LAmom

SICK OF BEING POOR

It was only yesterday that I said, "There are people in this country who are really not in a position to save up anything.  Every penny they earn is necessary just to keep body and soul together."

It turns out that every penny they earn still isn't enough to keep body and soul together.  The Los Angeles Times tells us that the cost of health insurance for a family of four now exceeds the income of a full-time minimum wage worker.

The study by the Kaiser Family Foundation and Health Research Educational Trust, published each fall before open enrollment season begins, is considered the definitive survey of what coverage will cost workers.

This year the survey found that average annual premiums for family coverage grew more than 9% since last year to $10,880. A minimum wage worker earns $10,712 before taxes.

"What we are seeing is an unraveling of the way we finance healthcare in the United States," said William Custer, director for the Center for Health Services Research at George State University in Atlanta. "It is coming apart at the edges, and those edges are small business and low-wage workers. The levees are breaking."

According to Kaiser, the number of businesses offering health insurance to their workers continues to decline, with just three out of five businesses offering insurance to their workers. That's just 60% in 2005, down from 69% in 2000, the study found. The drop stems almost entirely from small businesses dropping coverage because of cost concerns.

LAdad readily admits that he doesn't like his job at UPS.  He goes to work at 2:00 am and gets all banged up and sore loading parcels onto trucks.  The reason he does it instead of seeking other work is because UPS offers full health coverage for our entire family.  My job offers no health insurance.

"We're in a new universe of healthcare coverage, where it is a commodity only for the wealthy," said Jerry Flanagan, with the Foundation for Taxpayers and Consumer Rights, a Santa Monica consumer rights group.

And yet people want me to believe that every other First World country on this planet is communist because their governments provide universal health care that is paid for through taxation.  And that if the U. S.  tried to follow suit we would end up bankrupt.

HT: Alas.

NAPPTURAL

I've been "napptural" for 20 years now, but I had never heard the word before a few weeks ago.  Here's an informal definition that I lifted from somebody else's blog:

Napptural is a black woman who proudly wears her hair in it's natural curly, coily, or woolly state.

I've been spending an inordinate amount of time now at the newest addition to my list of links: www.nappturality.com, a site for black people who embrace their "nappy" hair.  There are some awesome hairstyles on there that I'll soon be trying, and I'm loving being a part of a whole community of women who are proud of their natural glory, since napptural women often feel very alone in their choices.

For all of us, and especially for women, our appearance plays a big part in how we are judged by others.  Making counter-cultural decisions about what we think is beautiful and how we want to look is not encouraged by mainstream society.  For black women, this becomes a huge issue.  Believing that you look great just the way God made you is very liberating.

For anyone out there who is unclear about what the heck I'm talking about, the continuation of this post explains from the very beginning what it is that the vast majority of black women in America do to their hair, and what it means to be a part of the minority that doesn't.

IGNORE YOUR BODY; JUST TAKE THIS

A new experimental drug is being touted as a possible future treatment for the effects of sleep deprivation.

Researchers at Wake Forest University in Winston-Salem, N.C., say an experimental drug called CX717 temporarily improved performance and reversed the effects of sleep deprivation in the brains of monkeys.

The drug works on a type of brain receptor involved in cell-to-cell communication, boosting the action of the neurotransmitter glutamate.

"In addition to improving performance under normal conditions, the drug restored performance that was impaired after sleep loss," senior researcher Samuel Deadwyler said in a prepared statement.

Um, we already have an effective treatment for the effects of sleep deprivation.  It's called sleep.

A drug that could reverse the effects of sleep deprivation would be regarded by some as a breakthrough in helping health professionals, shift workers, military personnel and others required to function at top level while coping with sleep deficits, the researchers said.

I can imagine a few situations where treating sleep deprivation with a drug could be helpful.  But I think it would end up being used much more to encourage/coerce people to push themselves beyond their healthy biological boundaries.  Rather than work out saner schedules for doctors, nurses, and others, we would just expect them to medicate the problem away.

