Tag Archives: Social justice

Apology accepted…I guess?

Howdy, interwebs. I have been blogging a lot less than I used to. For those of you that haven’t been around for the long haul, I used to post a lot, and I would dive in to controversial topics often. But, I cut down on my blogging for many reasons, not the least of which is how divisive and angry people can get online, and how annoying it gets to rehash the same arguments over and over.

Well, every now and then I get pulled back in. Here is where I should warn the more sensitive of my readers that there will be some four letter words coming, because of the, um, writing style of the person involved. Today, when I woke up, one of my Facebook friends posted a link to this post about white privilege by a certain contentious blogger. It starts with “Years ago, some feminist on the internet told me I was “Privileged”. “THE FUCK!?!?” I said.”

Sigh.

Let’s hop on the wayback machine. I was that feminist. Here is the original post, if anyone wants to follow the sordid path. It wasn’t even a touchy post about white privilege, with nuance about class. It was a post about a blatantly racist display in which Obama was compared to a monkey. She still couldn’t handle it, and wanted to make the discussion about how she was poor as a child, and how mean black people were to her. She didn’t say “THE FUCK?!?!”. She accused me of reverse racism, and proceeded to call me a “cunt” who was “stalking” her (when she was posting on my blog, not to mention the cognitive dissonance of being a feminist who uses either term in that way…huh?) on twitter. She also used my real name and location on twitter, even though she was well aware that I was blogging anonymously at the time. This led me to “coming out” and subtly changing the way I discussed my patients, friends and medical school -> doctoring on here.

Here is where I was a “good feminist” as she called me in the post I saw on Facebook, and linked to many resources for her to learn about the concept of white privilege, and the BS that is so-called reverse racism.

She still hadn’t learned the lesson when we interacted here on the Unnecesarean, which all you old timers will remember was a hugely popular blog at the time in the natural birthy circles.

Now, on the one hand I am happy that she has at least woken up to the reality of white privilege, including her own. I am happy that she has spent the past few years working on her blog readership, while I have spent that time becoming a doctor and letting my blog languish, and she is getting the information out to many people. I may not agree with her, often, and honestly avoid her like the plague, as do many old timers from the natural birth blogosphere. I didn’t even find out about this post from November until today. I definitely have a problem with her lack of civility. She has gone from saying that I’m a cunt to saying “Lord help me, if I have to explain Privileged one more F*CK*NG time today. Seriously? LOOK IT UP. White? Privileged. Straight? Privileged. Man? Privileged. Got food? Privileged. American? Privileged. Health Insurance? Privileged. Please for the love of god if you think you’re a feminist, LEARN ABOUT PRIVILEGE.” I guess that’s an improvement?

So, I can’t comment on the latest post in which she has promoted me from a “stalking cunt” to a “good feminist” who introduced her to intersectionality and white privilege. I’m not a paying member, and I doubt my comment would get through her cadre of moderators. She is not well known for allowing any negative comments about her, at all, on any site she has control over. Please note I did not ban her from my site or moderate her comments. I politely asked her to, in my own nice way, to “Seriously? LOOK IT UP.” (her words now) before she came back to discuss the topic.

I still want to remind her of the concept of white women’s tears, which I explained to her back when this all started. She still spends almost the entire post about white privilege talking about her poor upbringing. Listen, I am sorry about every time she was cold and hungry. Poverty = horrible. I am a class warrior with the best of them, trust me. But, if you still spend every discussion of white privilege talking about how poor you were when you were a little white girl, you are still missing the point.

