In the company of woo

I find myself in the company of woo, and as a skeptic it is bringing me some grief.

It's all about homebirth - planning to deliver a baby at home, attended by a midwife, rather than in a hospital.

Deena and I came to homebirth through an examination of the evidence. (Here's a discussion I participated in on the Bad Science forums before Kaia's birth.) We were convinced, by scientific studies and analyses, that planning a home birth here in the UK was at least as safe as planning a hospital birth, given a competent attendant and a handy hospital in the event of complications. So we went for it.

However, many people choose homebirth for less evidence-based reasons. They cite personal intuition, or the "naturalness" of it. Not just as reasons to prefer homebirth, but as evidence of its safety.

At Edinburgh's Pregnancy and Parents Centre (a haven for various types of woo, as well as useful support groups and great toddler activities), when we went to the "home birth support group" to relate our experiences and our evidence-based approach, it was alongside others promoting woo of various flavours as part of their support of homebirth.

A recent post on homebirth at Science-Based Medicine has stirred up an epic-length discussion, with passionate defenders on both sides. I've participated, but fear that just being on the homebirth side has made me, in some people's eyes, an advocate of woo.

This is the problem: I agree with the woo-birthers that homebirth can be safe, but I disagree (passionately, vigorously) about why this is a legitimate position. And the disagreement isn't immaterial. At the homebirth meeting, someone recommended homeopathy to treat post-partem haemorrhage. One of the most serious and potentially life-threatening complications of pregnancy, and she advised drinking high-priced water. That is dangerous advice, and I wish I'd been quick-thinking enough to respond persuasively (rather than sitting like a lump and grinding my teeth).

What is a skeptic to do? On the one hand, having someone agree with me in one breath, and back me up with an appeal to intuition in the next, makes me want to revisit and question my beliefs that much more carefully. (That's something a skeptic should be doing anyway, for all their beliefs, but who has the time?) On the other hand, to adapt Niven's 16th law, "There is no belief so true that one cannot find a fool believing it." Just because someone agrees with you for bad reasons doesn't mean you're wrong. I came to my belief about homebirth on the basis of the science, and I'm determined that only science will dissuade me.

But there's also the whole social side. Just as many of my fellow atheists wrinkle their brows at me when I say I go to church, many skeptics seem to do the same when I talk about homebirth. Atheists often assume that the word "church" is synonymous with supernatural beliefs and submission to a holy text, things that would feel alien in our Unitarian church. Similarly, many skeptics assume that, because it's associated with modern medicine, hospital-based birth is inherently safer.

I'm tempted to close by declaring, evangelist-style, that skeptics must beware of this tendency to take association as evidence. Its association with woo-birthers says nothing about the safety of homebirth; nor does its association with high-tech hospitals demonstrate the superiority of hospital birth.

But perhaps a more humble conclusion is in order. Here goes:

I promise to keep vigilant for evidence that might contradict my current beliefs.
I promise to honestly communicate any changes of position that such evidence might lead me to.
I promise to avoid being swayed by other people's assumptions (whether or not they are skeptics).
I promise to make every effort to pin my beliefs to the evidence, and nothing else.

Confession of a born essentialist

We have an innate tendency to psychological essentialism. Bruce Hood articulates this tendency well (see his book Supersense). His most vivid example is the serial-killer's shirt. If you are given a nice shirt - one that fits well and suits your style and wardrobe - and told that it once belonged to a serial killer, how will you react? Most people will avoid the shirt - even avoid touching it. Of course, the shirt contains no "serial-killer essence", but the association sparks something deep our psychology: we want to avoid objects that are associated with bad things.

This was probably hugely adaptive in our evolutionary history: if you avoid touching things that have been handled by, say, a seriously ill person, you are less likely to become infected yourself. It doesn't matter if the reason you avoid them is rooted in an accurate knowledge of the germ theory of disease or an improbable metaphysical notion of guilt-by-association - if it saves your life and is affected by your genes, it will give you a selective advantage over people without the trait, or with a weaker version of the same trait.

Essentialist psychology provides a compelling explanation for why people would believe in certain immaterial properties of matter even if the universe is completely material. Which leads some philosophical naturalists (humanists, atheists, etc) to smugly think that we've risen above the illusion: we see through the illusory sense that our instincts push us into. We aren't tricked into god-belief or imagining a life after death.

