Category: English

Source: The Conversation – UK – By Anastasia Topalidou, Research Fellow (Perinatal Biomechanics and Health Technologies), University of Lancashire

Maternal and newborn deaths are rising globally, not just in low- and middle-income countries, but in wealthy nations too. Researchers have described the situation as a “global failure” and a “major scandal”.

In the UK, more women are now dying during pregnancy and childbirth than at any time in the past 20 years, despite a fall in the birth rate. A national maternity investigation has just been launched, and public concern is growing.

Yet while politicians and healthcare leaders debate staffing levels and service delivery, one major contributor to poor outcomes is being almost entirely overlooked: biomechanical complications during labour.

Biomechanics refers to how the body moves and responds to physical forces. During pregnancy, it describes how the body adapts to the increasing demands of carrying a growing baby. During labour, it involves some of the most physically intense and complex actions the human body can perform, as it prepares for and facilitates the delivery of a baby.

After analysing 87 studies from around the world, we discovered that not a single one had ever investigated the biomechanics of labour. None examined how women’s bodies actually move, adapt or respond during birth. All the research focused solely on pregnancy. And despite rising maternal deaths in the UK, not a single antenatal biomechanics study had been conducted here either.

This isn’t just an academic oversight. Labour is biomechanically intense, involving force, posture, motion, muscle control and joint loading. Without evidence on how positions, manoeuvres or techniques affect the birthing body, maternity care relies largely on tradition, anecdotal evidence and outdated assumptions.

A dangerous lack of diversity

Some pregnancy-related biomechanical changes have been documented, but these vary widely from person to person. There is no “typical” pathway. Yet standard guidance assumes a one-size-fits-all model, often failing to account for these variations.

Worse still, almost no studies included data on ethnicity. Only one mentioned participants’ ethnic background, but it did not analyse the data by group or explore any differences. That is a serious gap, given that anatomical features like pelvic shape, joint mobility, spinal alignment and culturally shaped movement patterns can vary across populations. These differences could significantly affect how women move and give birth, yet they remain completely overlooked.

This is a serious problem, especially in the UK. Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) – the national programme that investigates maternal and infant deaths – along with other official reports, consistently show that Black and Asian women are nearly three times more likely to die during childbirth than white women. If all the biomechanical knowledge we have is based on white bodies, yet clinical guidance is applied universally, we may be missing important risks or needs. This lack of inclusive data could be contributing to the persistent racial disparities in maternal outcomes.

We also found that even widely used techniques such as squatting or the McRoberts’ manoeuvre – a common emergency intervention – have never been biomechanically validated during labour. This means that no one has scientifically tested how these movements affect the body’s joints, muscles, and bones during actual childbirth. So, we don’t know if they help, hinder, or have no measurable impact on the birthing process.

A handful of studies tested some of these positions on pregnant women in static, controlled conditions, but none included women in active labour. Those studies revealed no measurable advantage for any of the positions tested. Even the McRoberts’ manoeuvre did not significantly change pelvic or spinal alignment.

That means decades of advice, clinical practice, and emergency response protocols may be based on theory and biomechanical guesswork, rather than evidence. And while these techniques are used every day – often in urgent situations – they have never been scientifically tested on women in active labour. So no clinical studies have examined how these interventions actually affect the birthing body in real time. We don’t know if they work as intended, or if they could be refined to improve safety.

Tradition over science

The consequences of this blind spot are not theoretical or a matter of academic curiosity. They’re about safety, dignity and fairness. Maternal and neonatal outcomes are getting worse. Stillbirths and deaths shortly after birth have increased. Behind these statistics are real families and real tragedies. Many of which may have been preventable.

So why haven’t we filled this gap? Part of the reason is technical: traditional biomechanical systems are difficult to use in clinical settings. But that’s no excuse. New technologies are being developed all the time. If we have the capability to launch rockets and explore space, we should surely be able – and arguably obliged – to understand the basic biomechanics of human birth.

