Fun times at ACOG

Hi! I missed you, blog!

My hotel left a lot to be desired, and it charged an exorbitant fee for internet access. I survived the weekend with phone internet access only! *Twitch twitch*

I am still up to my eyeballs in things to get done. So, this will be a brief update.

I met Dr. Berghella, of the USPSTF Evidence-based labor and delivery management (pdf) report on which I based my research project. He gave an amazing presentation on cervical insufficiency. When I spoke to him afterward about my project investigating why many physicians seem to not follow evidence based standards of care when it comes to labor and delivery intervention practice patterns, he said, “It makes my blood boil.” I wanted to give him a high five!

I met the author of What To Expect When You’re Expecting. I read it when I was pregnant with my first son. I wasn’t as alarmed by it as many birth activists tend to be. Then again, I wasn’t a birth activist when I read it, just a clueless first time pregnant person who was lucky her CNM only pitted her, hooked her up to the continuous EFM and made her push for hours with an anterior cervical lip while flat on my back. (Do I sound bitter?) Luckily, I didn’t get an episiotomy or anything worse, but I certainly wasn’t well informed about the interventions I received or could have received. Looking back at what I know now, I think it was certainly over-the-top about certain things (like diet, and mother blaming of food choices), and wasn’t the best resource when it came to information about actual labor and delivery, or options such as out of hospital birth. I’m glad there are a lot more books and resources available now than there were 12 years ago.

I met Dr. Fogelson from Academic Ob/Gyn. At his event, I met the physicians behind Girlology, who are great. I also met Dr. Jody Steinauer, founder of Medical Students for Choice, who is even cooler in person than on paper.

I met with some programs at the residency fair. The residency director for OHSU said she thought I would be a “good fit”. (Squeal!) I also met with a resident from University of Washington, among representatives from other programs.

The highlight among highlights was an event sponsored by Bayer celebrating the 50th anniversary of the oral birth control pill. Gloria Steinem appeared via satellite, and Dr. Sandra Carson and Dr. Joycelyn Elders spoke in person.

Here is a picture of my fellow medical students and I with Dr. Joycelyn Elders. Double squeal!!

Me, Dr. Elders, and friends

Me, Dr. Elders, and friends

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30 Comments

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30 responses to “Fun times at ACOG

  1. SQUEEE!!!! so exciting and cool about everything!

  2. I was clueless enough, with my first delivery, to get the episiotomy. Glad you avoided it.

    You know where Jocelyn is from, don’t you? Go Arkansas!!!

    • MomTFH

      She showed pictures of growing up in Arkansas. It clicked for me because it must have been an extra connection between her and Bill Clinton.

  3. Love it! (the picture, that is)

  4. There is clueless but the other side of the coin is know-it-all which actually is clueless because they know everything so that no more information can pass into their neurons. As a nurse I was more comfortable with the clueless type because they were less likely to blame sh1t on me that was not my fault. I am happy to take responsibility for stuff that is my fault but who wants to take responsibility when their is a bad outcome? All of a sudden the informed woman tells us how uninformed she is. Oh no, I think I am feeling a bit bitter today. Must work on anger issues. Enjoy your blog, keep on keeping on.

    • MomTFH

      I think someone who is convinced and adamant can still be (and may be more likely to be) working on faith than information, and is not truly informed. But, especially when talking about a condition like postpartum depression, I think it’s good to know there are lots of others, and not to feel marginalized and alone.

  5. Jasmine

    Cool, I also met Dr. Jody Steinauer, her friend delivered one of my babies and aborted the other. My fetus was 24 weeks but I just didn’t feel like having another child. Ah, thank god for choice.

    • MomTFH

      I am a little confused about whether your post is in earnest, but I am going to give you the benefit of the doubt.

      24 weeks or viability is the legal cut off for abortion in most states, but it is difficult to find a provider that will do a first trimester abortion, much less a second or third. Less than 1.5% of all abortions in the United States happen after 21 weeks, and those few that do happen are usually in teens, including victims of abuse, impoverished women who had to raise money, rural women who had to arrange travel, and all of these problems are exacerbated by laws requiring waiting periods.

