Recent Posts

Tuesday, February 28, 2012

Book Giveaway! The Immortal Life of Henrietta Lacks

What an amazing, heartfelt book. The book details the life of Henrietta Lacks and how she became the unwitting progenitor for landmark advances in medicine - and yet never saw a penny for any of it. Among the book's timely topics are HPV and cervical cancer as well as the raging debate over informed consent - especially for the indigent.

Read more about the book here: review

If you'd like to be eligible to win a copy, post a message in the comments section with your name and contact information - please make sure you either leave an email address for me to contact you, or enable your profile to receive email so I can reach you if your name is picked. This is very important - because even if you leave a comment, if I can't contact you then you won't be eligible. Comments must be received by noon Monday, March 6, 2012. 

Good luck!

Friday, February 24, 2012

Facebook censorship reaches a new level of absurdity

If you're a natural birth and/or pro-breastfeeding advocate, you've likely heard about Facebook's ridiculous stance on breastfeeding photos - and how they frequently leave up images that show half-naked women doing anything but breastfeeding. But lately their ironic censorship has reached a new level of battshittery.

Photo credit: Seana Berglund
This photo, showing a woman's placenta, was removed. According to a leaked document, these are guidelines on content Facebook finds objectionable: "Depicting the mutilation of people or animals, or decapitated, dismembered, charred, or burning humans...Photos and digital images showing internal organs, bone, muscle, tendons, etc. Deep flesh wounds are ok to show; excessive blood is ok to show.... Crushed heads, limbs, etc. are ok as long as no insides are showing. ... Note: No exception for news or awareness related content."

I can appreciate that when it comes to certain issues, Facebook has a conundrum on their hands: intent can mean a lot when it comes to what you're posting. And obviously the placenta is an internal organ, but there is nothing threatening about a life-giving organ such as this. Unfortunately, it seems like when it comes to this policy, Facebook has it bassackwards: "crushed heads" are okay - I can't think of a context where that's necessary except in gory accident photos or some kind of horror film exposition - but the placenta is not. What?

And how can images of internal organs, bones and tendons be a good thing? If they're used for educational purposes, in which they're done all the time. So in their minds, a medical textbook - or educational photo such as the one above - is wrong. Not even news photos - taken by someone who obviously thinks the reader can gain some insight from seeing it - is appropriate, according to them.
But, in an ironic twist, the photo from a pro-life group showing "what an abortionist does" was removed - presumably because yes, it shows a mutilated, dismembered .... wait a minute. Human? Can we call it that? Since some argue that up until a certain point the fetus isn't a human being, or a "person," what should we call it? If, in fact, it's not a human being, then it should be allowed to show under the "excessive blood and crushed head" rule, maybe? Insides are showing, yes - but again, if it's not technically considered a human, then what?

Whew. I think we're stepping into dangerous territory here.

Which brings us to the next image. This one was removed as objectionable content, presumably flagged by users, and then reinstated - with an apology - from Facebook.

This content, posted by Dutch physician Rebecca Gomperts, clearly shows how a woman can abort her fetus by taking misoprostol, or Cytotec.

Several things bother me about this, and I feel that Facebook is ridiculously libelous in reinstating, and apologizing for removing, this content.

Whether she's a physician or not, Gomperts has no business offering this information in the form of a profile photo - presented like a prescription - to a woman she's never even seen before. She has no idea the age, health condition or anything, really, about the audience she's reaching, and whether Cytotec is really appropriate for them or not. Drug allergies? Sorry, no clue. Whether you're really nine weeks along or not? Nope. Not sure of that either. And her suggestion to see a doctor only if complications arise is essentially asking another physician to finish what she started - for good or bad.

Both in the profile photo and on her website, she advocates lying to medical staff - something that could interfere with your care, depending on the situation. And I'm not sure that doctors are all that stupid that they won't figure something out. If you're not telling them the truth, how can they adequately care for you?

Not only that, but it's laughably insane that she makes presumably desperate and troubled women think that they can just walk into any pharmacy around the world and demand this product. Depending on who's reading it, the dispensing laws could vary greatly. One could probably get it over the internet without a prescription, which is illegal, and possibly dangerous - in that you can't really guarantee what product you're taking, or who it came from, by ordering in online. And ironically, her website warns against doing that because of the risk of receiving a fake product. God only knows what could happen then: either it won't work and you'll still be pregnant, or it could do some serious damage to your health. I hear another giant can of worms opening somewhere...