The real barrier is structural neglect. Women were routinely excluded from clinical research until the 1990s, and even now, research into women’s health remains massively underfunded and overlooked. As a result, childbirth, one of the most common yet life-altering events in medicine, is still shaped by untested ideas.

This isn’t just a research gap. It’s a failure of safety, equity and scientific responsibility. We are delivering babies in the dark, and those most at risk are often the ones who are left behind.

Dr Topalidou received a Pre-Application Support Fund Award from the National Institute for Health and Care Research Applied Research Collaboration North West Coast (NIHR ARC NWC) to support this work. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS, or the Department of Health and Social Care.

– ref. Why we still don’t understand what happens to women’s bodies during labour – https://theconversation.com/why-we-still-dont-understand-what-happens-to-womens-bodies-during-labour-261803

Source: The Conversation – UK – By Ryan Davey, Lecturer in Social Sciences, Cardiff University

You get a payment reminder through the letterbox, maybe for a credit card, an overdraft, a bill, or a parking fine. You ignore it and leave the envelope unopened, or put it to one side to deal with later. Many of us will recognise this scenario.

Ignoring debts and other payment commitments is often dismissed as being irresponsible. But a closer look reveals that many people see things differently, reflecting a deeper point about inequality in Britain today.

To understand people’s experiences of debt problems better, I lived in a low-income community in the south of England for 18 months, where debt problems were commonplace. I also interviewed debt advisers and their clients across the UK. It gave me a unique opportunity to understand their situation and how they respond to debt, something which I detail in my new book.

While debt relative to income is falling, the total amount of unsecured household debt now far outstrips its peak during the 2008 global financial crisis.

Amid big rises in the cost of living, more and more people have been borrowing money to cover essentials like food, energy, rent or council tax. In October 2024, 4 million low-income households held loans they took out for this purpose, and nearly nine out of ten of them were going without essentials anyway.

Meanwhile, lenders continue to charge the highest interest to those least able to afford it. In 2024, an estimated 5.5 million people were falling behind on their bills or credit repayments.

In the community where I lived, many people worked, but their wages were not enough to afford what they needed. So residents borrowed money to make ends meet, claimed welfare benefits or did cash-in-hand work. This reflects a broader reality with labour markets in Britain today, where 4.5 million wage-workers are paid below the real living wage.

As a result, most of the residents I worked with were in arrears with one or more payments. They received phone calls, letters and knocks at the door from debt collectors, threatening court orders, or they had to deal with bailiffs trying to seize their possessions. Some worried about being evicted.

This is a distressing situation that can easily lead to mental health problems. Debt problems are strongly linked to diagnosed mental health disorders and even suicide. All of the debt advice clients I interviewed had experienced anxiety, depression, suicidal thoughts or other mental health issues.

Making light

However, in the community where I temporarily lived, many residents had found ways to try to stay optimistic despite the threats of debt enforcement. Some made light of their debts by joking about how bad they were at repaying or how poor their credit ratings were.

Many people focused on their home and family life. One woman worried about it being “a skint few weeks”, saying: “We’ll get through it. We always do. You just focus on what’s around you.”

An unemployed man in his late forties told me how his pride in his 12-year-old daughter kept him from “going suicidal”.

Most of all, though, people avoided their creditors. Residents often strained to meet repayment demands, but just as often they ignored them. They hung up the telephone when debt collectors called, left envelopes unopened or stashed away, or pretended not to be at home if bailiffs visited. One man said when he received a demand to pay his water bills: “Well, they can fuck off,” and threw the letter in the bin.

Trying to deal with debt head-on, in the sense of paying what debt collectors were demanding by the exact time they demanded it, could create immense anxiety and even physical health problems. One man told me: “You know, for a while I was trying to keep on top of them and eventually … well, it was making me ill [because of worrying about it]. So I couldn’t keep on like that. I just left them and got on with things.”

