Monthly Archives: January 2010

Update on the Tebow ad

Since I posted about the Tim Tebow anti-choice Scrutinize Your Focus on the Family ad that is scheduled to air during the Super Bowl, I have found out some more disturbing information.

Mrs. Tebow claims that she was told to get an abortion while pregnant in the Philippines, where she and her husband do missionary work. In fact, they run an orphanage there. But, abortion is and has been illegal in the Philippines. Making abortion illegal does not reduce abortions. It just makes them more deadly.

According to this UN Humanitarian Affairs report:

there are an estimated 560,000 cases of induced abortions per year, resulting in some 90,000 women being hospitalised for post-abortion care; and about 1,000 deaths a year in the island nation.

Most of these women are already mothers. Their children are much more likely to die before the age of 12 without a mother. It also makes them more likely to need to go to an orphanage. Like the one the Tebows run, out of the kindness of their Christian hearts.

But, it is the Christian religion* that is contributing to the orphan problem in the Philippines. According to this 2006 Guttmacher report (pdf) on Unintended Pregnancy and Induced Abortion in the Philippines:

At the same time, weak government support for modern contraception and the insistence of the Catholic Church on natural family planning methods contribute to low levels of modern contraceptive use and persistent reliance on less effective methods. Many women use no family planning method at all.

I am all about the middle ground on this issue. I don’t have a problem, like some reproductive rights activists do, with saying I want abortion to be rare. I know it’s hard to discuss something with nuance, but that doesn’t necessarily say it’s because it’s an evil procedure. Unintended pregnancy is the problem. No one wants to be in that situation. The only way to prevent it, experts say in so many places I won’t even bother to link it, is by increasing the autonomy of the women in the community: access to affordable effective contraception and abortion without shame, education, microloans, and the like.

Making abortion illegal and letting them die, bleeding in the hallways of hospitals or in their beds, surrounding by their surviving children, is not pro-life. How can members of the same party who houses Lt. Gov. Andre Bauer, also align themselves with groups like Focus on the Family? The supporters of this ad, Focus on the Family and their socially conservative hardline choir, think talking about the poor as breeding stray animals who don’t know any better with unconcealed contempt is compatible with calling the birth control and the IUD “a chemical assault and destruction of some unborn?”.

Let’s reduce abortions, spontaneous or medical. Let’s reduce death. Let’s reduce the number of orphaned children. Let’s prevent unintended and intended pregnancy losses. Effective, affordable contraception is the best way to do this.

*I am not anti Christianity, nor anti all Christians. My family is all quite religious, most of them practicing that religion as pro-life, socially conservative Presbyterians. We don’t see eye to eye on this issue. I was tipped off about the disconnect between Mrs. Tebow’s claims and the reality of reproductive care and maternal mortality by someone who went to Catholic school with my husband. I am off to a celebration of a Catholic christening today of a boy at whose birth I was the doula.

Religion, to me, is personal. That is why I support conscience clauses for health care practitioners, and (edited to correct major typo!) STRONGLY OPPOSE one-child only laws, and forced abortions or forced sterilizations. But, when it comes to maternal mortality and public health, I don’t think religion has a place in the discussion. Any group that would worship a god that thinks maternal mortality isn’t a higher priority than their rules about sex and reproduction isn’t someone I want at the table. They can preach to their choir all they want, and people can choose to observe in the way that is right between them and their deity(ies) of choice, or lack thereof.

TAKE ACTION:

Go to Emily’s List and sign their petition. This is what I wrote in the comment section:

1000 women died in the Philippines (where Tim Tebow was born, and his family does missionary work) in 2008 alone due to the unavailability of safe, legal abortion.

How many of the orphans at the Tebow’s orphanage had moms who died from the lack of contraception and legal, safe abortion there?

This is not something worth breaking your non controversy Super Bowl ad over.

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Blog for Choice

I missed Blog for Choice day this year. Rachel has a great round up at Women’s Health News. The research team I am doing my fellowship had a grant application due today. I rocked the references. We had some long days, and it finally was finished yesterday afternoon.

