California pregnancy-related deaths triple in the last decade

A new investigative report released by California Watch reports that maternal mortality rates in California have seen a spike in recent years, almost tripling in the last ten years.

To me, there is one clear cause of this kind of increase, and that’s the c-section rate, which according to California Watch have increased 50% in the same decade in CA.

The World Health Organization recommends a c-section rate of about 10%. We currently have a national average of 30%. In some hospitals it’s as high as 90%.

C-sections are major abdominal surgery. There are risks involved, and with so many c-sections, you’re going to start having deaths as a result.

We need less c-sections. Period.

The other thing this report revealed was that there was significant increase in maternal mortality among non-Hispanic whites, a group traditionally excluded from maternal mortality and low infant birth weights. Well again, this is probably because of the c-section rates, which might even be higher among this group than women of color.

The idea that increases in technology use could actually harm women, rather than help them, is impossible to believe for the OB-GYN community:

When researchers unveiled their initial findings to a conference of the American College of Obstetricians and Gynecologists in 2007, there were gasps from the audience, according to participants at the San Diego event. The idea that California was moving backward even in an era of high-tech birthing was implausible to some.

This is exactly the point. Overusing technology it’s just as harmful as under-utilizing it. The bottom line is that OB-GYNs are trained as surgeons, and their dominance of maternity care is proof of that–they are performing more and more surgeries than ever.

We need practitioners who are trained to care for women birthing without technology, namely midwives. Technology has a role, but it should be the exception not the rule. And let’s be clear here. It’s not just c-sections that are to blame. It’s also increasing induction rates, epidurals and other medical interventions that disrupt the process and are more likely to cause interventions.

“For every maternal death, there are 10 near misses; for every near miss, there are 10 severe morbidity cases (such as hysterectomy, hemorrhage, or infection), and for every severe morbidity case, there is another 10 morbidity cases related to childbirth,” Camacho wrote in an e-mail.

Washington State: Only 30% of incarcerated women are shackled during labor

The Superintendent of the Corrections Center for Women (the only one in WA state that houses pregnant women) said 30% of women are shackled during labor in a recent MSNBC article.

Only 30%?! Wow, how nice of them.

Bills have been introduced in the Washington State House and Senate that would outlaw the inhumane practice of shackling incarcerated pregnant women during labor and delivery. The laws would prevent the use of any types of restraints on pregnant women who are incarcerated.

Let’s hope this law passes, so 30% can become zero.

Thanks to Peggy at Open Arms for the heads up!

Has swine flu impacted your doula work?

I’ve been wanting to write about doulas, pregnancy and swine flu (also known as H1N1) for a while now. The epidemic has alternately fascinated and frightened me since the first reports of it last Spring.

Lately the hype has died down, although we are in the midst of flu season, the one that world health officials would bring serious deaths and contamination across the US. I’ve noticed an huge increase in public education and awareness campaigns about washing hands, getting vaccinated and staying home from school or work if you are sick. I’ve even seen hand-sanitizer machines installed in public areas like bus and train stations. I’ll leave my thoughts about hand sanitation for another day, but let’s say I’m skeptical about the negative effects (including breeding super-strain versions of viruses).

Today, Women’s E-News published a piece about the 28 pregnant women who have died as a result of swine flu so far, so I decided it was time to delve in to the issue.

From Women’s E-News:

At least 28 pregnant women with H1N1, commonly known as swine flu, died last year in the United States and another 100 were admitted to an intensive care unit through Aug. 21, according to the latest Centers for Disease Control and Prevention, or CDC, figures. Pregnant women are 7.7 times more likely to die from H1N1 compared with the general population, according to an August 2009 editorial in the medical journal Lancet.

However, pregnant women who get the H1N1 vaccine get sick less often and their babies are less likely to get sick with the flu than babies whose mothers did not get a flu shot, the CDC says.

Those are some scary figures, especially for pregnant women, who are often barraged with information about what could go wrong (see: what to expect when you’re expecting) and lots of fear during that time. Couple that with sensationalist media coverage about how WE ARE ALL GOING TO DIE FROM SWINE FLU TOMORROW and you’ve got an unpleasant situation.

Continue reading

Have you miscarried? A research opportunity

From Lisa Rosenzweig, a doctoral candidate in Clinical Psychology:

Research Opportunity for Women who have Miscarried

Everyone has a unique experience with miscarriage and unfortunately, little is known about women’s experiences of support and how this may affect responses to miscarriage, and so I invite you to participate in my dissertation research study examining women’s experiences following a miscarriage. Although there is no direct benefit to you, survey results may help healthcare providers better understand and meet the needs of women following miscarriage. This online survey takes approximately 15-20 minutes and is open to women who have miscarried a wanted pregnancy in the previous 6 months who are 18 years of age or older, living in the United States, and involved in a relationship with a significant other. Participants are eligible for a raffle for a $50 American Express gift certificate. For more information, please don’t hesitate to contact me.