This poem is by a Native American poet named Chrystos

Those Tears

of a white woman who came to the group for Women of Color
only
her grief cut us into guilt while we clutched the straw
of this tiny square inch we have which we need
so desperately when we need so much more
We talked her into leaving
which took 10 minutes of our precious 60
Those legion white Lesbians whose feelings are hurt
because we have a Lesbians of Color Potluck
once a month for 2 hours
without them
Those tears of the straight woman
because we kicked out her boyfriend at the Lesbians only
poetry reading where no microphone was provided
& the room was much too small for all of us
shouting that we were imperialists
though I had spent 8 minutes trying to explain
to her that an oppressed people
cannot oppress their oppressor
She ignored me
charged into the room weeping & storming
taking up 9 minutes of our precious tiny square inch
Ah those tears
which could be jails, graves, rapists, thieves, thugs
those tears which are so puffed up with inappropriate grief
Those women who are used to having their tears work
rage at us
when they don’t
We are not real Feminists they say
We do not love women
I yell back with a wet face
_Where are our jobs? Our apartments?_
_Our voices in parliament or congress?_
_Where is our safety from beatings, from murder?_
_You cannot even respect us to allow us_
_60 uninterrupted minutes for ourselves_

Your tears are chains
Feminism is the right of each woman
to claim her own life her own time
her own interrupted 60 hours
60 days
60 years
No matter how sensitive you are
if you are white
you are
No matter how sensitive you are
if you are a man
you are
We who are not allowed to speak have the right
to define our terms our turf
These facts are not debatable
Give us our inch
& we’ll hand you a hanky

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Breaking the silence

I am happily coming down off the high of presenting at the Medical Students for Choice annual conference – I was part of a fantastic panel on Protecting Choice in Birth. I felt honored to be sharing the table with some brilliant people – two wonderful ob/gyns, two reproductive justice lawyers, and little old me. We talked about the legal and ethical underpinnings of patients’ rights and choice in birth: site of birth (e.g. out of hospital birth), VBAC, even use of a doula or refusal of certain interventions.

It was a wonderful experience. The director of MS4C told us the response was so overwhelming that the conference was buzzing about our panel, and we are definitely invited to return. I learned a lot from my co-panelists, and loved the enthusiastic response from the audience. One sweet medical student literally had his jaw agape when Farah Diaz-Tello, from the National Association for Pregnant Women, described a woman who had her baby taken away and put in foster care for simply wanting to postpone signing a blanket consent for any intervention or procedure during her labor and delivery. She had a healthy, spontaneous vaginal delivery with no complications during her SECOND psych consult (after the first psychiatrist deemed she was clearly mentally competent and allowed to refuse consenting to an unnecessary hypothetical cesarean), and apparently her six year old is still not in her care due to the red tape surrounding her case. Jaw dropping, indeed.

I talked about my journey, including being a patient, mother, midwifery student, doula and research fellow before becoming a doctor. I discussed the hostile-to-patient-autonomy atmosphere in South Florida, my fellowship research on labor interventions, and how to present risk to patients.

I almost burst into tears when my co-panelist, the lovely and dynamic Dr. Hanson, showed pictures of twins and breech births she has delivered all over the world. I did end up tearing up during lunch, not just because birth is moving and emotional, but because I am slowly accepting that I will most likely never be doing these difficult deliveries, and my wonderful copanelists innocently asked me about my residency plans. I may not be doing deliveries at all.

I got a decent amount of invitations to obstetrics residency programs. I am slowly canceling them, one by one. I simply cannot justify moving my two boys to a city where I don’t know anybody, then disappearing to work my ass off 80 hours a week at all times of day or night. I also don’t want to put them in public schools in the Deep South. When I got divorced during my third year of medical school I knew that would mean facing residency as a single mom. The divorce was worth it, but now that I have experienced the reality of how hard internship is, even with significant family support in my home town, I had to reconsider my options.

I will most likely be pursuing a family practice residency at a local residency program, probably at the hospital where I am doing my internship. Yes, obstetrics can fall under the family practice umbrella, but I would be the first family practitioner to get hospital privileges in the greater Miami area in recent or remote history. In other words, the chances of that happening falls between not likely and impossible. Yes, not even if I do an obstetrics fellowship, which would involve leaving town for a year. It’s just not the standard of care here, even if it’s normal in other parts of the country. And my custody arrangement stipulates that I practice here after training. So, even if I move for residency, I would have to uproot again and come back.