On to the choice stuff. I am of course extremely annoyed about this Tim Tebow Focus on the Family Super Bowl commercial nonsense. NPR reports that CBS has made an announcement in defense of accepting the ad, which, based on an anecdote about Tebow’s mother refusing a medically recommended abortion when she had amoebic dysentary and ending up with a Heisman trophy winner, encourages people to ignore medical advice during pregnancy when they take teratogenic medications. Or is just about a mom lovin’ her son, depending on who is telling you about the ad.

CBS has refused to take Super Bowl ads they have deemed too controversial in the past from the likes of MoveOn.org, PETA, and the United Church of Christ, who were simply stating that they were inclusive to everyone. Now that the Tebow Focus on the Family ad is causing an uproar, CBS has announced oh, by the way, did we mention we have changed that policy? Coincidentally, right before FOTF approached them, I suppose.

I took the Redhead’s advice (hat tip to SharkFu) and made a donation to Planned Parenthood. I also threw some money at Medical Students for Choice, a group of which I am a proud member. Please join me as part of the backlash to this nonsense.

I trust women. I trust Tim Tebow’s mother to make her own choice about her pregnancy, and I trust all women to have that choice, too. Even if they come to a different decision than she would. I also hate that this anti-choice advocacy totally ignores all of the women (and mothers! and their children!) who die every year due to illegal abortion. Here is my blog for choice day post from last year if you mistakenly believe that anti-choice laws don’t kill mothers and their children, or other myths about abortion.

If you can’t afford to give money, consider installing the GoodSearch toolbar on your browser, and your searches will earn money for Medical Students for Choice.

I am having a Beatles Rock Band party during the Super Bowl. My hubby will have the game on in the living room, but I will be in the back room doing the Beatles thing. And making and serving food. I hope to miss the Tebow commercial. And any commercial with farting horses.

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Howard Zinn died

The world is a better place because he was in it. And not just because he drove Matt Damon to elementary school.

You can find the full text to the People’s History of the United States here.

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Reply turned post, human incubator style

This is a comment I made on Melissa’s awesome Anti-Choice Gone Wild post at Shakesville, one of many posts and news reports about Samantha Burton, the Florida woman who was court ordered to comply with bed rest in a hospital against her wishes, and then was forced into a cesarean section for a baby that ended up as a fetal demise. (I think I read about it at the Unnecessarean first.)

Well, one Mommy wars frontliner decided to say this in the comments:

Umm…according to the excerpt, Burton didn’t want to leave in order to seek a second opinion or transfer to another hospital – she just wanted to *leave* the hospital. It sounds like she changed her story after the fact to imply that she just didn’t like the care she was receiving at TMH. And then she claims, “I was desperately hoping to receive the care I needed to save my baby,” turning her own miscarriage into a sleazy emotional appeal, when she had no intention of going to another hospital and obviously cared shit-all for her “baby” (I don’t consider it a baby till it’s born) since she’d been smoking through the entire pregnancy. Newsflash Burton: you -were- receiving the care you needed – unfortunately, it just wasn’t enough.

It’s actually terrible that this is going to be the test case for the court, because there was no need to appeal to her pregnancy *whatsoever*. Her health was in danger, she refused to follow her doctor’s advice, the doctor appealed to the court, the court ruled that her decision was unsound, THE END. Why did the judge have to bring up the fetus? It’s totally irrelevant.

But these slippery slope arguments are just paranoid, people. The doctors aren’t out to get us and our dubious rights to “privacy, stupidity, and non-abusive terrible parenting.”

Here is my reply:

@TiPerihelion,

Her health was NOT in danger, she had signs of preterm labor. The fetus was in danger of preterm delivery. (Which, by the way, is not the same thing as fetal demise (aka stillbirth), which is what ended up happening, or a miscarriage, which is a loss before 20 weeks. She was past 20 weeks. Fact check before offering strong opinions. The baby was delivered by a forced c section. She didn’t have preterm delivery due to labor, or a miscarriage.) 8 to 10% of all pregnancies in the United States end with premature delivery. Do you think all of these women are required to be on bed rest in the hospital? Bed rest is not proven to prevent pregnancy loss, and was not practical nor desirable for this woman.