Lisa Rosenzweig
Teachers College
lsr2106@columbia.edu

Link to the survey here!

Lynn Paltrow: Can There Be Justice for Pregnant Women if the Unborn Have “Human Rights?”

From Lynn Paltrow’s piece at RH Reality Check:

This summer, the question of abortion and the rights of the unborn once again took center stage as a presidential campaign issue. In August, at the Saddleback Civil Forum, Pastor Rick Warren asked both presidential candidates: “At what point is a baby entitled to human rights?”  Senator John McCain’s answer, “at the moment of conception,” immediately established his anti-abortion bona fides.

But the right answer, as a matter of international human rights principles and simple justice, is: human rights attach at birth, not at conception.

This is the only position that ensures that upon becoming pregnant, women do not lose their human rights.

Political candidates of all persuasions should rest assured that to oppose the recognition of human rights before birth is not to deny the value of potential life as matter of religious belief, emotional conviction or personal experience. Rather, it is to recognize the value of the women who give that life.

Right on.

Dream reflections

So I don’t usually get this personal at Radical Doula, but this dream felt too relevant not to share. On Friday night, in the middle of facilitating a two-day training (my day job) I had a really vivid dream that I was pregnant. So vivid in fact that it stayed with me throughout most of the day on Saturday.

Now a pregnancy dream might not seem that odd, as I am a doula, and spend quite a bit of time thinking and writing about pregnancy and birth. But put me in the position of pregnant woman? That’s just weird. In the dream I was in New York, and knew I was pregnant, but apparently not how far along. I went to a birth center there (of course, even in my dreams I’ve still got my politics) and they informed me I was about to pop. Like any day. Mind you I was not very big in this dream, just a little tummy.

So then my panicked anxious self kicks in, thinking about how my life will change if I have a baby (I’ll have to move out of my group house!) and how I really want an abortion but its too late. The other thing that flashed through my dream-mind was: I have to find a doula!

A friend today informed me that pregnancy dreams mean something big in your life is about to change. That’s a possibility, but if there is one thing I know for sure, I won’t be getting pregnant in real life anytime soon.

Some thoughts on gender and pregnancy

So I’m a little late on this hot news item, but I’ve been trying to process some of the media and reactions before commenting. To get the low-down on the Thomas Beatie situation, read his own testimony about his pregnancy here. In short, he is a transgender man who decided to carry he and his partner’s child.

What has fascinated me most is the media reaction to Thomas’ pregnancy. At first, the media headlines seemed to question his pregnancy: Man claims to be pregnant, read the headlines, instead of Pregnant Woman claims to be Man. The fact that they questioned his pregnancy and not his masculinity was striking.

It seems some people thought the whole thing might be a hoax (maybe because he just looked SO masculine!) but after Thomas went on Oprah and People Magazine, the hoax possibility was disregarded.

What this case brings me back to is the ideas and definitions around gender and sex. When people define what makes someone a “woman” the definitions shift shakily depending on the circumstances. For example, ability to reproduce and birth a child is often cited as a defining category of woman. But, as Judith Butler points out, there are many times in a woman’s life when she is not actually able to birth a child. Before puberty, after menopause, not to mention the larger number of women who experience infertility. Are people who cannot bear children still considered women? Yes.

The gender definition shifts again if you look at chromosomes–women are XX and men are XY. Well, increasingly we are discovering that there are people who aren’t either XX or XY, and that the gender categories don’t fit neatly with the chromosomes either. Same thing with secondary sex characteristics (Women are people with breasts. What about men with breasts? Women without breasts?).

These are things I think about a lot–not just the social construction of gender (the ideas that are associated with men or women, like weakness and strength) but also the social construction of biological sex categories. Particularly being part of a birth activist community, which in many ways is centered around essentialist ideas about gender (women know how to give birth), constantly makes me reflect on how we use these categories, often in ways that are limiting and too narrowly defined.

Thomas Beatie is a very stark example, and an exercise in gender definitions for the general public, who don’t often think about these categories. We take for granted the ways our gender identity (and our biological sex) define and limit who we can be. I believe this is because our gender is at the core of our identities.