Well, it's not that easy.

I was playing with Kaia (my 2-year-old daughter), and she told me that her doll needed a nappy change*. As an expert, I was invited to conduct the procedure. I used a nose tissue to wipe the doll's bottom.

When I went to put the tissue back in my pocket (for future use), I was momentarily overcome by my inner essentialist. I had a strong sense that the tissue was unclean. All simply because of an act of imagination!

I quickly realized what was happening, and put the tissue in my pocket anyway. In fact, once I became conscious of the illusion, it quickly dissipated. Thank goodness for skepticism. I wonder if I would have recovered as quickly if I had not, a few years ago, attended a talk here in Edinburgh given by Bruce Hood.

Have you ever had a "silly essentialist" moment like this? How did you react? How did you feel once you realized what was going on?

* I feel I should point out that this wasn't one of those modern imagination-free dolls that actually produce wet nappies.

A new descendent

Just a quick note to point you to this announcement of the birth of our son a week ago.

I have an idea ...

At work, I recently came across an amazing resource: CiteULike. It's a free website where you can build up a list of citations. I use it to manage the long list of papers and books I read and cite as a researcher. I can label citations, like I label blog entries on this site, according to common themes.

It also has social features: sharing citations between users, getting automated recommendations based on common research interests. And there are Groups.

Which gives me an idea.

There are loads of skeptical blogs out there. There are the science-based parenting folks (such as SBP themselves, Rational Moms), the science-based medicine gang (SBM, Ben Goldacre, etc), and of course the general skeptics (Bruce Hood, Massimo Pigliucci, Richard Wiseman, and loads more).

These blogs often bring up new or interesting research that bears on our lives - as parents, as users (and taxpaying supporters) of health care, and just as people trying to navigate the modern world. But finding a particular study that I remember reading about on some skeptical blog can be a real pain.

So it occurs to me - why not set up a group, or a set of groups, on CiteULike, where skeptics could post scientific articles of interest to the community? You can put notes on each article - for example, pointing to reviews on skeptical blogs. You can talk about the articles (and the body of evidence around given topics, like acupuncture or spanking) in forums. You can associate informative tags with articles. Or you can simply hang out and see what other people have dug up. The resource could be used by bloggers who like to check original research, and also by skeptical consumers of new and traditional media claims.

It's not something I can do on my own. I don't have the time or the expertise to dig up all the relevant papers.

So this is a call to all you skeptics out there who have a little bit of time or expertise. Are you willing to help get things started?

I've taken the first step: I've created a CiteULike group, Skeptical Parenting, to pilot this idea. I chose parenting partly because that's where I am closest to having some substantive expertise, and partly because my second child is due to arrive any day now.

The next step is up to you. Here is what I ask of anyone who is interested:

• Join me as a member of the group, or start another group. "Paranormal Research", "Science-Based Medicine Users" - whatever you're most into as a skeptic. If you start another group, let us know in the comments here. (Do a search on CiteULike before starting the group to make sure someone hasn't already started one.)
  
• Blog about this yourself - not many people read my blog, but some of you have very widely-read blogs. The more people read about this idea, the sooner we'll reach a sustainable number of participants.
• Tell your friends. We don't all have blogs, but we all have skeptical acquaintances on- and off-line that we can share cool new ideas with.
  
• Comment here, so I know that I'm not just talking to myself.

I think we could build this into a really valuable resource. What do you think?

Rational parenting on Facebook

There's a new group on Facebook for skeptics who are also parents. It's called Rational Moms and Skeptic Dads. Seems like a great place to share freethought parenting tips, resources, and gripes. Check it out.

(Thanks to the Rational Moms blog for pointing it out.)

The high point

Yesterday was a real milestone for me - a culmination of five years of thinking and working and writing and rethinking and reworking and rewriting. To have it declared worthy of the honour of a PhD degree was probably the most satisfying moment of my academic career so far.

But I think the high point of the day was later. After the three hours of the viva, after an afternoon of congratulations from friends and colleagues, after an evening in the pub recounting the events of the day and sharing stories with fellow students and academics.

