

Now I don't know why that's that is.

I don't know if that's a trend, you know, across across everybody else.

You know that you tend to have bigger babies as you have more babies potentially, but that doesn't get factored into growth scans and measurements either, does it?

31:50

Yeah, yeah, mine, mine all got bigger from 7 LB to 8 LB ten.

Or I think that one might even have been bigger again, I can't remember.

And even that, you know, I was oh, it's going to be a really big baby.

Why are they trying to frighten everyone?

32:06

Yeah.

So, you know, back to this trial, nickery admissions, the amount of people going back into hospital was high.

The amount of babies ending up on antibiotics was high.

Yeah, yeah.

Again, it's, it's, it's the, it's the other, it's the other, you know, not spoken about impact of, of, of this trial that I think is really worrying because we're not talking about they're, they're just focusing on the shoulder dystocia, which it didn't show anyway, by the way.

32:38

When I read the trial and I got to be honest, I like zoned out after about two minutes of trying to read it.

Didn't it contradict itself though?

Didn't it say there wasn't a difference and there was a difference in the trial?

Yeah, not to mention that there was a whole load of typos.

It was riddled to typos.

32:54

And I'm not talking just like, I mean there was grammatical errors, but there was also like numbers were wrong.

So you were trying to interpret the data and you couldn't because there was typos in the data.

The references, when you look through the study and you look for a reference, it actually points to the wrong reference in at the end of the study.

33:12

I mean, the whole thing is just I am used to reading studies, OK?

I'm used to interpreting data.

And you know, that's my, I live and breathe for reading a really good racist study.

And I really struggled.

And this is something that I was speaking to Charlotte, the smart dooler, who I'm going to publish her podcast episode later about interpreting data.

33:34

As a pregnant person, you are relying on your midwife, on your obstetrician to be telling you information from these studies to say whether your care is evidence based or not.

And they are getting it wrong.

33:49

They are picking the wrong things out of this study.

They are warping what the outcomes of this study were.

So this it's a real issue.

I'm just that you're shaking my head because in my experience, they don't know the studies, They don't read the research, they don't keep up to date.

34:06

They are told that this study says this and then that's what they go.

With and that's what they go.

With and ask them, you know, I've been in meetings where they get offended because you ask for evidence.

I've had clients and I've said to them, ask them for the evidence because they won't have it.

And they'll say to them, oh, go look for the Cochrane study.

34:23

That is not your healthcare provider giving you evidence.

That is them telling you to go and do your own research.

And you know, there is so little research on leaving birth alone that I don't.

As far as I'm concerned, all research that we have, all of it now is fundamentally flawed.

34:42

It's all dated.

None of it accounts for the amount of caesareans and inductions that we're doing now.

Even this trial is dated.

It was dated before it even came out because it started in 2019 when induction rates have gone through the roof.

So it's just there is no longer in this, well, anywhere.

35:00

I don't think a baseline of leave it alone.

And you know, when we're looking at still birth rates and things like that going back to 2019, what relevance have they got to a world in which 70% of people are being induced in caesarean?

35:18

No, Nobody wants a still birth, but they still happen, and they're happening more.

You know what, I just downloaded the latest ONS data and Embrace data report and updated my graphs as a graph that I share periodically.

35:36

And I think if I haven't shared it this week, it's going live next week.

Looking at the rates of still births and the rates of induction C sections and postpartum hemorrhages, still birth rate hasn't changed.

Induction, C-section and postpartum hemorrhage rates have gone through the roof.

35:53

And again, looking at, you know, 2024 data, the trend is the same, right?

And you know, reductions are not preventing.

Stillbirths.

No, I thought it got up slightly or might not of this time because.

I think it's the same, roughly.

It's roughly the same.

But you know, and we know that some trusts are changing their what what classes as a postpartum hemorrhage, but they're not changing what classes as a postpartum hemorrhage when they want to traumatize you into having when an induction next time, they're only changing it for their stats when you go in.