These accounts reveal a deeper point about inequality in Britain. Financial lending tends to extract wealth from those with less and transfer it towards the better-off. Debt is a systemic feature of our economy, and debt problems have complex causes. However, the threat of enforcement convinces many people they are single-handedly responsible for being in debt. This places the blame for poverty on the shoulders of those experiencing it, subtly implying the wealthy are morally superior.

Stigma

More than mere personal prejudice, the stigma around debt is hard-wired into the legal system. If we assume that every legally valid debt must be paid as a moral duty, no matter what, then we ignore the economic realities that make borrowing a necessity for so many. This simplistic assumption only reinforces the hardship of those in debt.

Take the example of people ignoring their debts. Usually they are labelled as irresponsible or lacking financial skills. But ignoring debts is often a deliberate response to a situation that people find immoral or harmful to their health.

It is tempting to think that if debt is the problem, the remedy is to reform it. Subsidising credit so lower-income groups pay lower interest, restoring funding for debt advice, amplifying the voices of those who have been in debt and widening access to insolvency and debt cancellation could all improve things.

But reliance on borrowing is also a symptom of broader issues. These may be better addressed by efforts to redistribute resources and curb coercive sanctions, such as taxing wealth, guaranteeing higher incomes (both wages and benefits), controlling the cost of rent and other essentials, protecting against eviction and abolishing bailiffs.

In the meantime, many indebted people on low incomes will continue to ignore debt collectors’ demands. Through their actions, I believe they question the widely held assumption that there is always a moral duty to pay in our unequal world.

Ryan Davey has received funding from the Economic and Social Research Council, the William Wyse Fund and the Cambridge Political Economy Society Trust at the University of Cambridge, and a Vice-Chancellor’s Fellowship at the University of Bristol.

– ref. Why people ignore debt letters – and what it says about inequality today – https://theconversation.com/why-people-ignore-debt-letters-and-what-it-says-about-inequality-today-256293

Source: The Conversation – UK – By Faek Menla Ali, Associate Professor in Finance, University of Sussex

More than a decade of devastating conflict has left Syria’s economy in tatters, its infrastructure in ruins and its population deeply fragmented. The fledgling transitional government in Damascus, which came to power following a lightning rebel offensive in December 2024, often speaks of a “new Syria”. But the pressing question remains: how long will recovery take?

The numbers are stark. In 2011, the year war broke out, the World Bank estimated Syria’s GDP at around US$67.5 billion (£50.7 billion). Its most recent estimate, for 2023, puts GDP at US$20 billion – a drop of more than 70%. And these figures don’t tell the whole story. Inflation and currency collapse make it difficult to compare over time.

Some organisations offer rough inflation estimates for Syria, but these are obscured by currency depreciation. The Syrian pound has lost more than 99.5% of its value against the US dollar since 2011, falling from 50 pounds per dollar to around 10,375 pounds per dollar today. This severe depreciation distorts the real domestic price picture.

To get a better sense of on-the-ground price trends, I recently conducted an informal survey of non-tradable goods and services across Syria. It included things like rent, haircuts and private clinic fees. The results of this exploratory approach suggest that, in US dollar terms, prices for such items have risen by about 50% since 2010.

In other words, inflation in Syria has been real and significant – not just a side effect of exchange rate collapse. Patterns varied sharply across the country. While prices have increased in areas of relative stability and refuge, they stagnated or declined in cities devastated by war.

With this inflation adjustment, I estimate that Syria’s real GDP in 2024 – measured in constant 2010 US dollars – is closer to US$13.3 billion, an 80% drop from its pre-war level. This figure more accurately reflects the economy’s actual performance, including wellbeing, living standards and productivity.

To put this figure in context, Syria’s GDP would now be around US$121.3 billion – excluding the anomalous pandemic year – had the economy continued growing at its pre-war average of 5% per year. The gap between this counterfactual and current output reflects the immense toll of the war.