The high point came when I was home again, and I was putting Kaia to bed, and she fell asleep on my chest.

Ahh, perspective.

Big Girls, You Are Beautiful!

When our daughter, Kaia, was born, she was a little big. And she got bigger so fast that before she was a month old she had grown out of the lovely purple tam I had knitted her. At six months old, she has bigger feet than her ten-month-old cousin.

And she is beautiful enough to stop time. (Empirical fact - I've experienced it many times.)

Everyone - medical professionals, family members, complete strangers - sees her size as a sign of good health, and praises her for it. She is a big girl, and it's a good thing.

Her mom is also bigger than average, and also time-stoppingly beautiful. But people, especially doctors, rarely take her size as a sign of good health. Doctors worried about it when we were trying to conceive; they worried about it when we succeeded and started planning for a minimum-intervention birth; they worry about it almost every time she has an appointment with them, whether her complaint is size-related or not.

When does being a big girl go from a sign of good health to a sign of bad health? Why?

This is not just a modern question about human development. It is also an interesting historical question. For much of human prehistory, the most worrying medical problems were malnutrition and starvation - being big was a sign that you were healthy, had a reliable diet, and (probably) that you were well-off. And of course, fertility and sexuality were positively associated with good padding, as figures like the Venus of Willendorf attest. When did being a big girl go from a sign of good health to a sign of bad health? What changed?

Perhaps the health risks of being big were just obscured by all the other difficulties ancient people faced. Today, we've all heard that being big puts you at greater risk for heart disease, diabetes, and various other causes of early death. We all know these are established facts. Don't we?

Fortunately, Deena has a great interest in her health, not just her size, and has done a good deal of research. She has discovered, through a combination of reading and personal experience, that weight-loss diets almost always fail, or provide only a temporary fix and anyway the health risks connected with size are (except at the high and low extremes) almost entirely imaginary. These conclusions are also drawn by Paul Campos, author of The Obesity Myth. He was interviewed (mp3) on the Truth-Driven Thinking podcast by Steven Gibson. In the interview (and in the book itself, which I haven't read), he explodes most of the common beliefs about obesity and health. The facts are well-summed up in this quote:

“Even if it were true that thin people had better health than fat people which on the whole, except at its extremes, they don't; and even if it were true that you could show that there was a strong dose response between weight loss and improved health which, again, is not true; it still wouldn't make sense to be focusing on weight loss as a public health intervention unless you could actually produce it, but here's the thing: we can't!”

And he's not the only one to debunk popular myths about weight. So where does that leave me? I have a big, beautiful, cheerful daughter, who is growing up in a culture where big becomes a liability at some stage in the process of growing up, despite the absence of empirical support for the prejudice.

Will the ignorant assumptions of people around her give her feelings of inadequacy and shame? Will she be driven to try unhealthy diets in a desperate attempt to fit into the insanely limited idea of beauty promoted by media?

Fortunately, Kaia has several things going for her. She has her own natural love of being. She has family who love her as she is. She has parents determined to arm her with the critical thinking skills to combat the culturally-biased spin that the media (and many scientists) put on legitimate scientific research into human health. She is growing up in a world where many people are determinedly combating the irrational preconceptions of the wider society - the size acceptance movement, as well as a quietly successful fact-based, government-sponsored health sector focusing on a balanced diet and a sensible amount of exercise.

And there are plenty of people who celebrate the diversity of the human form. Kathryn of A Mindful Life posted not only this exuberant and sexy video of Mika's song "Big Girl, You Are Beautiful"





(it's now one of my favorite songs), but also a photo of her lovely, swimsuit-clad, pregnant self - a charming celebratory affirmation of big beauty. And when it comes to big affirmations, she's not the only one. Not by a long shot.

So finally, here's a picture of the two most important, stupendous, heart-flutteringly delightful women in my life.

Big girls, you are beautiful!

Belated birth link

Our baby girl, Kaia, is now four months old. When she was born, I promised you, my faithful reader, that I would wax on at length about the strength and beauty of the event.

Time has rushed on, and events have intervened. I am still not able to sit down and write what deserves to be written. But I just checked an old thread at Ben Goldacre's Bad Science forums, and realized that I could give the illusion of writing more by pointing out what I had written some time ago.