36:22

There's still classroom 500 mil, which used to be normal bleed anyway.

They just change things as they and, and this trial is just an absolute clear example of how they're manipulating what is going on, as well as how they manipulated and ran the trial in the 1st place.

36:41

Yeah.

So I think the key things I want people to take away from listening to this episode is that if you're being told you're having a big baby.

Probably not big.

36:58

If they are big, it's probably not an issue.

If they're telling you your your big baby is going to cause a shoulder dystoia and brachial plexus palsy and permanent damage, statistically, it's very unlikely to happen.

And actually the study showed that actually there were more cases of brachial plexus palsy in the early induction group than they were for the people that had standard care.

37:17

Again, quote, and I think this is one of the, this is, again, it's a this, I think it's so important as a pregnant person, you have support from somebody who is impartial and can give you some of this information and understands a lot of this stuff.

37:37

Because I don't think you can rely on your care provider, your NHS care provider to be giving you this information in an unbiased way, or someone who really understands the the data that's coming out of these studies.

So having like a one to one with Sam, for example, and booking some timing with her.

37:56

If you're being told that you need an induction for a big baby, I think is a really good idea.

Coming and booking on a course with me to understand what your options are and the impact of some of these medical interventions so that you can make a balanced decision on what you want that birth to look like and what decisions you want to make in the birth room, I think is really important.

38:16

And as data like this comes out, you know, we saw it with the ARRIVED trial, we're seeing a big baby trial.

These studies are being used to justify medical intervention when actually the studies show you the opposite potentially.

And I'll add to Erin.

That anybody right.

38:31

So any healthcare professional that is suggesting to you to use CTG is lying because the use of CTG or continuous monitoring in your birth is another thing that has no evidence base.

Birth small talk on Instagram is the absolute go to.

I send everybody there, but they are relying on a technology to save your baby because we know that induction stress is babies that has no evidence base.

38:58

So the whole thing is a shamble in non evidence based practice.

Women and babies and birthing people are the biggest uncontrolled experiment in the world.

They are experimenting on us and they are experimenting on our babies and you need to not blindly trust, you know, and that includes don't just blindly trust S either.

39:22

Do their own work.

Do your own research.

We are not anti induction.

I have been to inductions.

I regularly speak to people who are being induced all of the time and I don't sit there going don't be induced.

If somebody comes to me because they're being induced, I will support them to have the best possible induction that they can.

39:43

And in my considerable experience and people need to understand, no, I'm not medically trained.

I don't claim to be, and I'm not giving medical advice.

I read thousands of birth stories a year.

I have probably read more birth stories than anybody that I know on a regular basis.

40:00

And when induction is medically genuinely indicated, it goes well.

Because the body knows right when you have been coerced and beaten and battered into it, it does not go well because it is not the right thing to be doing.

Injection, when it comes from your own heart are two clients of beautiful inductions.

40:20

Because they knew it was the right thing to do.

They believed that they were doing the right thing and it went, they weren't in a fear state when they went in.

And it makes such a difference.

And you know, this trial puts so many people in a fear state.

It was always going to be a bad trial.

Yeah, yeah.

40:37

Yeah, thank you for saying that, Sam, because you're right, not all inductions are unnecessary.

Some of them are medically necessary, absolutely, and they can go really well.

But this study particularly is going to be a stick to beat people into submission for inductions, say that this trial says.

40:58

Anything about big babies when they own, we're back to where we started.

They don't start to say 60% of them.

And it's not accounting for the fact there is no evidence for the use of growth scans for big babies.

They've only ever been evidenced for small babies.

41:16

And I, as I said, because we're back into this, casts that into doubt in my mind.

Yeah, because I've always.

Known that the lack of.

Continuity made it pointless.

Yeah.

So I think we, yeah.

We we could go around in circles with this because it is the most frustrating.

41:33

And it's not just you, Erin, who said that it was hard to unpick this trial.

