Week 38: Pick your hills

Unless it’s a life-or-death issue, consider climbing down your hill. |  The Metropolitan Museum of Art

Unless it’s a life-or-death issue, consider climbing down your hill. | The Metropolitan Museum of Art

During the last 37 weeks, we’ve focused on how to sharpen your research skills to get better answers to your questions. During these last weeks, we’ll talk about what to do when your research smacks into the real world, when your birth plan falls apart, your unvaccinated relatives drop by unannounced, that woman in your new moms group makes the wrong choice, or when someone on the internet is wrong.

One of the perils of doing good research is that you know all the right answers. Well, you know that there are no “right” answers, only “right-for-now” answers, but still, you’re more informed than those around you, a fact that is not likely to endear you to others, especially when you use your research skills to critique their parenting.

You need a formula to help you decide when to intervene and when to let go, to distinguish between what’s annoying and what’s critical. How do you phrase your objections carefully, or, barring that, what issues are you willing to destroy a relationship over?

How do you decide whether or not this is your hill to die on? If lives hang in the balance, offend with impunity. Of course, this is rarely the case, as few issues are truly life-or-death. So what other factors can you use to make your decision?

Let’s use an example faced by many parents toward the end of the third trimester: extended family vaccinations. The current advice from the CDC is that all members of a baby’s extended family receive the Tdap vaccine, and that all parents and caregivers receive a flu shot.

Your plan may include barring anyone from contact with your baby until they provide vaccination records, or hanging a sign on your stroller that says “I know I’m cute, but don’t touch me until you’ve washed your hands!”

These seem like entirely reasonable steps to take, knowing the research as you do. You know that whooping cough can be mild in adults, who may not even be aware they are ill, but a serious danger to babies, leading to hospitalization in about half of cases. You know the flu claimed a record-setting number of lives in the 2017-2018 season.

As you’re probably familiar, simply telling people these things is not likely to win them over to your cause. And some issues are so contentious that we may never sway people over to our side. But you can at least communicate sensitively and openly in an attempt to reach an imperfect compromise.

Step 1: Calculate risks

To give an honest accounting of risk, draw from the math skills you’ve learned with this calendar. First, you need a denominator to show how likely it is that your infant could catch a particular illness. How many infants contract whooping cough? Of that number, how many are hospitalized? How many die? Without those numbers, you only have a hazy description of a hidden danger. Knowing the answers to those questions can help you determine the overall likelihood of a baby contracting whooping cough and the risk of hospitalization or death in babies who do contract whooping cough.

Your specific circumstances should factor into your risk calculation as well. What if you live in a county where the vaccination rate is quite low? What if there is a whooping cough outbreak in your community or the neighboring town? What if your baby requires time in the NICU, meaning that unvaccinated family members could harm not just one baby, but dozens?

You’re probably thinking of the term “risk” as a shorthand for “risk to my baby.” But in any decision, there are more risks to consider, and before making demands of family you should weigh the risks to them, too. First, you need to consider any potential adverse consequences of vaccination, which can include time, money, and pain alongside all of the much less likely risks of vaccine injury.

You also need to consider the risks posed by making this your line in the sand. If it is important to you to have your baby’s whole family gathered together to celebrate, your vaccination policy may cost you your baby’s full-family greeting into the world.

With an accurate risk assessment in mind, ask yourself how truly risky non-vaccinated grandparents are. If it’s too risky for you, scroll down to Step 5 and climb your hill. If the risks are small but concerning, move on to Step 2.

Step 2: Communicate your concerns

If you have decided the risks warrant further confrontation, you need a better communication strategy than saying “anti-vaxxers are stupid.” or passive-aggressively posting articles to facebook (you’re not supposed to be there, anyway!).

You also need to do better than the majority of parenting websites, which encourage parents to rely on the scare-shame combo when talking to grandparents. Don’t forward an article about a baby who died from pertussis, as those cases are still, thankfully, rare. Don’t ask What if you didn’t know you had pertussis and passed it to the baby? Could you ever forgive yourself? You’ve just done the research that demonstrated your baby’s risk of contracting a life-threatening case of whooping cough is relatively low. Before that, we’ve spent months talking about why we all need fewer parenting stories that scare and shame. Don’t contribute to this hysteria.

Instead, communicate the risks as you calculated them in Step 1, and explain why you think vaccination is the better course. If there is a single article that helped you think differently, consider sharing it, but also consider that a single article about vaccination is how we got into this vaccination mess in the first place. It may be better to focus on your overall philosophy toward risk assessment and share a book about that philosophy with others.

Is your family listening to your concerns and making thoughtful commentary? Move to Step 3 to hear their side. Are they sticking their fingers in their ears while singing “la la la not listening”? Climb that hill.

Step 3: Consider their objections

You’ve communicated your concerns, but you also need to listen to your family’s concerns. Ask them what their concerns are about receiving the vaccination. Is it a fear of needles? A fear of pain? A concern about the cost of the vaccination? It may help to ask them “What would make you change your mind?” The answers to that question (a needle-less vaccine, help at home so I can take the day off, money for the office visit) could help you settle those objections.

If the objection is “I don’t trust the medical-industrial complex,” or “The government can’t tell me what to do,” or “It’s not natural,” you’re not just wading into debate, you’re swimming out to existential territory, where serious disagreements of religion and culture tend to surface.

After hearing their concerns, do you think your family may have a point? Move to Step 4. Do they still sound unmoveable? Get climbin’.

Step 4: Compromise

Perhaps your family is willing to get the Tdap, but unwilling to get the flu shot. That might be enough for you. Maybe they’re not willing to get any vaccinations, but instead comfortable with waiting one month before coming to visit the baby. Maybe you can all agree to no family-based child care arrangements until the six-month mark, when your baby will start receiving vaccinations.

Did you come up with a solution that works, even imperfectly, for everyone? Congratulations! That’s parenting. If you’re coming to blows, climb that hill.

When all else fails…climb your hill

Take a cue from the academics: research is a conversation, sometimes a heated one, but rarely does it come to blows. Agree to disagree, accept the consequences (fewer visits for them, less help for you) and move on, at least until the next fight over solid foods or car seats or co-sleeping.

In the meantime, if you need to vent some steam, there’s Science Kombat, a free 2D fighter game that pits Einstein against Curie and Turing against Newton. The game’s in Portugeuse, so assuming that babies really can hear from the womb, you may consider it early language immersion training.