      Or, these are women who were pressured or threatened by people in their lives. Finally, there are the women who desperately want a healthy baby, but have cancer, or have a fetus with a malformation that is incompatible with life.

      It would be really, really an uncommon scenario for someone, especially a mother (although 61% of women who get abortions already have a child to raise) to wait until the last point in a pregnancy, where the procedure is more challenging, more expensive, harder to arrange (most practitioners won’t go near a 24 week termination), and they would have already been showing and feeling the fetal movements.

      If I didn’t know better, I would say you were trying to demonize 1/3 of women. Women do get elective terminations. They just usually don’t wait until 24 weeks, and it would be very unlikely a practitioner would agree under those circumstances.

      If you are interested in learning more about abortion, Guttmacher Institute has some really reliable information.

  6. Jasmine

    Hi MomTFH,

    I’m not trying to demonize anybody, I’m glad they are providing this important service. Yes, there are doctors who will perform elective abortions at 24 weeks, and why not? It’s my right to bodily autonomy. Remember, 1.5% of abortions per year is ~ 20,000 at 1.3 million abortion in the U.S., certainly many of these are elective and there is nothing wrong with it.

    • MomTFH

      No, there is nothing wrong with legal abortion before viability, for elective reasons or medical reasons. I think women are better served if we try to decrease delay in seeking terminations. This study shows some of the barriers that lead women to seek second trimester abortions, and they include many of the issues I mentioned.

      I am not sure if any of these barriers, such as fear and having to travel to find an abortion provider applied to you. If so, I am sorry.

      I think bodily autonomy is relevant in that I don’t think anyone should be forced to carry a pregnancy to viability and birth against their will. I do think abortion rates could be decreased by access to appropriate education and contraception, and those 1.5% of 21 week + abortions could be affected by increasing access to abortion in the 87% of counties in the United States without an abortion provider, decreasing ideological intimidation and demonization of women who terminate, reduction of restrictive laws on getting a timely abortion, and Medicaid funding for abortion.

      Of course, a large amount of these procedures are done for anomalies or other medical reasons, so those would not be eliminated by these means.

  7. Jasmine

    I had no barriers in obtaining my abortion.

    “I do think abortion rates could be decreased by access to appropriate education and contraception”

    why should abortion rates be decreased?

    A woman owns her body during the entire pregnancy. She does not cease to own her body after the second trimester, seventh month, or whatever line one wishes to draw. She owns her body once that line is crossed, just as she did before that line was crossed. If the justification for abortion is that a woman owns her body, and she owns her body during the entire pregnancy, then to forbid her to choose an abortion at any time during that pregnancy is to violate her bodily autonomy. If she wishes to rid her body of the child, she can do so whenever, and however she wants to—that is, if bodily autonomy is an absolute right. But if her bodily autonomy can be denied when week X arrives, then clearly the right to bodily autonomy is not absolute

    • MomTFH

      Not everyone agrees about bodily autonomy being the only factor involved in this discussion, or that any bioethical principles are absolute. I don’t. Bodily autonomy is extremely important, but not absolute. Prostitution is illegal in this country (not that I necessarily think this is effective or ethical.) One cannot slash ones wrists in public without being restrained and committed.

      Ethics is more complicated than that. I am not sure if you are trying to set up a straw man argument.

      My argument for the support of abortion lies in humanistic concerns about reproductive rights and maternal death in general. It is actually the opposite of online debate on how absolute one bioethical justification is for abortion. It is acknowledging the reality of women’s lives – that they can be trusted to judiciously use birth control if it is accessible and affordable. That the 50% unplanned pregnancy rate and 22% abortion rate is not what women would choose if they had true free choice in this country. I think abortion is one reasonable health decision when faced with unplanned pregnancy or a pregnancy with medical complications, but that does not mean that I do not also want to decrease unplanned pregnancy or complicated pregnancies!