But Charlotte, as as Erin has mentioned, and Shelley Potier spent a whole day backing and forth with each other trying to unpick this trial.

Yeah, because, and Charlotte is a researcher.

Shelley is amazing with research.

41:49

Shelley, Erin and Charlotte, my 3 go to for evidence.

Basically, look at the what they've said about the research, you know, rather than just me ranting away about how terrible it is.

But they couldn't understand it either.

Even two of them batting their heads together, like, and have I got it wrong?

42:04

I can't remember which bits they thought they got wrong, but it was like if we read this wrong, Yeah.

It's a yeah.

I feel like potentially it is written in such a way to make it so hard to understand that they can try and just push the narrative that they want.

42:23

I feel like it's almost intentional.

And so, yeah, I think do your own research there.

There is, there is lots of information about big babies out there and a lot of it backs what we're saying.

42:43

Do you know the best place to to read about?

Big babies come into my own birth group.

Get into my Big baby group guide and read stories from women who have had big babies, their own big babies, their own stories, in their own words.

Nothing is censored in my home birth group.

43:00

Nothing.

Every story that somebody will.

I regularly speak to people and they say, you know, I don't know if my story's for the group.

I say if you're in the group and you'll remember your birth story is important.

However it happens, whatever happened, there is nothing that doesn't come into this group.

Come and read the story of some people who have actually had big babies at home with no intervention and see the difference in how they talk even when they've had intervention in how they talk about their births compared to what we are seeing in the constant trauma stories that we see in trials like this.

43:34

It's just appalling.

Yeah.

I will make sure that the link to your group is is in the show notes that people can join.

Thank you so much for your time today, Sam.

It's been you as always, a pleasure.

43:50

I love a good rant.

I feel like I've kind of got a lot of budget today, even my poor my.

Poor teenagers who are what, 1215 and 17 and have genuinely no interest in the big baby trial, have done nothing but listen to me rant about this trial since since the the paper came since the BBC put their article out selling this trial as giving women choice.

44:11

They that was, yeah, that made me, that gave me the rage that hasn't really dissipated because what choice, the choice that they took away.

This trial changed how big babies were treated within the NHS before it was ever published.

44:28

Yeah, and.

I read that and I.

Was like, Oh my God, they're going to start sending this as a saviour and I and I just I haven't stopped.

So my target year old is like, you could just see him.

Like why is why are you talking to me about this?

I'm not interested.

So you know you have always had a choice.

44:49

Yes, this trial tried to take it away.

Yeah, yeah, absolutely.

Absolutely.

And breathe.

And thank you for having me to rant.

Rant with Sam.

It's always good.

It's always good.

45:06

Thank you.

Thank you for your time.

And yeah, if anyone does want to reach out to me or to Sam, I'll make sure that all of our contact details from the show notes.

But, yeah, just don't take the headlines at face value to make sure you're getting your information from more balanced sources, not the BBC or, you know, any other big media outlet.

45:27

Because the journalists that are writing those those articles are not birth workers.

They're not jewellers, they're not midwives, they're not obstetricians.

They're journalists.

And they are, they don't know what they're talking about, quite frankly.

So make sure, make sure you're getting information from somebody that does know what they're talking about.

45:43

Yeah, yeah, yeah.

Thank you so much.

I can't wait for your one with.

Charlotte, I'm really looking forward to that.

Yeah, I'm going to.

I'm going to I've.

Got a Beth.

I've got an amazing Beth stories published and then Charlotte's is going to go live.

And yeah, it's, it's, it's a good one.

45:58

It's good, a good one to understand the issues of trying to interpret data and research studies, which we've touched on today.

So, yeah, it's a good one.

Thank you, Sam.

The Better Birth Podcast and all of its content is for educational and informational purposes only.

46:22

You should consult your midwife or your doctor for anything in relation to your own pregnancy and birth.

The opinions and the views of the guests on the Better Birth Podcast are their own opinions and do not necessarily reflect the opinions of Better Birth or Erin Fung.