Ever walked around in public with a pregnant woman? The primary question she will be asked is “What is it?” referring to the sex of the child. When we call something so fundamental to our identities into question, it is extremely destabilizing.

Is there room in the birth activist movement for more radical ideas about gender and sex? Here’s to hoping.

More studies to scare pregnant women

The New York Times had an article yesterday about a recently released study that claims that caffeine can double the risk of miscarriage. This is just another study to throw on the pile of “you’re going to harm your baby if” studies.

Research on pregnant women is a difficult issue. As it stands, due to ethics guidelines and a strict Institutional Review Board policy it’s very difficult to get permission to do studies on pregnant women. They are placed into the same special category as minors and incarcerated people–they are considered unable to give consent.

Now there are a few reasons why this might be. Minors are not considered capable of giving consent because of their age–it’s difficult to involve them in medical studies, particularly things like clinical trials, and their parents usually have to consent for them. People in prison are not allowed to give consent because of the history of abuses they have faced at the hands of medical research–it is also likely that they might feel coerced because of their incarceration. I think the most likely reason pregnant women aren’t considered able to give consent really lies in the ideas of fetal personhood–the unborn child she is carrying can’t give consent, therefore she can’t. That takes us down a slippery slope that most reproductive rights advocates are afraid of because it gives the fetus rights.

But what does this all mean for pregnant women and birthing mothers? What it means is that the research on pregnancy and obstretrical practices is not all that scientific. The studies can’t be set up in the rigorous ways they traditionally are. There can’t be control groups, you simply can’t test things out the way you normally do. Which means that studies like this one rely on data from women who are making their own decisions about how much caffeine to intake, so there are a lot of variable that are hard to factor out.

But most importantly what it means is that obstetrical technologies are used anecdotally. No one can run a study on the effects of pitocin in labor, except to look back at cases that already happened and try to compare. Same thing with epidurals, with fetal monitors, with cytotec. So instead doctors learn the hard way, and the SLOW way, by trial and error. But at whose expense? Just looking at the short obstetric history we see a lot of these mistakes:

  1. Thalidomide babies: Birth defects caused by a drug to avoid morning sickness;
  2. Twilight sleep: a drug used in the 1950s which erased all memory of childbirth but resulted in women being restrained and having rages and fits, in addition to affects on the baby
  3. Episiotomies: It was once believed that cutting the perineum (skin and tissue between the vagina and anus) was preferrable to natural tearing. After a lot of years of routine episiotomies, they figured out that women were more likely to have really serious tears (and all sorts of other nasty problems) as a result of the episiotomy, and that natural tearing (with its jagged edges) healed faster.

Feel free to add your own to the list in the comments!

Who decides?

Next week is the Anniversary of the Roe vs. Wade Supreme Court decision which upheld a woman’s right to an abortion. In preparation I’m going to blog about some more reproductive rights centered topics leading up to next week.

First off is a shout-out for the just released NARAL Pro-Choice America report Who Decides? The Status of Women’s Reproductive Rights in the United States. The report gives a state-by-state breakdown of the laws affecting women’s ability to choose abortion, access emergency contraception, get insurance coverage for reproductive health services, among other things. They give each state a grade that corresponds to these issues.

For example, my lovely home state of North Carolina receives a D+ from NARAL for a variety of reasons including that 83% of counties in NC have no abortion provider (which is consistent across the country, by the way). You can see what grade your state gets here.   

They also have some awesome maps that give an overview of certain restrictions across the country, like this scary one about states with almost total abortion bans (even though they are unconstitutional) on the books.

What would be really awesome is if next year, NARAL could add some information about birth–which states allow midwives to practice and which allow home birth. I know a lot of you would agree that how you birth is a fundamental reproductive right as well.

Pregnant New Mexico Teenager Arrested and Deported

This is ridiculous and just proof that the administration’s haphazard immigration crackdown is ineffective and completely unjust.

U.S. immigration officials deported a pregnant Roswell High School senior after she was pulled from class Wednesday by a local police officer regarding a traffic ticket issued days before.

She was only 18, and who knows what happened to her when she was sent back to Mexico. Frequently these individuals no longer have ties in their country of origin, and this girl’s mother remains in New Mexico. This kind of thing isn’t going to strengthen “security” or immigration enforcement, and it is a blatant violation of human rights. The detention centers that people are sent to while in the process of being deported are often jails that have been “converted” into detention centers.

These kinds of stories just keep coming, along with ones about women who are separated from their infants, many times who suffer from dehydration and complications from the disruption of breastfeeding.

For more information about the immigration justice movement, http://www.immigrantsolidarity.org/.