After taking the pills, you are supposed to take a pregnancy test within three weeks (at which your fetus presumably would be a maximum of 12 weeks old, which could dramatically change the course of treatment if you were still pregnant). What do you do if the test is still positive? Call Dr. Gomperts?

Oh yeah, about that. Up until a few years ago she'd probably be in the middle of the North Atlantic on a ship, offering medical abortions to women from various countries who seek her care. I'm not even going to go there - except to wonder what kind of follow up care these women received to make sure everything really went as planned. Does she care? Would she just hand you over to someone else? Or would she wait around to make sure it's all the way it should be? If you regret your decision, which some women actually do, will she offer post-abortion counseling? Probably not, as she'd likely be halfway across the Atlantic by then.

For "practical" reasons, she stated that she didn't perform surgical abortions on the ship, presumably because she didn't have the resources. Her reasoning was because it would require about 20 minutes per woman, and for legal reasons they didn't want to be out in international waters that long. (Not, I guess, because they really wanted to make sure you were okay after the procedure.)

I'm not arguing that if a woman really wants to do this, she'll do it anyway. What I do find extremely alarming is the detached, remote attitude of this doctor - and how it presumably insinuates that this woman will be alone, on her own, in her decision, with possibly no support. If something goes wrong, who is to blame? Gomperts? Facebook, because of the bad outcome? How are they going to handle the potential liability? Misoprostol does have a failure rate and some women will need further procedures in that event. Even though it's a small percentage, it's a very real risk. And it's also never been FDA-approved as a standalone abortifacient.

It's important to note that just as it can happen in a laboring woman, a uterine rupture, although rare, can happen when inducing abortion with misoprostol. At the very least, this can cause excess bleeding, and possibly impact future pregnancies, should you decide to want additional children. And some factors, according to one reference, site the rising cesarean rate as a factor, ironically:
"Uterine rupture with the use of misoprostol has been reported more frequently in multiparous women and in women with uterine scars. It is more often observed at term than in the second trimester [3]. The rate of caesarean births has been on the rise, it has lead to and increasing numbers of women with a uterine scar seeking TOP [37]."
(Interestingly they mention the risk of rupture at term, something few OBs are willing to do when it comes to inductions of labor.)

The subject of the case report was a 27-year-old mother of two with no prior uterine scar who sought a termination (referred to as TOP) at 10 weeks, based on her last menstrual period. (Ultrasound revealed she was really 16w5d instead.) After having an incomplete abortion with the use of misoprostol, she went back for a follow-up procedure, where it was found that she had sustained a uterine rupture and 50 ml of blood was noted in the abdomen and the woman was prepped immediately for surgery.

Now, as rare as that can be, can you imagine going through that as a scared, lonely teenager - by yourself? Based on information you found on the internet?

Surprisingly, as far as I can tell in the black hole of Facebook rules and regulations, there is no rule against dispensing medical advice on their site. Which means I could presumably tell people how to use any type of drug to do anything, whether it's legal or not, and whether it's truly "safe" or not. I'm obviously not a physician, but why should that stop me, according to their rules? And haven't we all, at one time or another, seen, heard or witnessed a physician giving very bad advice? Just because they have a medical degree does not make them perfect. It doesn't even mean they always, absolutely know what they're doing.

After Gomperts' ship was sunk, so to speak, she decided to offer pills online through her website. A physician would ask the patient, someone living in a country where abortion was illegal, about two dozen questions over the internet to check for contraindications and the pills were shipped out in a plain envelope.

The issue of prescribing without even seeing the patient is still a problem. If you're a woman living in a country where you can be prosecuted for having an abortion, what happens if you take these pills and something goes wrong? Will you avoid the doctor because of the fear of getting in trouble? Will Gomperts' organization face prosecution because they prescribed you - even after answering those 20 questions - a medication without seeing you? What if the person is lying, out of desperation to just get it done and over with?

The bottom line in Gomperts' profile photo is that it's irresponsible. It glosses over the need for crucial follow up care and doesn't stress the reasons why you should seek it, especially if the misoprostol was ineffective. And it doesn't adequately address the risks associated with it, or the potential failure rate (which is between 10-15 percent). How is this adequate informed consent?

Again, if you want to do this, you're going to do it anyway - I'm not denying that. But to ignore the possible complications of doing something like this is irresponsible, and I bet if it were any other medical predicament besides this, we'd be up in arms. 

Thursday, February 9, 2012

Let's talk about poop!