I can still do women’s health. I can still do prenatals. I can do lactation medicine, including the pediatrics portion. I can even be the medical director of a local freestanding birth center, just not their backup surgeon. Which, honestly, was never a huge draw for me. I want to be at the normal pregnancies, not a back up for the ones that go wrong. I can do family planning. I can still do academics, including medical ethics, which is an interest of mine.

So, most of the time I am ok with this. Most of the time. I have a lot to be happy about. I have great kids, good family support, a supportive director of my residency program, relatively good health, friends, a cute little house, a fuzzy loyal dog, and a blossoming (very tentative!) new relationship with a nice guy. And I’m a doctor, for Chrissakes. With a job in a shitty economy.

So, anyway, another permutation on the journey. Let’s see how it plays out.

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Reply turned post, from abortion to homebirth style

Hello! Hey, I’m a doctor!

Please go read this excellent article at RH Reality Check: Why Birthing Rights Matter to the Pro-Choice Movement.

Here is a great quote from the author Laura Guy, who is a doula (yay!) and a certified lactation consultant (IBCLC) (double yay!):

But let’s be clear about something. Reproductive justice means that everyone has complete control over if, when, where, how, and with whom they bring a child into the world. It means that people have accurate, unbiased access to information regarding all facets of their reproductive lives, from contraception to pregnancy options, from practices surrounding birth to parental rights. It means that our choices are not constrained by politics, financial barriers, or social pressure. In other words, how can the right to give birth at home – safely and legally – not be on a reproductive justice advocate’s radar?

As I commented on the article, I was thrilled when, during the keynote address at my first Medical Students for Choice meeting, the speaker mentioned out of hospital birth. Reproductive rights are full spectrum. They start before sexual activity begins – bodily autonomy begins with birth, stretches through childhood with protection from oversexualization, extends through accurate sexual education, includes contraception and freedom to choose when and how to become sexually active, and definitely doesn’t end once one decides to carry a pregnancy to term. The ability (or lack thereof) of women to choose the site and mode of their delivery, among other important issues of autonomy during pregnancy, are key ways that women’s rights are challenged daily in this country. Pregnant women are not human incubators.

So, seems like a bunch of mutual appreciation society activity here. Where is the angst that usually prompts the reply-turned-post? Well, on the RH Reality Check link of Facebook, one commenter says: “This is great and it’s also important for women to have the right to medical interventions (like elective C-sections) they feel are right for them.”

Here is my reply:

‎@Kathleen – within reason. Feeling something is right is one thing, but unnecessary medical intervention is not a “right” per se.

It’s a very nuanced issue that may not fit well in the comments section on Facebook. For example, evidence and expert position statements warn against early induction. Feeling like an induction is right is not enough of a reason to get one. Take it from someone who has been in the paper gown, sick of being pregnant, and in the white coat – many women feel like an induction before the end of pregnancy.

Also, someone who is a really poor candidate for vaginal delivery (placenta previa, for example), may feel like they want a vaginal delivery, but it is not medically advisable. Same goes for women who are poor candidates for homebirth. I think homebirth is an excellent option for good candidates. Not all. There is a role for practitioners to play here, too.

As a physician and most likely a future ob/gyn, I will be one of many practitioners who need to constantly work that balance between respecting a patient’s autonomy, providing good informed consent, and practicing good medicine with a good conscience. Medicine is more than ordering off a menu.

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Awesome free resource!

I am so thrilled with the free books available at Herperian.org. They are designed for ease of use and medical accuracy, and take into account limited resources in remote locations. Each of the books is available in multiple languages.

squatting position for pushing stage

I downloaded “Where There Is No Doctor”, “Where Women Have No Doctor”, and “Book for Midwives.” I haven’t had time to read them completely. Each one is more than 500 pages! I glanced through the midwifery book first, and was thrilled with what I saw. The section on the second stage of labor discourages frequent cervical checks, for example. It also has illustrations of alternative pushing positions, or in this case, physiologic pushing positions. The section on breastfeeding has accurate, non alarmist but very true information that formula can be harmful, including an illustration of an emaciated baby with diarrhea, warnings about unclean water sources, and the valid point that formula companies use predatory advertising practices to sell their product.

