“Model Minority” myths and maternal health

A belated post about my column last week for RH Reality Check, in response to the Pew Foundation report about the “rise of Asian Americans.”

Last week’s report from the Pew Research Center, The Rise of Asian Americans, has stirred up much controversy. Many advocates in the Asian American and Pacific Islander (API) community are arguing that the findings further a damaging idea about Asian Americans — the “model minority” myth. Advocates have said that these myths, which include the idea that Asian Americans are wealthier, more educated, and happier than other groups (all purported in the Pew report) are damaging because they hide the real challenges that exist for Asian Americans and Pacific Islanders, in particular for certain national and ethnic minorities that fall under the API umbrella.

One place this “model minority” concept can have negative implications is in discussions of health disparities. Whether due to population size or misconceptions about the health of Asian Americans, we do not often hear about the specific health disparities facing the API community. In the discussions about race and health, people of color are often grouped together, and disparities are talked about in terms of the gap between white people and people of color (Asian Americans included). These simplifications ignore the differences between racial groups, and even within nationalities and ethnicities within those racial subsets. Because of the Pew report, and as part of my focus on race-based health disparities and maternal child health, I decided to look further into the data on Asian Americans and Pacific Islanders.

What we do know is that API women suffer from higher rates of certain negative maternal and child health outcomes than their white counterparts.

Read the rest here.

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New column: Preparing for the trans baby boom

My latest column for RH Reality Check was published this week. An excerpt:

This shift in attention toward the issues facing trans and gender non-conforming pregnancy is indicative of a bigger shift overall — more and more trans and gender non-conforming people are giving birth. As Pati Garcia, a Los Angeles doula and midwife-in-training put it during our panel: “We’re on the cusp on a trans baby boom.”

Trans health as an overall field is still in its nascency. Our understanding of hormone therapies, gender reassignment surgeries, and much more is still being developed, so it’s no surprise that the field of pregnancy and parenting for trans people is also new and developing.

Within the needs of trans people in pregnancy and birth is the challenge of addressing what seems like an obvious connection: between pregnancy and femaleness. Trans people are often neglected in the arena of pregnancy and birth because of the strongly-held notion that only female-identified people experience pregnancy and birth. While not all trans people, whether they were assigned female at birth or not, can experience pregnancy (because of infertility or hysterectomy), some can and do, prompting the need for our pregnancy and birth providers to accommodate.

It’s not easy, as it’s a process that is intensely gendered. Everything from maternity clothes to the language of health care providers carries the assumption that the pregnant person identifies as female (and often that the other parent identifies as male). Language is an obvious barrier from the get-go: maternal health, pregnant women, all of the language associated with pregnancy and birth is gendered. From body parts to actors, all is coded in a way that would make a pregnant person who is not identified as a female feel uncomfortable.

Read the whole article here.

It was inspired by my panel at the Philadelphia Trans Health Conference, so big props to Pati Garcia (aka Chula Doula), Ryan Pryor, Abigail Fletcher and Lucia Leandro Gimeno, my co-panelists. It was an amazing conversation about trans and gender non-conforming centered midwifery and doula care. And the room was full! I love how many more people are focusing on these intersections, because there is much work to be done.

Proof that anti-abortion laws hurt ALL pregnant women

We’re only just starting to see the impacts of new extreme anti-abortion legislation that has been passed around the country.

As I argue in this post, these laws also restrict the choices of women who want to parent. I’m going to try to keep an eye on the stories that highlight these connections because I think it busts open the myth that anti-choice activists are only focused on restricting abortion. They’re actually focused on restricting women’s autonomy in a myriad of ways related to pregnancy.

From Nebraska State Paper:

Nebraska’s new abortion law forced Danielle Deaver to live through ten excruciating days, waiting to give birth to a baby that she and her doctors knew would die minutes later, fighting for breath that would not come.

And that’s what happened. The one-pound, ten-ounce girl, Elizabeth, was born December 8th. Deaver and husband Robb watched, held and comforted the baby as it gasped for air, hoping she was not suffering. She died 15 minutes later.

The sponsor of the controversial Nebraska statute, Sen. Mike Flood of Norfolk, told the Des Moines Register that the law worked as it was intended in the Deavers’ case.

“Even in these situations where the baby has a terminal condition or there’s not much chance of surviving outside of the womb, my point has been and remains that is still a life,” Flood said in an interview with the Iowa newspaper.

The law, the only one of its kind in America, prohibits abortions after the 20th week. It is based on the disputed argument that a fetus may feel pain at that stage. It took effect last October.

These situations, while rare, do happen. Not all women, when faced with a fetus that is known not to be viable, would choose to terminate early. Some would want to carry the fetus to term, and spend that time in whatever way they choose.

The point is: she should have a choice. No one should be forced to carry an unviable fetus to term. No one should have lawmakers interfering with a medical decision that should be kept between the family and the medical providers.

“Our hands were tied,” Danielle Deaver of Grand Island told The Register in a story published Sunday.  “The outcome of my pregnancy, that choice was made by God. I feel like how to handle the end of my pregnancy, that choice should have been mine, and it wasn’t because of a law.”

Also, what kind of BS argument is that about fetal pain? For one thing, the research behind the idea of fetal pain is super sketchy. And for another, what about the suffering of this newborn as it died?

I’ll keep saying it over and over: anti-abortion laws don’t just hurt women who want to terminate their pregnancies. They also hurt women who want to parent.

h/t Mary M.

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!