Okay, this probably won't amuse you unless you're a mom, so if can't relate, it's probably best to just skip this post.

I saw this on a onesie once: "Why
does everyone always blame me when something
smells around here?"
Photo credit: Cris Watk.
My 8-year-old is going through that Alfred E. Neuman stage where all he talks about are poop and pee. Of course I tell him I don't want his brother saying things like that, but then I think - wait a minute: moms talk about poop all the time. I know there are people who complain about their mom friends talking about their kids' poop on Facebook. But I guess that's our job, like a rite of passage. It doesn't faze me anymore; in fact, I find it rather entertaining and perhaps a little scary that after one particularly amazing bowel movement my child managed to produce, I was actually considering taking pictures just to show my husband when he got home from work.

(He, in turn, brought up the aforementioned bowel movement to our neighbor and she finished his thought for him with, "And she was about to take a picture of it, right?" which we both found amusing. So I guess I'm not the only one.)

As a sort of jumping off point from yesterday's post, I often wonder, when will it ever end?! I'm not in any real rush to start potty training; in fact, I've been kind of lazy about it, actually. Tater Tot does quite well, just only when he wants to. One day in big boy underwear was enough for me, considering when I think of potty training my Persian rug usually comes to mind. But man, wrangling a kid into a change-friendly position is sometimes about all I can handle. Some days he's totally okay and mellow, and other days - like today - I literally was changing him as he was lying face down hanging over the edge of the coffee table. He thought it was hilarious. I did not.

Yesterday as we were shopping, Tater Tot got really quiet while sitting in the shopping cart. I looked over at him and his little face was turning red - when I asked him the obvious question he frowned, pushed me away and told me, "Get out of here!" I guess you're entitled to your personal space, even if it is in the middle of the vitamin aisle.

And while I probably won't be buying diapers much longer (hopefully), I'm sure to carry wipes with me. Because you never know when those turnpike pit stops are going to pop up.

I also wonder, do you have names for your kids' poop? Like in relation to size, especially? I hope I'm not alone on this. Usually the ones the size of a walnut or less smell like the worst thing you've ever smelled in your entire life. And the 'Florida' ones, as we've affectionately called them, still plug up the freakin' toilet even after special care is taken to assure their safe passage. And that's all I'm going to say about that.

What's the weirdest place or position you've ever changed a diaper in? And how long into the conversation before you and other moms start talking about 'the inevitable?'

Wednesday, February 8, 2012

What do stay-at-home moms do all day?

The Stir writer and fellow stay-at-home mom Amy Keyishian recently wrote an article in response to an advice column she read: a childless woman was wondering what her friend could possibly be doing at home all day long that she doesn't have time for her? I had to laugh, because her day sounded a lot like mine.

Some commenters thought it "depended on the mother," with one pontificating about mothers who "plop their kids in front of the TV all day!" Yeah, whatever. I think it depends on the kid, really, because they are all different. Like I said to another bus stop mom this morning, "It's always something. And the more kids you have, the more 'somethings' it is!"

Sometimes my day starts before it's really begun, if that makes sense. Like when my youngest, a double-barrel finger sucker, is kicking and thrashing in frustration - all while completely asleep - because he's so congested he can't suck his fingers and it's making him very unhappy. Lately he's been waking about as often as a newborn, which is making my sleep pretty much impossible. Sometime after 4 a.m. I rocked and nursed him, and just held him blissfully for almost an hour, until I couldn't stay awake any longer. Then I crawled back into bed with the heating pad, got all settled, and then: my husband's alarm clock went off. Are you kidding me?! 

I'm home all day with my youngest, who is almost three, and some days are definitely more challenging than others. Okay, forget that - usually it's always challenging in some form or another. I don't know about you, but my typical day goes something like this:

1) I vacuum, for the second (or third) time that day. I'm already a freak about crumbs on the floor, but I've learned not to put the vacuum cleaner away until the graham crackers have also been put away. Likewise, don't put the sweeper away until after you've picked up the toddler from his high chair and brushed another mountain of crumbs off his butt.

2) I change a diaper... or seven. Another thing newborns and toddlers (at least mine, anyway) have in common: They freaking poop all the time. Tater Tot loves fruit, and obviously his bowels are in good working order. Again.

3) I run. There is nothing that gets you up from your seat faster than a kid running around with a full, open gallon of milk.

4) We watch TV. Yes, the TV is usually on. We're not always watching it, but when we are, we're usually discussing the finer points of Dinosaur Train or something similar.