“Where Women Have No Doctor” has some overlap. There is a great section on abortion, with nonjudgmental language, and emphasis on safe abortion and management of complications. the chapter begins with reasons why some women choose abortion, and the first one is “She already has all the children she can care for.” Many people ignore the fact that most women who choose abortion are already mothers, and in developing countries with high maternal mortality rates, there is real danger to their already living children if their mother has an unwanted pregnancy. The midwifery book has a training chapter on manual vacuum aspiration.

Safe abortion is a safety net

Both books have good sections on family planning. Even though they are designed for practitioners in remote areas and perhaps minimal training, there is a good balance between necessary actions and not overstepping and perhaps causing harm by doing interventions with a lack of training. For example, the section on IUD insertion states that insertion can cause injury or infection, and should be inserted only by someone who is trained, but does not have alarmist contraindications. And, the book warns against putting in IUDs without permission, and the right to refuse an IUD.

The women’s health book also has a nonjudgmental section on sex workers, with information on risk reduction and negotiating condom use. It also has a section on women with disabilities.

I downloaded the Spanish version of the women’s health book. I figure I can read it to improve my medical Spanish, and I may be able to use it as a translation tool.

OK, I have gushed about the books enough. Go check them out!

Thanks, KK!

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Reply turned post, Trisomy 18 and mental masturbation style

I can get really frustrated by people who enter into philosophical arguments about serious medical ethics questions online. Many of these people have a definite agenda, often controlling access to abortion, but try to couch it as some sort of intellectual exercise. Many of these commenters are men who toss around large words like “autonomy” and “qualitative determination.” This happens all over the interwebs, and I know better than to spend my time hunting down every blowhard that litters a comment section with his ideas on viability and fetal rights.

However, I clicked through a link on my Washington Post headline newsletter on Trisomy 18, since it is a topic that genuinely interests me. Presidential candidate and notorious crusader against contraception and abortion Rick Santorum has a daughter with Trisomy 18, one who is questionably lucky to have survived the few years she has, and has been hospitalized yet again. I was generally pleased with the accuracy and tone of the article. I hesitantly stumbled into the comments section, and then happened upon a perfect example of what I like to refer to as mental masturbation, from a commenter named “johnbmadwis”, which he wrote in response to a comment drawing the logical connection between the suffering and medical expense of Santorum’s daughter, and his position on the ability of other families to choose this road for themselves:

But haven’t you just made Santorum’s point and fueled the fire of the pro-life proponents? That is, the pro life advocate’s long held belief that abortion rights advocates are not really talking about rape and incest, but rather personal evaluations of the quality of life of the fetus or externalities such as heartache and expense. Regardless of the condition of the fetus, pro life advocates would say society has a moral interest, they’d say imperative, in preserving the life of such a fetus from individuals such as yourself, who may want to terminate that life due to such condition. At what point, if any, does that societal interest give way to individual autonomy? Would you truly advocate for the ability to terminate that life after birth? in the last weeks of pregnancy? 3rd trimester? viability? Whatever the point, what is the guiding principle? Individual autonomy? Quality of life? (determined, assuredly, by one other than the one whose life is at stake – so, whose individual autonomy?) at what point does one achieve individual autonomy? Does a fetus have individual autonomy At some point the life of the fetus does, presumably, outweigh the individual’s autonomy, right? When? Is individual autonomy equally valid if it were exercised for clearly base purposes such as mere inconvenience or desire, say, to have a boy instead of a girl? Who should make that qualitative determination? Society? The individual carrying the fetus. The affected fetus? The personal choice of a couple does affect the life of another human being in your scenario, so, it is reasonable to ask you when, if ever, do you believe that personal choice must give way to other principles or interests?