Only 20% of women who smoke quit when they are pregnant. 18% of women in the United States are smokers, and half of all pregnancies are unplanned. It’s an addiction, I don’t know if you have heard. Just how many mothers are you trying to say care “shit-all” about their babies? 1 in 6 mothers?

We all have our priorities. Exercise has also been associated with pregnancy loss. I wonder what you think of women who are selfish enough to take epilepsy meds.

I was training as a midwife, and the second birth I observed was a mom who was pregnant with her third child. She had her other two children with her, an eight year old and a two year old. She was smoking and drinking Cuban coffee during her labor. The father of the children was in prison. Her step mother and mother in law were there, chain smoking and drinking Cuban coffee on the patio of the birth center, stopping every now and then to try and take a swat at one of her kids if they ventured outside.

When I saw her have a cigarette, I grabbed the midwife and said “How can you let her smoke?!” She said, “This is her third pregnancy, and she’s in labor. Do you really think she’s going to quit right now?”

When we asked her if she had anyone to help her with her very demanding children while she was in labor, she said no. By the looks of the women outside, I understood. She said the family bed was going to get crowded once she, both of the other kids, and the new baby were all in it. They all would be sharing one room. I saw her change her wriggling two year old’s diaper at 8 cm dilation, then give birth within half an hour, supported by her brother. When I hear women say they “can’t” deliver without an epidural (not that there is anything wrong with choosing it electively, but it’s not a “can or cannot” issue), I always think of this woman.

Don’t you dare say she didn’t care shit-all about her kids.

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My big fat reading list

I keep on accumulating things I am reading that I wanted to talk about. Well, it has turned into a link fest. So, here’s my linkaround for the week, mostly journal club style:

Maternal Obesity and Breast-feeding Practices Among White and Black Women (pdf) and abstract. I had many problems with this article. First of all, the associations seemed really inconclusive. I would have preferred this data looked at through another lens, not obesity, but, since it was published in Obesity, I guess that was the point. The only association in any of the groups with BMI and breastfeeding was in the very obese, and that was only in white women. How is this an examination of race and BMI, except to show there WASN’T much of an association. I am also dismayed but not surprised at the higher cesarean rate among overweight and obese women. And, considering those higher cesarean rates, why did the adjusted hazard ratio NOT adjust for mode of delivery, when cesarean section has (in some research, not all) been associated with less initiation and success in breastfeeding? They adjusted for: mothers’ age, education, marital status at birth or during the pregnancy, Medicaid status, and pregnancy complications; parity; and first trimester initiation of prenatal care, but not mode of delivery.

What the data (not the discussion) highlighted was the racial disparity, not much about obesity and breastfeeding, and doesn’t offer much in the way of offering solutions or explanations as to why black women have such poorer rates of breastfeeding initiation.

Also from Obesity, BMI and Mortality: Results From a National Longitudinal Study of Canadian Adults.

Although a clear risk of mortality is associated with obesity, the risk of mortality associated with overweight is equivocal. The objective of this study is to estimate the relationship between BMI and all-cause mortality in a nationally representative sample of Canadian adults. A sample of 11,326 respondents aged ≥25 in the 1994/1995 National Population Health Survey (Canada) was studied using Cox proportional hazards models. A significant increased risk of mortality over the 12 years of follow-up was observed for underweight (BMI <18.5; relative risk (RR) = 1.73, P 35; RR = 1.36, P <0.05). Overweight (BMI 25 to <30) was associated with a significantly decreased risk of death (RR = 0.83, P 0.05). Our results are similar to those from other recent studies, confirming that underweight and obesity class II+ are clear risk factors for mortality, and showing that when compared to the acceptable BMI category, overweight appears to be protective against mortality. Obesity class I was not associated with an increased risk of mortality.