5) I play trains. I must admit, I can create a wicked Thomas the Train layout. The other day, Tater Tot pointed to me and said, "You Emawee." (Emily) Then he said, "You say 'woo-oot!'" When I say, "I have to eat breakfast," he says, "No." Um, okay.

6) I go shopping. Because for every three items I remember to buy, there's like six I forgot. (see #2 - diapers.)

7) I try to leave the house. (again, see #2) For every kid you have, I've found that you need to add like 10-15 minutes of prep time. Because someone always has to poop or pee literally seconds before you're ready to walk out the door or a shoe/jacket/hat/glove just cannot be found.

8) I referee (usually from the shower or the toilet). Because each of my kids seems to think that once the bathroom door closes and their hear the lock click, surely this is the perfect time! to destroy something or each other.

9) I help with homework. Sometimes this is harder than all the other stuff combined, because for some reason they apparently don't do math like they used to anymore.

And then there's all that other stuff, like cooking, cleaning (is that poop on the carpet?!?), Facebooking... what do you do all day?

Friday, February 3, 2012

So, where exactly *can* you breastfeed?

In 2010, right after National Breastfeeding Week, CBS ran the following slide show on their site: "9 places "they" say you should not breastfeed." Like this blogger asked, Who exactly is "they?" Even though almost all US states have laws on the books that protect the rights of the nursing mother, many just don't seem to get it.

Some that made the list include:

Photo: CBS News.
1) In front of men.
For me, this was probably one of the most annoying, because I often hear more supportive comments from men than from fellow women. While some guys make idiotic comments about it like NASCAR driver Kasey Kahne made a few months ago, it's completely unfair to make them all look like drooling idiots with a one-track mind.

2) In public. That could mean just about anything to some people. And strangely enough, the photo they used to illustrate this point was "edited" to not show the nursing mother's breast, but yet left intact when the same photo was used for the accompanying survey. Did someone forget that it was supposed to be offensive?

TV personality Barbara Walters
expressed her discomfort
after witnessing a mother on a flight
nursing her baby without a cover.
She reportedly made her hairdresser
sit between them. So apparently
the skies aren't so friendly after all. 
3) On a plane.
Actually, many people would probably say children shouldn't be on flights at all, because who wants to be stuck in a confined space with children? And if you're nursing them, that's even worse. (Never mind that CBS mentions that one benefit to nursing while flying is that it can ease pressure in baby's ears, which makes for less fussing and crying. But it's still wrong, apparently.)

4) In front of kids. This one made me really sad, because otherwise if you don't allow children to see the most natural way to feed a baby, they're going to think - much like many adults - that bottle-feeding is the only way to do it and won't know any better. The Sesame Street clips show us that kids are naturally curious and can have the process explained - and showed - to them in a perfectly age-appropriate, respectful manner.

I bet many people who think it shouldn't be done around kids have no problems with - much less notice - the amount of skin children are regularly exposed to every day: on TV programs and in commercials, while passing by shop windows at the mall, and in public from many others whom they come into contact with. Without explaining to children the parallels and ironies of this, they probably no doubt grow up very confused by the whole thing.

5) In a restaurant. People have to eat, and a baby's no exception, really. Their rationale for why, though, is f*king ridiculous, if you'll pardon my french.
"Advocates say serve it up, but some doctors worry that if a mom has an infectious illness like HIV, her breast milk can spread the infection to others. So, moms should be careful to keep breast milk off surfaces."
The idiocy here is amazing, and I think just another psychological roadblock that many people can't wrap their heads around: that infants need to eat, too, even if it's not from the table. HIV? Really? What, is she going around and squirting milk into people's faces or something?

6) On the job. I'm sure this one will piss you off as much as it did me, because it's hard enough to get support while nursing and working full time. I honestly do not know how moms can work full time and pump, because I considered pumping a nightmare and dreaded it. It's just another serious booby trap - and while you're at it, try not to notice how many smoke breaks that guy in the cubicle next to you takes (the ones that no one says a word about, by the way).

7) At a friend's house. Okay, eff that! If you have a friend who is upset by the sight of you nursing while a guest in her home, then find new friends. Because she clearly isn't one.

8) In a public bathroom. This one was the most ironic - while on their "blacklist" of places not to nurse, it's probably the one where people tell you - or politely suggest - to go to most. This is another psychological one, I think: because just like in a firing squad, no one really wants to be considered the bad guy who made a woman feel shamed enough that she headed to a bathroom to feed her child. And they also don't want to think about how dirty those bathrooms are. So by not thinking about it, it makes it okay, I guess. Kind of like, 'If I ignore it, it will go away.'