My reply, which was thankfully limited by a character limit, is here (I added a few hyperlinks to this version, but otherwise it is unchanged):

@johnbmadwis, these questions have been answered by courts and medical ethicists. There is an obvious glaring difference in autonomy between a child who is already born and a fetus, whose existence depends entirely on the mother, whose life is intimately affected and at risk by carrying a pregnancy. Late term abortions (post viability) are extremely rare, and most states have strict limits on the conditions under which such procedures can be performed.

If you are worried about a slippery slope, it is pretty obvious the slope has been tilting towards restrictive legislation limiting all abortion, not just the dramatic but rare cases you bring up. More than 400 bills have been proposed recently in state legislatures seeking to place barriers on access to abortion, from extended waiting periods for all terminations, overreaching excessive requirements for providers and facilities that don’t extend to other, riskier outpatient surgeries, to personhood bills for fertilized eggs.

Trisomy 18 is a serious condition that is considered mostly “incompatible with life.” Not only is the fetus likely to die in utero, but if it survives, it is likely to die as newborn. The article (mostly) covered this really well. (We do know the “cause” of most trisomy 18 – nondisjunction during meiosis II – which is much more common the longer the egg has been in a suspended state of meisosis, i.e. in older mothers).

Santorum’s daughter is lucky in some ways to be a 1% in more ways than one, but this is more than just some sort of ethical masturbation in a comment section of a blog. This issue involves the emotional and physical challenges to the mother. Have you ever carried a fetus, commenter with a male sounding handle? Have you ever had a stranger put their hand on your belly and ask when you were due, when you knew the fetus would most likely die before birth, or soon after? Then there’s the suffering of the baby if it survives, and the emotional toll such care takes on caregivers – do you have any idea what it is like to work in a NICU on suffering, terminal infants? With major cutbacks in personnel in public hospitals, too.

Not to mention the health care dollars arguably misproportioned here. I got to tell pregnant mothers with no insurance yesterday that they had to pay full price, cash up front for necessary basic lab tests. These are mothers who don’t have husbands flying around the country campaigning for president. These are mothers who may and do skip important labs, or prenatal visits, because they have to choose between knowing if they have hepatitis B or food for their existing children. We got to tell a mother who was having her fourth baby and desired a tubal ligation that there was no funding anymore for it. She could pay $1400 up front to the clinic then pay more in hospital fees. Maybe she could google birth control – oh, wait, she probably doesn’t have a computer.

Enjoy wringing your hands about the autonomy of a trisomy 18 fetus. It’s a luxury.

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When good care isn’t emotionally driven care

Hello, folks! I am slowly getting over not matching. Slowly. I am trying to strategize for the next match. And, I’m trying to take care of myself, emotionally and physically, in the aftermath.

In the meantime, I am on my last rotation for medical school. It is a “rural selective”, which is a required elective at a rural or underserved location. I am fulfilling it at a local community health center in the women’s health department. Fun!

I am taking part in a day long orientation today. In one of the presentations, the speaker had a point on one of the slides about mandatory reporting, and included all domestic violence as falling under that category. I rose my hand and suggested that we had been trained that elder abuse and child abuse fell under that category, but other domestic violence did not. I couched that statement by saying it was controversial and I didn’t say I necessarily agreed (although I do).

One of the other attendees got very perturbed by my correction, and said I was wrong. I said I disagreed, politely. The speaker and several other attendees said they thought I was correct, and one pointed out that other vulnerable adults, such as someone with a disability, also fell under the mandatory reporting group. At the end of the speaker’s presentation, the offended woman called me out specifically, and again told me I was incorrect, but again, had nothing to back herself up other than her strong emotional response. Since this was a training on legal requirements of the job and privacy, and this population definitely would include adult victims of domestic violence, I decided to look up the law.