So here it is, a link to the childbirth/homebirth discussion.

Language and the framing of popular science

Deena just showed me a very well-written article, "Watch your language", about the framing of science in public health. It looks at the issue of breastfeeding versus bottle-feeding infants, and how the language we use affects the perception of the alternatives in subtle but powerful ways.

The World Health Organization says on breastfeeding that:

Breastfeeding is the ideal way of providing young infants with the nutrients they need for healthy growth and development. Virtually all mothers can breastfeed, provided they have accurate information, and the support of their family and the health care system. Colostrum, the yellowish, sticky breast milk produced at the end of pregnancy, is recommended by WHO as the perfect food for the newborn, and feeding should be initiated within the first hour after birth. Exclusive breastfeeding is recommended up to 6 months of age.

According to a 2005 survey, only 8% of babies (less than 1 in 12) born in the UK are breastfed exclusively for the first six months, despite the fact that 84% of mothers "said they were aware of the health benefits of breastfeeding."

This seems to be typical of developed countries.

Why? Read the article. I suspect that the ideas presented there are transferable to other public science issues.

High-tech philanthropy: how you can be the next Bill Gates!

I have just come across a really cool initiative for educating children in developing countries: One Laptop Per Child (OLPC).

I know, I know. Just from the name, it sounds like the sort of pie-in-the-sky idealism cooked up by affluent do-gooders in their summer home who have never had to live on what people earn in developing countries.

But check it out. Really. Each unit costs only $200 US (less than £100).

As the founder and president of OLPC, Nicholas Negroponte, says, "It's an education project, not a laptop project." The design and distribution strategy reflect that. They have held to a number of simple design features in creating this laptop, the XO, which should make it ideal for use in the most under-developed areas:

... the laptop could not be big, heavy, fragile, ugly, dangerous, or dull. Another imperative was visual distinction. ... [T]he machine's distinctive appearance is also meant to discourage gray-market traffic. There is no mistaking what it is and for whom it is intended.

XO is about the size of a textbook and lighter than a lunchbox. Thanks to its flexible design and “transformer" hinge, the laptop easily assumes any of several configurations: standard laptop use, e-book reading, and gaming.

... The integrated handle is kid-sized, as is the sealed, rubber-membrane keyboard. The novel, dual-mode, extra-wide touchpad supports pointing, as well as drawing and writing.

... It contains no hazardous materials. ...

In addition, —for use at home and where power is not available—the XO can be hand powered. It will come with at least two of three options: a crank, a pedal, or a pull-cord. ...

Experience shows that laptop components most likely to fail are the hard drive and internal connectors. Therefore, XO has no hard drive to crash and only two internal cables. For added robustness, the machine's plastic walls are 2mm thick, as opposed to the standard 1.3mm. Its mesh network antennas, which far outperform the typical laptop, double as external covers for the USB ports, which are protected internally as well. The display is also cushioned by internal “bumpers.”

The estimated product lifetime is at least five years. To help ensure such durability, the machines are being subjected to factory testing to destruction, as well as in situ field testing by children.

(from the features page)

And, more importantly, they are inexpensive. They are built as simply as possible, and run with only free software (their conditions for software inclusion are analogous but not identical to those found in the excellent GNU General Public License).

You can participate in various ways - by volunteering, by donating to OLPC. But my favorite is the "Give 1 Get 1" campaign. You pay for two of them; one goes to a child in the developing world, and the other comes to you for your child to use. Let's face it - it's a great little device, especially for the price tag.

So from 12 November, for a fraction of the cost of a normal laptop ($399 US, or £191.93 at today's exchange rate) you can buy your child a sturdy, versatile educational tool while contributing to an innovative and promising effort to lift poor children out of poverty through education.

As a long-time fan of laptops, of open-source software (particularly Linux), and of education, I find this plan very exciting. I would love for Kaia's first computer to be an XO. (I kinda think it'd be nice to have one myself, too.)

Of course, I'll also have to keep my eyes on other projects with similar goals (see here, here, and here). They all seem to be interested in the charitable goals of helping kids in developing nations, so I don't think competition and rivalry will become too much of a problem.

Let me know what you think. I am currently in the first flush of excitement over this idea - I haven't turned my critical-thinking fully on this idea. Would you contribute to this project? Would you buy one of these for your own child as well as for a needy child?