Meanwhile, CBS News' response is "Better for mom to catch hell for nursing in public than for junior to get a cold." Catch hell? From whom? And they still make mom sound like she's doing something wrong: acknowledging that someone will disapprove, or that she's a bad mom for exposing her kid to all those germs.

Some think the only real place to do it is your own home. (And hell, even then some moms have taken crap from relatives or friends visiting in their own home about covering up or going into another room.) The car? Nope, someone can still see you, unless you either put a giant blanket over both of you or have heavily tinted windows. And if they see you getting out of your car with a baby, they'll probably still think, "Oh my God, eww! She was feeding her baby in there! Why can't you just use a bottle already?!" 

Many use the rationale that "it's a private act, it needs to be done at home." I guess that means that for as long as I nurse my child, I'm going to be tethered to my doorstep? Really?

They're invisible chains, but they're chains,
I think what this segment is really trying to say is "Breastfeeding is best, but we don't like it." According to this survey, there is no perfect place to nurse your child, apparently. 

More reading:
Survey: Should women breastfeed anywhere? (note: the original tagline for this survey said "Should moms be allowed to breastfeed anywhere?)

Thursday, February 2, 2012

The politics of nursing in public: haters gonna hate

The other day someone graciously shared this very powerful photo on my fan page:

Photo credits: Teresa Henderson/Michelle Hickman/Becky Wheeler
It generated a lot of interest and definitely some controversy, with 160 shares and more than 500 comments - more than my page has ever seen all in one place before.

Most were overwhelmingly positive, and of course, it'll also bring people out of the woodwork. In moderating the comments, I noticed some interesting things happening, though.

Whenever someone argues against breastfeeding in public, specifically, they always say things like this, "I don't want to see her breasts in public!" But the mother isn't showing any breast at all, so they move on to something else, like the age of her child.

If the child can walk and "could ask for the boob," then he was too old. Or that breast milk didn't provide much nutrition, if any, past the age of one year. (Not sure why, but that part about walking seems to stick with many, who think that's the magic age when kids are automatically independent and don't need their parents anymore.)

Thankfully some pointed out that even newborns can "ask" for milk - by doing the breast crawl, rooting, shoving their fists in their mouths, and finally, crying. And some children start cruising, walking well before a year old, so then what?
Photo credit: Carin Araujo
"'If they're old enough to ask for it, they're too old!' Right! My four-year-old just walked up to me and was like, 'Mommy, can I have an apple, please?' and I was like, 'Oh hell no, if you're old enough to ask for it, you can starve!'" 
Others then mentioned how they felt misled because the photo was staged. Psychologically I think it makes people feel better to know that this particular mother really didn't have to nurse her child in there, even though thousands of women everyday feel compelled to do something very similar.

One guy gets huffy and says "he was lied to." "Just a random pic is VERY misleading." In other words, I don't want to admit or believe that women really do have to sit in a toilet stall to breastfeed because of my delicate sensibilities!"

Some stated that they supported breastfeeding in public, as long as mom was modest about it and used a cover. While I personally preferred to be covered, my babies never liked it much. And I've heard many stories from nursing mothers about how, even though they were covered and showed nothing, they were still confronted publicly about it. A friend told me how, when she was at the mall, she had barricaded herself in a corner, behind her stroller, her baby covered, and someone still came tottering over to her to complain about what she was doing.

As usual, many women asked why the mother couldn't "just pump for those occasions?" Because we all know it's so easy! I asked readers on my fan page if they had trouble pumping and almost everyone that responded said "Yes!" I thought it was just me. I had no problems pumping with my first child, but after that, would probably have to start three or four days ahead of time if I knew I was going to be away from the baby for even a short time. Dreadful.

Photo credit: Marek Bernat
"I don't think she should have to pump just so YOU don't feel uncomfortable. That's your problem... My son never took a bottle, so do you suggest I let him scream instead of nurse? If my son wants to nurse, shoving a carrot or a granola bar in his face is not going to appease him."
And lastly, they picked apart the fact that the mother was pregnant. "You're so not supposed to do that!" one person practically gasped.

In other words, if your supposed immodesty isn't an issue, something else always will be. You just can't please anyone, it seems, and someone will always find a reason to complain about your choice to feed your child. Haters are always gonna hate.