Rebuilding Syria’s economy will be a monumental challenge. At a high growth rate of 7% per year, it would still take over 30 years for Syria to catch up to its pre-war trajectory. Even with exceptionally strong growth of 10%, the process would stretch over two decades.

Jump-starting growth

The causes of Syria’s economic collapse are well known. The war resulted in the destruction of much of its physical capital, the displacement of labour, the erosion of institutions and the imposition of sweeping international sanctions.

Some US and EU sanctions have been eased. But this alone won’t be enough to reverse Syria’s economic decline. Meanwhile, the Trump administration in the US has announced 41% tariffs on Syrian imports, hindering future trade with the US.

The Syrian government is betting heavily on foreign direct investment (FDI) to jump-start growth. This approach comes with risks. In weakly regulated markets, FDI can raise both operating and consumer costs – particularly in monopolistic or oligopolistic sectors such as utilities, telecommunications and ports. This may contribute to rising inflation and worsening inequality.

Syria’s pre-war economic model, which was characterised by crony capitalism and limited competition, raises further concerns about whether FDI will genuinely broaden opportunity or simply entrench existing elites. Without transparent policy frameworks, there is a danger that liberalisation could crowd out local firms, undermine capacity building and fail to diversify the economy.

The privatisation of state-owned enterprises in Syria is already underway, though the future of the social safety net remains unclear. Greater openness may attract capital and expertise, but it will also expose Syria to global market volatility. This is an unfamiliar dynamic for a country that has long been insulated.

The critical question is whether the Syrian government’s strategy can generate an export-driven recovery. A stronger current account and healthier foreign currency reserves would boost the capacity of Syria’s economy to withstand future economic shocks.

Agriculture, once a major contributor to GDP, should be a policy priority. So too should revitalising Syria’s once-globally competitive manufacturing sectors, such as the textile industry in Aleppo.

The oil and gas sector, which historically underpinned fiscal revenues, will also play a key role if stability returns. Other possible growth areas include boosting the tourism sector and positioning Syria as a powerhouse for light manufacturing.

Yet FDI, and the broader surge in capital inflows, cannot deliver financial stability on their own. Many post-conflict countries experience balance-of-payments pressures and renewed economic crises if capital flows are not well managed.

Research on global capital flow dynamics over the past four decades has provided strong evidence of boom-bust cycles in these flows, especially in developing and emerging market economies.

Rebuilding effective institutions, the rule of law and accountability mechanisms in Syria will thus be critical. These are essential not only to attract investment, but also to prevent the corruption and rent-seeking that often characterise post-war transitions.

A credible path forward must also include the active mobilisation of Syria’s diaspora – a deep reservoir of capital, skills and entrepreneurial energy. Approximately 400,000 Syrians have returned from neighbouring countries since December 2024, most from Turkey. This has included a handful of prominent businessmen.

A final point is that any sustainable recovery depends on political inclusion, especially given Syria’s ethnic and religious diversity. Economies that embrace pluralism tend to be more resilient and prosperous. Long-term prosperity will depend not only on sound policies but also on the kind of state Syria chooses to rebuild.

The coming years will be decisive. Syria’s economic trajectory hinges on whether it can strike the right balance between opening to global markets and protecting vulnerable domestic economic sectors from the shocks of rapid liberalisation.

With prudent policymaking, transparent governance and inclusive political solutions, Syria can begin to lay the foundation for long-term economic recovery. Much depends on the choices made in this pivotal chapter.

Faek Menla Ali does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Can Syria rebuild its economy from the ashes of war? – https://theconversation.com/can-syria-rebuild-its-economy-from-the-ashes-of-war-262271

Source: The Conversation – UK – By Tony Milligan, Research Fellow in the Philosophy of Ethics, King’s College London

A sense of distance has always been part of romantic love. The experience of wanting to be with another person often requires separation, if only in the form of days apart for work and travel. Matters become more complicated, however, when that distance is mediated by technology – by dating app swipes, messaging on WhatsApp and FaceTime.