Identity and forgetfulness

A bit of philosophical dissonance to ponder ...

The observation is one of the most replicable in the literature: Whether tested in 1893 or 1999 (West & Bauer, 1999), among adults in Western cultures, the average age of earliest memory is age 3 to 3½ years. (from the APA Online)

Four- and three-year-olds can readily recall events from their second year. Yet, by the age of ten these earliest memories have receded behind what's been dubbed the "reminiscence bump." (from some recent Canadian research)

Add to this the sense that, without my memories, I would cease to be really me, and I find myself in a philosophical predicament. My daughter, Kaia, is unlikely to consciously remember anything that happens in the next two years. By the time she's ten, she'll probably have the adult "reminiscence bump" - no conscious memories before three years old.

What does this mean for her identity? Will ten-year-old Kaia be a literally different person from the Kaia I see today? Or am I wrong that my memories are key to my identity?

Perhaps - probably - there is a sensible compromise that will make sense of both the inescapable certainty that the baby is the same person as the teenager and adult, and of the intuition that our memories are a key to our identity.

But I haven't worked it out yet. For now, let me know what you think. How do you resolve this conundrum?

The descent of Mills

Two comments.

First, our beautiful daughter is now immortalized in a blog, hosted by her mom: The Descent of Mills.


Second, what Dale said.

Now back to gazing at Kaia.

What is humanism?

Humanism, at its root, is about humans.

Right now, for this humanist, it is about the two heart-wrenchingly beautiful girls sleeping in the bedroom - one exhausted after her first ten hours in the world, the other drained by an eighty-hour ordeal bringing her out.

I will have more to say later about bravery and stamina, about love irrevocably chosen and love irrevocably thrust upon me by my biology, about care and respect in the medical professions.

But for now, I leave to spend some more time staring at their peaceful, perfect selves.

Time and what is really mine

I planned to go to see a friend's band play a gig yesterday evening. I haven't seen them play yet, and I really thought this would be the first time.

Then I got a call from Deena late yesterday afternoon. She was feeling some mild contractions. Baby wasn't due for two more weeks; Deena still had another day of work before beginning her maternity leave.

Naturally, after a moment of dithering (surely baby isn't arriving quite so soon), the husbandly/fatherly hormones hit my brain and rushed to my bike, sped over to her work, and met her to take the bus home.

By then, it was becoming clear that it was just Braxton-Hicks contractions (ie, not labour contractions). Not a great surprise, but there was no way I'd go to see the band after that.

Deena is now officially on maternity leave. A few more B-H contractions today, she tells me, but no reason to think actual labour is imminent. I still have plenty of work to do – not only on my PhD, but also around the flat to prepare for baby's arrival.

One thing this episode brought to my mind is the undeniable fact that my time, our time, doesn't really belong to us in any sort of meaningful sense. No more than the current belongs to the canoe. We make our plans, we navigate the eddies and curves in the river, but ultimately it is not by our own efforts that we move on toward the sea. The only merit that earns us passage is our buoyancy, and the alternative to that is hardly a real choice. (Okay, the metaphor gets a little thin here. What is the sinking canoe? Death, perhaps.)

So although I may use phrases like, “wasting my time” and “use my time wisely”, I know that these are just polite fictions – euphemisms to help me ignore my powerlessness over one of the great impersonal forces that dominate my life.

What other fictions might I indulge in? Would I recognize them all, or do I need vivid wake-up calls like the birth of a new life to snap them into focus? I read a novel like Ursula Le Guin's The Dispossessed and wonder how far any notion of “property”, of mine and yours, reflects the actual reality of the world.

But there are some things of mine that seem to be beyond the reach of even this aggressive philosophical barrage.

My love. Not in the sense of the smitten poet, speaking of a person who is “his” or “hers”. Rather, the love that I give – my love for Deena. It is mine because I am its source. In creating it I let it go, I pass it on. The same goes for my deeds. My thoughts. My blog entries.

My child. The process of letting go may take longer, but eventually, like my parents did for me, I will have to finally relinquish any claim over this person who will so soon be appearing in our lives.