This is in the same vein as other rants I've made about technological advances.  They have the potential to make things better, but we usually end up demanding more of ourselves because of them.

From another article:

"It's possible that ampakines could also be used to enhance other cognitive deficits, such as occur in Alzheimer's disease, after a stroke or other forms of dementia," Deadwyler said.

That would be cool.  If we chose to mainly use this drug for the treatment of disease, rather than to ignore our natural biological needs, that would demonstrate a lot of wisdom on our part.

GOVERNMENT IN NYC IS TRIMMING THE FAT

From Newsday:

In an effort to fight the city's biggest killer, heart disease, the New York City Department of Health and Mental Hygiene is urging restaurants to voluntarily eliminate trans fats from their menus.

The New York State Restaurant Association will support the effort, Executive Vice President E. Charles Hunt said in a health department release Wednesday.

I like this!  They're not dictating to the restaurants what they can and cannot do, but they are urging them to take this positive action.  Los Angeles County Health Department, will you follow suit?

The NYC Health Department's anti-trans fats page has some links for anyone who wants to learn more about what trans fats are and what they do.

And here's something else I didn't know:

The Food and Drug Administration has already targeted trans fats. Nationwide, all foods containing the chemically modified oils must be labeled beginning January 2006.

Cool!

A SAFE MOTHERHOOD ISSUE: OBSTETRIC FISTULA

One of the items on the United Nations Department of Public Information's 10 Stories the world should hear more about is the problem of obstetric fistula among women in the developing world.

Poverty, malnutrition, poor health services, early marriage and gender discrimination are interlinked root causes of obstetric fistula. Poverty is the main social risk factor because it is associated with early marriage and malnutrition and because poverty reduces a woman's chances of getting timely obstetric care. Because of their low status in many communities, women often lack the power to choose when to start bearing children or where to give birth. Childbearing before the pelvis is fully developed, as well as malnutrition, small stature and general poor health, are contributing physiological factors to obstructed labour. Older women who have delivered many children are at risk as well.

That's from the United Nations Population Fund (UNFPA).  They also mentioned this:

Although FGC [female genital cutting] can increase the risk of haemorrhage and infection during childbirth, it is not clear whether it is typically a causal factor in the formation of fistulas. However, two fairly radical forms of FGC, the Gishiri cut, which is practiced in northern Nigeria, and infibulation, the stitching up of the vagina, can contribute directly to fistulas.

UNFPA has these suggestions for what people can do to help.

REPRODUCTIVE RIGHTS III

This is awful.

Dr. Helen Sandland, an obstetrician in North Carolina, is leaving the hospital where she had been practicing.  The reason?  Hospital administrators were pressuring her to do more cesarean sections.

In the decade she has delivered babies and cared for their mothers in New Hanover County, she [Dr. Sandland] has always had a [C-section] rate below 10 percent.

“I’ve always maintained I’m a midwife with a MD behind my name,” she said from her two-story Pine Valley home last week while preparing to move. “It’s better for Mother Nature to decide when it’s time, not the doctor. My philosophy is you don’t interfere unless you really have to.”

Her philosophy, admittedly different from the mainstream, attracted many patients who wanted the best chance of having a vaginal delivery. Dr. Sandland became known as one of the few doctors in the area who would try to deliver breech babies naturally or pursue a vaginal birth with a woman who already had one child with a c-section. Her solo practice boomed.

If her lack of medical malpractice lawsuits and gratitude of patients are of any account, she was not only popular, but also successful.

Popular and successful.  Bringing business to the hospital and having good birth outcomes.  So what could be the problem?

But the Star-News viewed two letters addressed to her from committee members. Written on New Hanover Regional letterhead dated July 6 and July 7, 2004, the letters discuss the conversation committee members had with her.

The first letter, written by Dr. Cobern Peterson, chairman of the Professional Review Committee, stated “concerns” regarding her practice. They include higher than average infant birth weights, much lower than average c-section rates and later than average gestational age of neonates at delivery.