Emphasis mine. As someone in the obesity class I, I am feeling a lot of harumphing about this right now. I am waiting to hear all the criticism of underweight people (not that I would or I want it) from the peanut gallery, and the admission that overweight and mild obesity isn’t going to kill us all with the fat. I want a big fat apology to Dr. Regina Benjamin. (Commenting note: Please notice I never said appropriate exercise or a healthy-for-you diet were bad. That is not the topic. The topic is whether overweight and obesity deserves the constant, relentless public shaming and association with lack of health that it does).

And, just to be balanced, CNN has some information on why being overweight may negatively affect your health: provider bias. Yes, I also agree that some diagnostic tests and techniques like a manual pelvic exam or Leopold’s maneuver can be more difficult with more tissue there. But, the misdiagnosing and over testing (and over sectioning) of overweight and obese women is due to provider bias as much as testing and maneuvering fail. (Hat tip to Shakesville for that last one).

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I write letters, White House Style

I wrote a letter to the president:

Health care reform can still pass, and the Democratic image can be regained after this Massachusetts election fiasco.

I would consider scrapping what you have, and throw a curve ball to take over the news cycle from the Republicans.

Pass a simple bill (through reconciliation) that expands Medicare to people 50 and over and 20 and under. Write simple rules for the insurance companies that cover what’s left: 1. no denial of preexisting conditions. 2. At least 90% of premiums have to go to health care. 3. No denial of pregnancy or birth control coverage, or unfair treatment of women.

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Captain Morgan is following me!


I went to a benefit at a local bar / restaurant / venue today. A good friend of mine was playing music at the benefit, so I made a rare appearance at a social event.

Anyway, I was thrilled that the one time I went to a bar, which happened to be the day after my Captain Morgan maneuver thread, there was a life sized Captain Morgan statue. Of course, I had to pose as if I was ready to catch.

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The Captain Morgan maneuver


I mentioned that a midwife friend of mine described using a foot-on-a-chair technique to resolve a shoulder dystocia during a homebirth. This was after they had already tried the Gaskin manuever (or, the woman had already been on her hands and knees. Not sure if she was flipped from lithotomy to hands and knees, which is what I understand the Gaskin maneuver to be).

I nicknamed it “the Captain Morgan maneuver”, much to my commenters’ glee. Has anyone else heard of or experienced an upright delivery with a foot elevated?

ETA: Jill said it first, here in her birth story.

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I don’t want my tax dollars to support _________

Reason #6.02 x 10^23 I love Jay Smooth:

Hat tip and transcript at Feministe.

I am so sick of people thinking if they don’t support something, they are so special that no one gets it. The same people who are so quick to call Obama a fascist or a socialist also seem to think there should be a dictatorship based on their own likes and dislikes, regardless of the law or the desire of the rest of their fellow citizens.

I thinking of coming up with my own video.

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New Lancet study on method of delivery

The Lancet just published an article entitled “Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007—08″. Here’s the conclusion:

Findings
We obtained data for 109 101 of 112 152 deliveries reported in 122 recruited facilities (97% coverage), and analysed 107 950 deliveries. The overall rate of caesarean section was 27·3% (n=29 428) and of operative vaginal delivery was 3·2% (n=3465). Risk of maternal mortality and morbidity index (at least one of: maternal mortality, admission to intensive care unit [ICU], blood transfusion, hysterectomy, or internal iliac artery ligation) was increased for operative vaginal delivery (adjusted odds ratio 2·1, 95% CI 1·7—2·6) and all types of caesarean section (antepartum without indication 2·7, 1·4—5·5; antepartum with indication 10·6, 9·3—12·0; intrapartum without indication 14·2, 9·8—20·7; intrapartum with indication 14·5, 13·2—16·0). For breech presentation, caesarean section, either antepartum (0·2, 0·1—0·3) or intrapartum (0·3, 0·2—0·4), was associated with improved perinatal outcomes, but also with increased risk of stay in neonatal ICU (2·0, 1·1—3·6; and 2·1, 1·2—3·7, respectively).
Interpretation
To improve maternal and perinatal outcomes, caesarean section should be done only when there is a medical indication.

Haven’t read the full text yet, but I will.

(Hat tip, Pushed Birth)

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