For myself, as a philosopher of love, there is no good reason to say that loving relationships of a mostly remote nature cannot endure – or that physical separation inevitably and eventually destroys love. Much of society’s collective understanding of love suggests this is simply not true. Longing for another human can continue at a distance, even if we want that distance to end.

That said, one of the most familiar uncertainties about romantic love is the fear that it is a drama played out within the self, and that the other person does not care in the same way. When technology mediates contact, this can strengthen familiar forms of scepticism about love – for example, about whether or not the other person is really who they seem to be. We want sincerity and depth of feeling. Not just a pleasing response.

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If I am apart from my wife Suzanne for any length of time, I want our conversations over FaceTime and WhatsApp to be quite different from the interactions that might be possible with an AI girlfriend. I still want a real, tangible person at the other end of the technology, with whom I could share an embrace if only we were together.

In other words, our technologically mediated interactions do not stand alone – they are part of a life which is largely spent together. Location matters, and this is one of the aspects of love that accounts of the philosophy of love are generally bad at understanding (with the possible exception of some of the work on love by Japanese philosophers such as Nishida and Watsuji).

I do not mention shared places at all in my own book on love. Yet they are central to being a couple. People do not typically just want to meet in some random location. We want to be together in a determinate series of places, including our homes. Too much technological mediation can undermine this sense of being somewhere together physically. Being together online is not the same.

Love and its limits

My thought then is not that technologically mediated love cannot endure, but that it becomes something second-rate if there is too much mediation and not enough actual being together in a shared physical place.

This is an unpopular thought for two reasons. First, it involves saying that Plato and a long line of western philosophers have been right: some kinds of love really are better than others. “Better” in the simple and obvious sense that they are geared towards meeting our needs, smoothing out the bad parts of life, and making sure there are also enough high points.

Scientists can see this at a neurophysiological level. Some kinds of love activate the brain’s feel-good attachment and reward networks more than others. Romantic love and parental love activate more of these networks than love for pets, though the latter does trigger a genuine response.

Second, it involves saying that love is not infinitely plastic – it cannot be just anything we want it to be. Romantic love has a social history reaching back at least a couple of thousand years and perhaps a good deal longer. Our few surviving remnants of prehistoric tales deal with loss and longing, played out across the night sky.

Yet love has an even larger history which is shared with other social animals. It is a mark of our creatureliness, our physicality as a special kind of animal. We are not ghosts flitting across the glaciers, embracing only in cyberspace.

Our heavily constructed romantic ideas about what we can mean to one another still depend upon a solid evolutionary foundation of wanting to be somewhere familiar with a special someone – and grieving when this is no longer possible. Dogs do it, chimps do it, and so do we.

And so, if anyone wants to say that a largely remote and mediated relationship can be just as good as being together in shared places, or that a romantic relationship with a holographic anime character can be just as good as a romantic relationship with a real person, then my response is “not for beings like us”.

The fact we are human sets limits to the kinds of love that can work well. As I explore in my research, love is not a democracy. All loves are not equal. There are limits to the ways in which technologies can mediate (or even take the place of) romantic relationships of the most fulfilling sorts.

None of which will stop Suzanne from texting me, or me texting Suzanne, with a suitable range of emojis. And none of which will stop us from video-meeting at every opportunity when we are separated by an ocean or two.

But as we do these things, the promise is always there of a return to the places where we exist physically together. Using technologies when separated by great distances is not a substitute for sharing these places. It is a way of saying that we are coming home.

This article features references to books that have been included for editorial reasons, and may contain links to bookshop.org. If you click on one of the links and go on to buy something from bookshop.org The Conversation UK may earn a commission.

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Tony Milligan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Love in the age of WhatsApp – a philosopher explains how technology reduces the power of a relationship – https://theconversation.com/love-in-the-age-of-whatsapp-a-philosopher-explains-how-technology-reduces-the-power-of-a-relationship-254342