None of these concerns actually pose any danger to mothers or babies.  They didn't say that babies were being born with postmaturity syndrome or symptoms of hyperglycemia.  They said the babies weigh more than the other babies in the hospital and are older at birth (probably because she's not inducing labor before the baby is really ready to be born), and more mothers are successful at having normal vaginal births.

The letter states “the main concern reiterated several times was an overall practice attitude rather than any individual case.”

In other words, nobody has been harmed, they just don't like the way she does births.

The next letter, written by Dr. Janelle Rhyne, acting chairman of the Credentials Committee, states Dr. Sandland’s privileges at the hospital would be reappointed for a period of six months but monitoring would continue.

It reads, “Your c-section rate is to be within an acceptable range as determined by the NHRMC OB/GYN Department with a plus or minus deviation of two.”

(. . .)

The c-section rate at New Hanover Regional is 27.9 percent. At the time, Dr. Sandland said, it was about 26 percent. That meant the committee was requiring her to reach at least a 20 percent c-section rate. To do so, she’d have to more than double her current rate.

If her patient's are having good birth outcomes, that means that her current c-section rate of 10% has worked adequately to make c-sections available to the mothers who actually need them.  So to double her rate, for each woman who she sections because it's necessary, Dr. Sandland would have to do another section that's not necessary.

Why are they giving her this quota to reach?

“Barto said in a separate meeting that a c-section rate of 25 percent would reduce the likelihood of getting sued,” she recalled.

(. . .)

Other times, especially when the unit was overrun with laboring moms, she said, there was pressure from department heads to speed up labor or consider a c-section.

“Quite a lot of c-sections are being done for so-called failure to progress,” Dr. Sandland said. “If you haven’t progressed in a couple of hours, a c-section’s waiting. There’s certainly a pressure to keep patients moving on through.”

I definitely heard that sentiment when I was working as a Labor & Delivery nurse at King/Drew.  They didn't do a whole lot of cesarean sections, but they would take other steps to speed up a woman's labor because "we need to get the bed empty."

Consumer watch dog group Public Citizen has estimated that half of cesarean sections are unnecessary and result in 25,000 serious infections, 1.1 million extra hospital days and cost more than $1 billion each year.

(. . .)

“We are going to see an increase in morbidity and mortality for the mothers,” she said, explaining how the first and even second c-sections are fairly risk-free but then scar tissue builds up and increases the surgery’s risk.

“Every subsequent cesarean section, the risk of a woman ending up with a severe hemorrhage, losing her uterus or ending up dying goes up,” she said.

There is a trend these days for some women to choose elective c-sections rather than give birth normally.  But Dr. Sandland's patients were coming to her specifically because they wanted to have natural births.  This hospital wanted Dr. Sandland to disregard both her patient's desires and their best health interests and start slicing more of them open.  She refused to compromise and is leaving the hospital and moving to another state.

Too bad for the women of North Carolina.

MORE ON PREGNANCY EQUALITY

I've said many times that childbearing should be covered by something similar to the Americans with Disabilities Act.

But not in the sense that a normal, low-risk pregnancy should be considered a disability.  Some say that our culture considers the male body to be the standard for "normal" physical functioning, and that any deviation from that is treated like a disease.  Pregnancy is not a disease.  Pregnancy is a normal human state.  Any setting that accommodates people should be able to accommodate pregnant people and their needs.

In my work as a midwife, I've heard far too many stories of women having to deal with situations that did not enable them to take good care of themselves or their babies.

For example, in the workplace the one right that women have won is the right to go on disability and stop working.  These pregnancy guidelines from the University of Michigan Health System give examples of situations where a woman might need to quit her job:

• If you have a job that requires standing for a long time, you may need to stop working as early as 24 weeks into the pregnancy.  When you stop depends on how long you are required to be on your feet, if you can take rest breaks and put your feet up, and on your medical history.