Is it just me, or is this list of things that are “mine” in a deep, irrevocable sense also some of the things that we humans value the most in our lives?

Becoming a person

It's now less than three weeks until the expected arrival of our baby. The physical symptoms are real enough – Deena started feeling baby move months ago, and I first felt movements shortly after. But there is still an abstract quality to the knowledge that these symptoms come from a human – a little person almost ready to come into the world.

Technically, baby could probably survive being born today. Our baby is already capable (with a great deal of help) of making that first, momentous step into independence. And yet, in another sense, this fledgling human isn't even a whole person yet. It has no name. It hasn't been held by our arms. It hasn't yet taken the uncensored atmosphere into its tiny lungs, drawing its own sustenance directly from the world.

I have a mind that yearns for quantum distinctions. Yes or no; right or wrong; child or adults; eggshell or off-white. Yet some of the most important milestones along my path as I've grown into the wise and seasoned almost-thirty-year-old I am now have involved seeing through the clear boundaries I've erected, seeing into the subtle, gradual shadings that separate one thing from its neighbour.

So now, as I tumble toward the terrifying, compelling, humbling brink of fatherhood, I contemplate this question: What is the boundary of personhood? When does a collection of atoms, molecules, cells, become a person?

There are the biologist's answers. A person begins at conception, when a unique genetic fingerprint comes into being that will (if circumstances permit) develop into a unique, autonomous individual. Is she a person when she is capable of surviving outside her mother's womb? Or is he not a person until he can function without his parents' help and support?

There are the philosopher's answers. A person begins when self-awareness dawns in the developing brain. Or is it when the capacity to experience physical sensations begins? Or when the young child is capable of exercising free will (rather than being driven exclusively by instinctual drives)?

Or the social anthropologist's answers. A person begins when the community begins addressing an individual as a member of the group (whether this occurs before, at, or after birth). A person begins after a particular social ritual welcoming the new being into the world and the community.

And, for all of us, there is of course the most obvious moment: the birth itself. The person is born the moment the baby emerges from his mother, and becomes physically a separate object in space. Given that so much of our language, custom, and law are built around this moment, above all others, I suspect that this very literal emergence, this clear boundary between in and out, is the one programmed into us biologically as the start of a new life, a new person.

But I can't ignore the fact that, for at least the past four years, Deena and I have had this person in mind. We have been shifting and shaping our lives subtly towards this new person we are about to meet. My mom sent us a quilt for the baby a year or two ago. And since we've known Deena was pregnant, we have addressed the baby (embryo/zygote/fetus/...) by a variety of nicknames; we have picked out actual names (not to be revealed to anyone else until baby is here); we have talked to baby, referred to baby's will (“Baby wants ice cream!”), to baby's moods.

So what does it mean for someone to be a person? If it involves others' attitudes, can a person begin to exist before sperm meets egg? If it involves the social embrace of the community, is someone not fully a person between birth and that welcoming ceremony?

I feel that our baby is almost, but not quite, a whole person now. I love this being already, but it's still a love partway between the abstract if fervent love of a longed-for lover and the love of a dear relative I talk with on the phone. I suspect that birth will seal it, complete the personhood of this already-loved being who come so far toward becoming a full human.

How do you feel about these questions? Have you experienced parenthood? Witnessed births? Mourned people who were never born? Is there a clear boundary in your mind between not-yet-person and person? Why is that boundary where it is? Why is it important?

My newest humanist hero

Deena and I are big readers, and so part of our preparation for parenthood has been to get hold of some key parenting books.

One which we have already read cover-to-cover, but whose practical relevance may not kick in for a couple of years, is Dale McGowan's collection of essays by various humanists, atheists, and others: Parenting Beyond Belief. Awesome book, by the way. Even before our kids are old enough to start trying some of the things mentioned in the book, it provides great reassurance for us as secular parents.

For some reason, I didn't really notice that he also has a blog sparked by the book. It was just before I started this blog that I found it, through his interview with my Friendly Role-Model, Hemant Mehta.

And it's great. The whole blog. I've read a good dozen or so of his blog posts now, and they're brilliant. Funny, moving, informative. He does what I aspire to do - describe what it's like to live as a humanist, compellingly and with mind-ticklingly lyrical wordcraft. It's brilliant.

Read it.