Danger, Data, Drama

I've been thinking about how we learn about risk and safety. In a world of hidden threats, what is danger? How do we know what to fear? A car cruising at freeway speeds with sleepy children buckled in back. Pills prescribed by a trusted doctor. Invisible pollutants. Unprotected sex. These things can kill us -- but they probably won't. You can live a lifetime, unscarred by accident or disease, and never know whether you were safe and smart -- or just lucky.

It's through the collective wisdom of our community that we know about latent risk. I don't personally know anyone who's lost an infant in a car wreck. But I buckle my son in his five-point harness -- because I (and my government) have looked at the data and determined that, in the right circumstances, it could make a difference between life and death. I've done this with almost every parenting choice I've faced -- whether to supplement with formula; whether to vaccinate; what kind of medical interventions to accept during childbirth, and which ones to avoid.

And no matter what we disagree on, all moms seem to agree that this is exhausting. We face information overload. We go to great lengths to avoid "risks" like artificial growth hormones and latex balloons -- and at some point, we have to let it go. "What's the harm?" We say. "How dangerous is it really?" My sister and I used to wrestle around on the floor of our Grandma's backseat while she smoked cigarettes and fed us colored marshmallows in the car -- and we turned out fine. Can a little peanut butter and a few unsupervised bathtimes really be that dangerous for our own children?

So at some point, we turn away from the data and the studies. We remember that we are mothers who can learn from other mothers. We value the knowledge of our friends, our sisters and mothers, as if we crave a primal community where we learn by sharing anecdotes. "I was induced at 38 weeks/ fed him baloney/let him use the walker," they say "and he turned out fine." Or on the other hand, "I know someone whose cousin had a VBAC/left him alone in his highchair/ fed them a raw carrot -- and they almost died!" The closer we are to these kind of horror stories, the more power they have over us. It's as if we are living in the wilderness and hear of our neighbors being attacked by a wild animal. The nearer they are, the more real the threat can seem.

Of course we need to temper our parenting decisions with common sense. And good old-fashioned Mom Talk can be a great source of support. But the wrong anecdote can overdramatize safe situations -- or veil the risk of threatening ones. When I hear about a friend's cousin's uterine rupture, for instance, I need to keep in mind where she fits into the big picture. With a 0.7% rupture rate, for every woman who experiences rupture there are over 142 who do not. Of course, it would take too long to counter a single rupture anecdote with 142 relatively boring stories about uneventful VBACs. So the dramatic anecdote survives, and thrives, until ultimately it threatens to distort the true risk of the situation.

And some risks are only apparent when viewed relatively. A .177% infant death rate for cesarean deliveries seems low enough to ignore -- until you compare it to the .062% rate for vaginal births (in a study of almost 12,000 babies who died in a 3-year period) . So while it's accurate for me to spread the word that "I had a cesarean and my baby is fine" -- is it intellectually honest? Over 4,000 of those babies died for no other discernible reason than a cesarean delivery. Was it smart decision of me to consent to surgery? Or was I just lucky?

And why does it matter? We can't be perfect mothers. We all take risks the moment we leave the house. And we crave and require each other's support. Tell me I'm not a bad mom; Tell me I'm not alone. Don't judge me. But I wonder if we're so hesitant to "judge" each other that we've lost our ability to use critical judgment where it's needed -- in analyzing important information about our children's health and safety. What will it take to give us the courage and confidence again?