      I am not going to sacrifice real women to some sort of dry sparring in a comments section. 70,000 real women die every year due to restrictive laws and real barriers to safe abortion care. Bodily autonomy? Sure, important. But not as important as them.

  8. Pingback: Reply turned post, devil’s advocates do the devil’s work style « Mom’s Tinfoil Hat

  9. Jasmine

    “That the 50% unplanned pregnancy rate and 22% abortion rate is not what women would choose if they had true free choice in this country.”

    I nor any of my friends have trouble obtaining birth control at all. . All of my fiends who had abortions were elective, because they met or slept with the wrong guy, or was in school or didn’t want to interupt a career etc, etc. We pro-choicers are losing moral ground because we are not being completely honest and making various excuses. Abortion should legal without apology.

    Again, why should abortion rates be decreased? why should we strive to decrease a legitamate medical procedure? Even in the 2nd or 3rd trimester?

    • MomTFH

      We can definitely disagree on this point. I did not have access to effective, affordable birth control for various reasons when I had unplanned pregnancies, and our anecdotal stories are not a substitute for substantial research on barriers to reproductive autonomy in this country. I already linked to research about why most women delay elective abortions and unplanned pregnancy. Apparently you and your friends weren’t included in those samples.

      Birth control is not widely available by private insurance, with is how 70% of women of reproductive age are covered. University insurance has stopped covering contraception. Just looking at one privileged group you have access to is not a representative sample of reality.

      I told you that I think unplanned pregnancy should be decreased. I think abortion procedures should be allowed in the 2nd and third trimester, and I think there are appropriate restriction on these procedures at and after the range (not point, because there is none) of viability, but there should also be important health, rape and incest exclusions.

      I think this is a nuanced discussion. It’s not the procedure itself I have an issue with. It’s a lack of reproductive control, from preconception to past birth. If you want to write a whole blog on your own space about how abortion access is based on a single bioethical principle and cannot be discussed through any other lenses or taking into account the actual reality of women’s lives, feel free.

      I think abortion should be safe and accessible, and think women should have enhanced access to affordable, women-centered, evidence based care. That’s it. I am not interested in defending a position (abortion should be reduced in a vacuum, not its risk factors) that I don’t hold. Abortions can be due to congenital birth defects. Does that mean I don’t think we should work to reduce birth defects? Abortions are chosen because women are poor, have no childcare, and have no health insurance. Does that mean I can’t tackle these social issues?

      Unless you come up with a new avenue of discussion, I am really not interested in pursuing this mental masturbation.

  10. Jasmine

    “We can definitely disagree on this point. I did not have access to effective, affordable birth control for various reasons when I had unplanned pregnancies”

    We really can blame lack of birth control coverge by insurers (even though most cover BC), etc because pregancy in not a disease or health problem (unless it’s being taken to cure a real problem like migrane headaches). Also, if you were not on BC, you knew there was a risk of getting pregnant but took that chance anyways. This goes back to the personal responsibility issue that anti-choicers use so effectively.

    Roughly 98% percent of abortions are elective, do the research (http://www.johnstonsarchive.net/policy/abortion/abreasons.html) and over 50% that had abortions were using contraceptives at the time.

    “and I think there are appropriate restriction on these procedures at and after the range (not point, because there is none) of viability”

    why should there be restrictions? you’re having a tough time answering this question and keep raising red-herring like birth defects that account for <1% of abortions. Please try and answer the question. Why are restrictions even necessary?

    We must not be afraid to answer the tough questions as pro-choicers.

    • MomTFH

      I have been clear. Restrictions after the edge of viability, and the already real restrictions in the status quo, that most practitioners don’t perform 1st, much less 2nd trimester abortions.

      I am concerned with lowering numbers through prevention only, not increased restrictions. In fact, I clearly argue for increased access, not restricted access, to elective and medical terminations. I have been quite clear on this, and any further inaccurate insinuation that I want to restrict abortion access in a vacuum, which is not true and I have NEVER SAID, will be deleted.