• Stooping and bending below knee level can be a problem.  If this is part of your job, you may have to stop working as early as 20 weeks into the pregnancy.

But how about the right to be able to continue working instead?  I really think that a lot of jobs that "require" standing and bending could be adapted to accommodate the needs of pregnant women.  Plenty of jobs that are done standing could be done sitting on a stool.

Other things that women need at work include:

• Adequate bathroom breaks and bathroom access.  Women have told me that they were limiting their fluid intake (bad bad bad!) because the only available bathroom was so far away.

• Opportunities to eat a snack between meals.

• A place where they can take a quick nap during their break time.

• Support for breastfeeding and breast pumping for new mothers.

• Flexibility in work schedules for new mothers.

I'm sure there are more.  And don't get me started about issues like the right to breastfeed in public.

Anyway, I want to hear from women about their experiences with inhospitable workplaces, schools, colleges, and other public facilities.  Tell me your stories and let's talk about how the situation can be improved.

Please leave your stories in the comments here.  Spread the word!

RESEARCH ON EMERGENCY CONTRACEPTION

One of the big questions about hormonal post-coital contraception has been, "How does it really work?".  This is a big deal to pro-lifers because whether something prevents the egg and sperm from meeting or whether it blocks a fertilized egg from attaching to the uterus and being nourished is a life-and-death difference.

The Population Council has published the results of animal and human studies that concluded that emergency contraception acts by hindering ovulation long enough for all the sperms to die off, therefore preventing fertilization.  It appears from these studies that EC had no effect if ovulation had already occurred.  So women who have already ovulated will still end up getting pregnant at the same rates whether they take EC or not.

I haven't seen any other research that looks in this much detail at the physiological effects of EC, so I don't have anything else to compare this to.  But from the looks of this, it appears that we can look at EC as a viable, non-violent means of contraception.

MENINGOCOCCUS AND PREGNANCY

Research in Holland finds an increased risk of meningococcal infection in children when their mothers are pregnant.

The theory is that pregnant women are a bit immuno-compromised. Their immunity's a bit less than other women of the same age. The reason that their immunity's down a little bit is that they don't want to reject the foetus.

In doing so, they become a little bit susceptible to other infections, and it's possible that they, if they get the meningococcus it's more likely to get a foothold – in their nose – and it's more likely that they would have lots of organisms there, so they might be more infectious.

I never thought that a woman's pregnancy could have such a direct effect on the health of her other children.  So it behooves us moms to make sure that during pregnancy we support our kids with the best nutrition we can in order to maximize their immune systems, promote good hygeine, and watch with even more care for signs of illness.

POLITICAL CORRECTNESS AND THE PILL

This article about hormone replacement therapy and endometrial cancer reminds me again of how much I dislike the idea of healthy women taking hormones.  I forget it sometimes because I spend a lot of time these days telling people that being pro-life does not mean I want to deny women access to contraception.

I had a discussion once with Cathleen that actually sensibly explained why Catholics might consider the pill to be an abortifacient while most Protestants don't.  But as much as I advocate for women to have access to the pill and health insurance coverage for it, my personal feelings about the pill are more in line with the views of Dr. Christiane Northrup:

But these are all made from synthetic hormones. It's the same stuff that we found didn't work so well in the women's health initiative.

(. . .)

Ideally, women would value their bodies so much that they would say to any prospective sexual partner, "I don't want to be on the pill. I don't like what this does to me. If you value your relationship with me you will use a condom." Also, one of the problems with the pill is it can decrease libido, and it puts you out of touch with your lunar cycle. Instead, you get in touch with the cycle of the pharmaceutical company! It kind of puts your pelvis to sleep for a while.

I completely support the right of women to use hormonal contraception.  When I worked in the gynecologist's office, I wrote pill prescriptions.  But I would never put that stuff in my own body, and I think most women would be better off using barrier methods.

Can people read this and understand that it's an opinion about a health issue and not a moral or legal principle?