When I located the appropriate information, I read it out loud to the group. This nursing CEU was the first good site I found, and it had very complete information. I read this part:

Intimate Partner Abuse

Florida statute 790.24 requires healthcare providers to report gunshot or life-threatening wounds or injuries. Obviously, this does not cover the majority of injuries sustained in IPV. However, reporting suspected domestic violence without the informed consent of the victim is unethical and may cause the abuser to retaliate.

She interrupted me and said “SEE? You have to report gunshot wounds!” and I continued to read the rest of the quote. Then she angrily said “Well OF COURSE you need their informed consent!”, and I countered “Well, then that’s not mandatory reporting, is it?” She got more agitated, and started pacing the room, telling me I am saying to send these women home to get killed. I said no, and tried to explain, again, the rationale of establishing trust with the patient, many of whom are not at a place where they are ready to leave or press charges. She said she would definitely report ANY case she saw of suspected intimate partner violence, and said she didn’t want these women killed. I said that they may not press charges, and then may not trust health care practitioners again, and still get killed.

I know that IPV is a sensitive, triggering topic for many, including me. I was in a relationship with verbal and emotional abuse, and trust me, if people came on too strong about me leaving him when I wasn’t ready to, I avoided them in the future. I would not come to them when there was an incident, because I didn’t want a lecture of how it was my fault for staying. When we went over this in medical school (and I was still in my abusive relationship), one member of my small group said she was a victim of physical violence in a past relationship, and she would absolutely never press charges, she would lie to any health care practitioner or official about it, and defend him under any circumstances, when she was still in the relationship.

These victims already feel an enormous lack of control. It is not our job to control them or act for them. It is our job to be there for them on their terms. Even if it gets us emotional.

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Hands on in the boondocks

Howdy. I have been busy, as usual. Not only working at a new rotation site, which has been wonderful, but driving more than three hours a day to get to and from this site.

Our medical school requires that we do three months of rural rotations. I am doing two at a community health center in the middle of the state. The surrounding town is a farming town, with a large migrant population.

I am absolutely loving it. I am starting off with the ob/gyn, and we do gynecology, family planning and obstetrics. It is a very hands on rotation with an attending physician who is eager to teach. I have done many pap smears, STD tests, contraception counseling, cervical checks on full term pregnant women, and I GOT TO INSERT AN IUD. That plus a journal club, a training on human trafficking and a training on contraception compliance. Not bad for the first week and a half!

Our first two days consisted of orientation, and the longest time slot was given to the lactation consultant, who I love. She is working on a “Men and Women’s Health Day.” When I gently pointed out to the Medical Coordinator of the site that it was trans exclusive, they took me seriously. I am going to be the point person for any individuals identifying as trans (or anyone else who has questions in that area) the day of the health fair. Apparently they had some there last year and were at a loss. I am going to start with the resources linked to by Rachel at Women’s Health News and go from there.

I’ll try to check in again. If I could type while I drove, I’d have a ton of posts. Instead I am listening to board review materials. And looking at the swamp wildlife. And trying to avoid a speeding ticket.

I can easily see myself working at a community health center. This is totally my bag.

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Who knew closing the gender and race gap could be so easy?

I thought this article on a 15 minute writing exercise that improved the performance of women in physics and students of color in high school was beautiful in its simplicity.

Think about the things that are important to you. Perhaps you care about creativity, family relationships, your career, or having a sense of humour. Pick two or three of these values and write a few sentences about why they are important to you. You have fifteen minutes. It could change your life.

This simple writing exercise may not seem like anything ground-breaking, but its effects speak for themselves. In a university physics class, Akira Miyake from the University of Colorado used it to close the gap between male and female performance. In the university’s physics course, men typically do better than women but Miyake’s study shows that this has nothing to do with innate ability. With nothing but his fifteen-minute exercise, performed twice at the beginning of the year, he virtually abolished the gender divide and allowed the female physicists to challenge their male peers.