      Birth control is prescribed medication that does have many medical indications, and birth is the leading cause of hospitalization in this country. I beg to differ on your reasoning on lack of health insurance coverage of birth control.

      Also, you linked to a Southern Baptist source, not a scholarly article. So, sorry, but don’t waste my time. Peer reviewed scientific evidence only.

      Yes, the majority of abortions are elective. Also, they are early, first trimester, uncomplicated, common procedures, not this elective 24 week straw argument of a case you described. Who is talking about the fringes here? Not me. I never said I had a problem with elective abortions. I never said medically indicated abortions were more common. I said they would be difficult to ethically reduce without addressing the causes – e.g. congenital anomalies and maternal health conditions.

      I have serious reasons to doubt you are pro-choice. If you have anything that accurately reflects my positions that is new to add, please do. Repeating the same argument that I want to restrict abortion, so therefore I think abortion is somehow wrong, has been adequately and repeatedly refuted. If you disagree, talk about it on a Southern Baptist blog somewhere.

  11. Jasmine

    “I have been quite clear on this, and any further inaccurate insinuation that I want to restrict abortion access in a vacuum, which is not true and I have NEVER SAID”

    MomTH, I am most definitely pro-choice.

    I will remind you, here is what you said:

    “and I think there are appropriate restriction on these procedures at and after the range (not point, because there is none) of viability”

    “No, there is nothing wrong with legal abortion before viability”

    so, I will ask you a third time. Why do want restrictions on abortion after viability?

    • There is an obvious new option – viable survival of the fetus outside of the womb. So, I think it is ethically appropriate to limit termination of pregnancy in this circumstance. I am no longer interested in obsessing about the edge of viability. There are bigger, more important ethical concerns about treatment at the edge of viability than your commitment to getting me to explain what the vast majority of the population agrees with. Viability is a valid cut off for reasonable restrictions on elective procedures. Plus, the risk of a termination at that point is the same as that of delivering. That is not the case with earlier terminations. It is a different procedure with a different set of other options and different risks.

      I am not an extremist, and do not choose to defend extremist views.

  12. Jennifer

    Wow, this Jasmine person sure is bent on using up a lot of your time by being as outrageous as possible and trying to pick an argument.

    Lovely calm and reasoned responses; that’s the way I would seek to counter such a person, if one were to engage me in an area where I had the knowledge to respond. Of course, once you’ve had your say, there’s always ignoring :)

  13. Jasmine

    Jennifer,

    what did I say that was outrageous?

    • Jasmine, even someone who gets their information on abortion from Southern Baptist sites must know that advocating for abortion post viability is an extreme point of view, one that is ethically repugnant to even the most strident pro-choice supporter. I am no longer interested in discussing it.

      Also, hyper focusing on late term procedures and elective procedures is a common tactic of anti-choice trolls.

  14. MomTFH

    I erased an additional comment on third trimester terminations. I have no interest in further hyperfocusing on anything at the edge of viability or beyond. This is way off topic of the original post, and not what I choose to do with my mental energy. Jasmine, if you think this is an important, key part of your pro-choice advocacy, I suggest you start a blog and write all about it.

  15. Jennifer

    You put plenty of good-faith energy into it. Definitely time to move on :)

  16. MomTFH

    And, I just deleted a horrid, graphic comment from her about killers and liars, and about extinguishing human life.

    So, it was lies behind the logical fallacies. I’m the liar? It is really surprising to me what some people think is ethical.

    Jasmine, if you want to save lives, please follow the links I gave you. 70,000 women die and 200,000 children are orphaned every year by anti-choice laws encouraged by zealots like you.

  17. Quercki

    Who is the old man in the picture?

    • MomTFH

      He was the moderator of the panel. He is a physician. I wish I could remember his name. He did a great job.

  18. Hilary – It was great to meet you at ACOG! Thanks for coming out to my event.

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