Tag Archives: The man

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

7 Comments

Filed under Uncategorized

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.

3 Comments

Filed under Uncategorized

Michel Martin rocks the mic

I have been a Michel Martin fan ever since I got satellite radio, and I was able to listen to her NPR show Tell Me More. She is a great interviewer, and I love the Barbershop segment.

But, it’s her “Can I Just Tell You?” commentaries that really impress me. She is thoughtful, analytical, intelligent, and not afraid to draw conclusions and make judgment calls. So much of journalism is pure regurgitation of talking points, it is refreshing to hear someone, especially a woman of color, not just break news, but put it back together, to paraphrase an NPR advert.

Well, her most recent “Can I Just Tell You” segment, No, We’re Not Going to Sit Down and Shut Up made it on my Newsfeed on Facebook, since I am a fan of NPR. Good for them for trying to increase exposure to this commentary.

She not only crosses ideological lines to defend Sarah Palin from some pretty atrocious sexism, but takes the unfortunately predictable blame-throwing response and uses it to paint a really insightful big picture. I recommend you read or listen to the whole segment at the link above, but here is a particularly great part:

“I cannot help but think that what the fury is really about is the loss of entitlement. It used to be that men with a shred of power could say whatever they wanted about women and women had to put up with it, or get a man to duel for them or something. Well now women get to rock the mike too.

It used to be, and often still is, that one set of values or perspectives dominates the way we look at issues and talk about them. You can see where the people who share that particular perspective begin to feel they are entitled to shape the conversation for all time. But things change — new voices rise, different people win elections, or dare we say it, get on the radio. Maybe some people have a problem with that. Tough. Because we’re not going anywhere.”

Leave a comment

Filed under Uncategorized

Reply turned post, advice on VBAC in rural New Mexico?

I replied to a post on Shakesville in which a community member who is pregnant after a prior cesarean asks for advice in seeking a VBAC in rural New Mexico, when the nearby hospitals have a no VBAC policy.

This is my reply:

You can contact me at hilseb at gmail dot com, if you’d like. I know a bit about this. I am in medical school, and am planning to be an ob/gyn. I am doing a research fellowship on obstetrics right now. I am a big proponent of evidence based medicine, which means I am a big proponent of VBAC.

Here is a link to all the blog entries at my blog I have written on VBAC. That’s just the first page. Click on older entries, and the list goes on. Just to give myself some cred, if my alleged bio doesn’t.

Here (pdf) is the incredibly recent, like published last month, and very thorough NIH evidence report on VBACs, which concludes “This report adds stronger evidence that VBAC is a reasonable and safe choice for the majority of women with prior cesarean. Moreover, there is emerging evidence of serious harms relating to multiple cesareans.”

Here is an excellent academic article on risk and pregnancy written by the American College of Obstetrics and Gynecology risk task force that has some very supportive language on offering VBAC and how to present risk to obstetric patients. According to this article, “Although rates of delivery-related perinatal death are indistinguishable between VBAC and primary vaginal delivery, there is a genuine differential in the rate of uterine rupture–related hypoxicischemic encephalopathy. Such perinatal morbidity is indeed devastating. It is also extremely rare. In a recent large prospective study, the probability of this outcome was 0.00046 in infants whose mothers underwent a VBAC trial at term compared with no cases in infants whose mothers underwent repeat cesarean delivery.” (emphasis mine)

Here is the website for ICAN, the International Cesarean Awareness Network. Here is their page on VBAC. Here is their VBAC reading list. Here is their database on hospital policies on VBAC. Here is their FAQ on how to face a VBAC ban. Unfortunately, there is no New Mexico chapter listed on their site, but there is a national group, an AZ group, and lots of resources available.

Here is a link to my buddy Jill’s incredible blog, the Unnecessarean.

I have been to many, many beautiful VBACs, most of which were successful, safe vaginal deliveries, which goes with the 75% to 80% “success” rate numbers abundant in the literature. Even the ones that ended in a cesarean were happy, healthy births that fit the informed consent of the pregnant person.

Please, please, don’t hesitate to contact me, if this post hasn’t overwhelmed you.

*****************************

If anyone else has any advice, please comment at the original post at Shakesville.

4 Comments

Filed under Uncategorized

Reply turned post, health care reform style

A Facebook friend posted a link to a news story about how insurance companies still say they will fight to deny coverage of preexisting conditions. I replied that I am sickened (no pun intended) by the people throwing bricks through congressional office windows, spitting on politicians, firing bullets into a congressional office, cutting a gas line at a politician’s family member’s house and calling in death threats, all in the name of defending this horrid status quo.

She asked me in reply “What do you think of all this health care stuff?”

I don’t know how much I have written about it recently, even though I have been following the debate avidly. I got turned off one step at a time with each compromise that was made, when each compromise didn’t earn one single Republican vote. What could have been a progressive reform pretty much got turned into a pretty close copy of the Republican’s answer to the Clinton era Democratic reform proposal. In fact, it uses a lot of ideas from the Republican platform in the 2008 election. We scuttled the public option, contraception coverage, put in extra barriers to abortion, cut the minimum of premiums taken in that had to go to actual medical care, removed end of life counseling, put in mandates, etc. etc. Although I think we have a gutted shell of a reform plan, it is still better than the status quo.

Here is my reply:

I am a big fan of the book “The Healing of America” by T.R. Reid. He looks at health care delivery and payment in several “civilized” countries, including countries like Switzerland that made their transition when we failed during the Clinton era.

It is grossly apparent to anyone who looks, apolitically, at health outcomes, disparities and access that the United States has one of if not the worst health care systems in the industrialized world.

I think we could easily switch over to a single payment system by simply expanding Medicare to pay for all, and then use the best elements from all of the health care systems that already work much better than ours. It’s not like there isn’t ample good examples around. Japan’s cost control and ample access to excellent practitioners and treatments (more visits to physicians per year than the US and best in all outcomes, with a fraction of our cost, and universal coverage), Canada’s self referral system, France’s electronic records card and billing (which would save billions in overhead in offices and hospitals) – for the doctors and business owners, not just the government and patients!), England’s subsidized medical education (in fact, most countries have this), and even Germany’s use of existing private insurance companies to organize the care.

What I don’t like is the knee jerk, angry reaction we have to this kind of reform in our country. In Canada, in Japan, in the UK, this isn’t a left/ right issue. It’s a matter of human rights, and it’s hard to find a politician of any stripe who wants to switch to the US system. In fact, it’s a common insult in the UK in parliament to say that another politician would rather have the US health care chaos, and it’s used by both sides.

As a future practitioner, I would hate to have to turn down a pregnant patient like I was turned down as having a “pre-existing condition” when I was pregnant. Fundamentally, I can’t see why anyone in the health care industry would support the status quo.

5 Comments

Filed under Uncategorized

And it begins

I saw the first Focus on the Family ad by the Tebows. They direct them to the Focus on the Family website to learn more about their story. You know, the story about a privileged white American woman who had lots of choices. Now, people can go to the Focus on the Family Site and read how their team of doctors thinks birth control is a chemical assault on the unborn.

Nice. I wish they were directed toward these posts instead so they could learn about the 200,000 children whose mothers die each year due to groups like Focus on the Family.

4 Comments

Filed under Uncategorized

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.

10 Comments

Filed under Uncategorized