The exercise is designed to affirm a person’s values, boosting their sense of self-worth and integrity, and reinforcing their belief in themselves. For people who suffer from negative stereotypes, this can make all the difference between success and failure.

People who are in the minority (and I mean a power minority, not a numerical one) – people of color, women in science classes, disabled people, etc. – often feel that their values and needs are invisible in an academic situation. This exercise simply affirms that this is not necessarily true.

I want to go into academics one day. I may need to do this exercise in my classes.

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I’ll tell you what I regret, and what conclusions I am jumping to

*Trigger warnings for discussions of sexual assault*

I don’t want to go into a lot of details about this, because I don’t want to violate HIPAA or trash any of my peers or future peers specifically. Suffice to say, I find it very disappointing that people in the medical community, including people who should really know better, don’t realize that someone who is severely intoxicated cannot consent to sex. It’s not “next day regret”, and I am not “jumping to conclusions” for following that theory. It’s sexual assault. End of story.

We are supposed to be advocates for our patients. It’s bad enough that people in the community don’t understand that rape isn’t just some scary dude jumping out of the bushes and clubbing some demurely dressed virgin over the head, and dragging her off to violently violate her. When physicians and future physicians dismiss (or worse, joke about!) sexual assault on intoxicated individuals, or even worse than that, discourage a peer from following that line of questioning with a patient because it would be “jumping to conclusions” because “we weren’t there and we can’t say if she consented”, it absolutely infuriates me. Especially if such a person has a history and physical strongly suggesting that this is a likely scenario.

OK, rant over.

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Excellent blog post on the BS that is abortion parental notification laws *link fixed*

I have always been against parental notification laws because it seems like the teenagers that would have the problems with notifying their parents probably have a good reason, and a good relationship with your parents cannot be mandated by some law. It seemed to be these kids who don’t have good parental support would be the least likely to be able to navigate the legal system, and probably have the least social and familial support necessary to be a successful parent, especially a teen parent.

Also, it seemed ironic that a minor is no longer considered a minor and can make medical decisions for herself once she becomes a parent, and supposedly can be trusted to make decisions for an entire new life – her baby, if she decides to continue the pregnancy and gives birth, but she can’t be trusted to make one single medical decision for herself to not continue the pregnancy. And finally, I was worried about abusive parents or parents that would throw a minor out of the house for becoming pregnant.

At a Medical Student for Choice conference, all of the abortion providers on a panel said it was much more common to see parents come in and try to coerce their minor daughters to terminate, and the daughters to be resistant, than the other way around. Of course, they refused to do terminations under those circumstances.

Well, Harriet at Fugitivus has an awesome post up about what the reality is like for teenagers trying to get judicial bypasses. She describes the many situations she sees, from a missing in action dad, to abusive parents, to dead parents, to illegal immigrant parents, to rape victims, etc. Here is an excerpt from the section on abuse victims:

She may know she’s from an abusive family. She may not. She may simply be used to not talking about it, because it’s so shameful. She may not know there’s anything to talk about, assumes that everybody lives this way.

She will not disclose to us, and she has not disclosed to the clinic, because we are complete strangers. The clinic doesn’t have access to her medical records, which could possibly help them discover the history of abuse. The clinic is not her usual doctor, or usual clinic. This girl does not disclose because abortions are performed as something separate and segregated from other routine medical care, and at a time during which this girl may have the guts to tell somebody what is happening to her, she is surrounded by complete strangers, and called a whore and a murderer whenever she tries to access those strangers.

Please read the entire post. It is wonderfully written, as all of her posts are, and it is chilling and moving. But, most of all, it is rooted in practicality and reality. I think a lot of social conservatives want to wag their fingers and think that is all it takes to make other people live the way they think they should ideally live, based on their own particular lofty standards, and then wash their hands of the consequences of what happens when real people don’t meet those standards. I prefer to live and reality, and would like to make reality work better for the most people. Parental notification laws are the opposite of that.

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