A majority of South Africans agrees that when science and religion conflict, religion is always right. Is this an indication the public is anti-science or does the question wording hide a more complex relationship? We examined the relationship between science and religion in South Africa using quantitative data from the World Values Survey and qualitative data from face-to-face interviews. As research on the potential conflict between science and religion is predominantly focused on Western countries, the present study focuses on Africa (...) and compares results with those of two Western countries. Findings show that almost 76% South Africans agree that religion is always right and religious belief, social trust and education were significant predictors of this perception. Comparing findings with data from Zimbabwe, the United States and Germany, we found that while the influence of religiosity is significant across countries, comparatively, trust seems to be more of an African issue. The qualitative interviews, however, provided an elaboration of the relationship between science and religion in South Africa, indicating that choosing either science or religion is not always an outright rejection of the other. The relationships were classified as those informed by cognitive dissonance, often expressed in hierarchical associations, and those influenced by cognitive polyphasia, a complementary and transformative coexistence. (shrink)

Background: Little is known about U.S. healthcare provider views and practices regarding evidence, counseling, and shared decision-making about in-hospital versus out-of-hospital birth settings. Methods: We conducted 19 in-depth, semistructured, qualitative interviews of eight obstetricians, eight midwives, and three pediatricians from across the United States. Interviews explored healthcare providers’ interpretation of the current evidence and their personal and professional experiences with childbirth within the existing medical, ethical, and legal context in the United States. Results: Themes emerged concerning risks and benefits, decision-making, (...) and patient-provider power dynamics. Collectively, the narratives illuminated fundamental ideological tensions between in- and out-of-hospital providers arising from divergent assignment of value to described risks and benefits. The majority of physicians focused on U.S.-specific data demonstrating increased neonatal morbidity and mortality associated with delayed access to hospital-based interventions, thereby justifying hospital birth as the standard of care. By contrast, midwives emphasized data demonstrating fewer interventions and superior maternal and neonatal outcomes in high-income European countries, where out-of-hospital birth is more common for low-risk birthing people. A key gap in counseling was revealed, as no interviewees offered anticipatory counseling regarding birth setting options. Providers directly and indirectly illustrated the propensity for asymmetric power relations between birth providers and pregnant people, especially in hospital settings. Conclusions: The narratives highlight the common goal of optimizing maternal and neonatal outcomes despite tensions arising from divergent prioritization of specific maternal and neonatal risks. Our findings suggest opportunities to foster collaboration and optimize outcomes via mutual respect and improved integration of care. (shrink)