"Booby traps" in the NICU

Photo credit: Benjamin Earwicker.

I've never had a baby in the NICU, but I've run across more painful, heart wrenching stories of women desperate to nurse their babies who were offered little, if any, support. Then others have nothing but glowing reports about how wonderful and supportive their staff was, how caring and understanding the nurses were. It leaves me wondering: why is there such a disparity of care and support for these mothers and babies?

Obviously premature babies have special needs and issues, and often times they are born too young to even have a strong sucking reflex down yet. Not all babies, though, who are in the NICU are premature, and even some that are don't have the same problems other babies do. While obviously the sucking reflex is a common problem among preemies, I can't imagine that it exists with all of them, and I start to wonder, is this a self-fulfilling prophecy? That because it can be a problem, we're just going to go ahead and treat it like it is one?

Popular breastfeeding websites like Kellymom.com and the Best for Babes Foundation both posted this article on their Facebook fan pages, and the response from some mothers was nothing short of heartbreaking. Some of the comments included:

"I was flat out told by a nurse that it's nice to try but don't be afraid to give up - formula is just easier."

"They were very pro-milk, but not pro-breastfeeding. I had no support after."

"I am VERY thankful my preemie was my second breastfed child. If he had been my first I am confident that the hospital would have ruined any efforts to breastfeed...they were supportive (somewhat) of providing breast milk to my baby, but not of my baby breastfeeding. I had to push very hard on the doctors and nurses in the hospital to make it happen."

"My son went for 3-4 hours. I literally told the nurse "you can take him but if anybody gives him formula I will kill them." An hour later, the same nurse said, "His blood sugar was low so I gave him a little formula."

This also happened to me with my third child, who was born at term weighing 8 pounds, 7 ounces - nothing huge. The nurse flatly told me, "We gave him formula because his blood sugar was low," and when I shot her a look of surprise, she said, "We don't ask, we just do it." I received no other information whatsoever about my son's condition, nothing - and wondered, What is it about my breast milk that can't solve this problem but formula can? I don't think so.

Much like the schedules and strict feeding routines have been encouraged among term infants, the same exists in the NICU. One mom told how the nurses would only let her put the baby to the breast for short periods, then wanted her to give a bottle so they could see how much he was getting. Like this mother, I remember being almost obsessed about wet and poopy diapers and the length and time of feedings, to the point where it was almost making me crazy. And like her, I had an almost epiphany where I asked myself, What am I doing?! and threw them away, which made the nursing relationship so much easier and more relaxed, for both of us.

In the case of infants who were there but weren't premature, it seems that formula was often still pushed.

"I had some nurses forcing formula if she wasn't finished nursing after ten minutes on each side."

"I'm surprised we didn't have issues establishing a nursing relationship! They constantly 'forgot' to tell me when he was hungry so i could come and breastfeed him (I was recovering from a very traumatic birth) and *sneaked* formula. I was SO MAD."

"My youngest was automatically put in the NICU because he was a vaginal breech delivery. He was born a day short of 41 weeks. He was 9 pounds. They told me they didn't now if they could "allow" me to breastfeed."

Many said the same thing: that the idea of breast milk itself was readily accepted, just not breastfeeding. Why? I have to wonder if it's not so much because of 'cultural norms' but because they don't want to see you - and don't want to run the risk of others being offended because of an inability or lack of desire to breastfeed. I've often thought there were serious psychological and control issues when it came to some nurses and breastfed babies. And while most nurses would happily turn over care to the preemie mom, some, I think, almost develop a complex - because they are so engrained and entrenched in the care of these babies that they get defensive of their territory when someone - even the mother - steps in. Our cultural attitudes about public breastfeeding can also spill over into healthcare professionals - the very people who should know the most about it, and facilitate it the most, can also be the same ones to totally undermine and completely destroy that relationship.

I came across this link to a blog post where a nurse overhears a potential NICU job candidate announce, during the interview, "I don't DO breastfeeding." In her post, she mentioned an article posted on the Breastfeeding Moms Unite! blog, "Do nurses learn about breastfeeding in nursing school?" She confirmed our worst fears - that they don't, or at least didn't when she was in school, learn much about either the physiology or the mechanism behind it. As she put it, "The nurses owned the babies back then..." I argue they still often think they do.

Why would someone make a public declaration of this? Especially a person who is responsible for the care of patients who could benefit the most from breast milk? The nurse who overheard the exchange actually felt that this person would be hired, and I can't imagine why. Unless we're praising formula strictly for the sake of convenience, instead of seeing breastfeeding as a public health issue - especially among those most at risk. Her poor attitude could - and probably will - compromise the care of some - maybe all - babies, and I just don't see how anyone could want that person on their staff.

And if you actually question their authority, take charge of your baby and defy their "orders," you just might run into this problem:

"I think the only reason I established a successful nursing relationship, despite NICU nurses who threw away my "extra" expressed milk and gave her formula because the "refrigerator had no space," who scoffed at the "trendy" idea of kangaroo care, who chastised me when I nursed in the open, busy main room in front of her isolette instead of in the curtained-off "family room" that was almost always in use and locked (the hospital social worker actually reported me to CPS for my "public indecency" in the NICU and my "troubling attitude!"), the doctor who insisted on "plumping up" my expressed milk with preemie formula and sent me home with two massive cases of free liquid samples of the nasty stuff, was that I have a hypersensitive bullshit detector and a hyposensitive reaction to the advice of outsiders."

More reading:
When should I give my baby formula? regarding hypoglycemia and the newborn
NICU nurse in job interview: I Don't DO breastfeeding"- StorkStories
Gettin' your baby fix on, Similac Style
The nurse's role in promoting or undermining breastfeeding
Anti-breastfeeding NICU - mothering.com post

Rethinking childhood vaccines

If we all sat back and thought about what we're knowingly exposed to every day, combined with what we don't know that we're exposed to, it would probably make us never want to leave our houses again, instead happy to sit at home and bathe ourselves in a bleach solution. There are so many unknowns in life - things we are afraid of that never materialize, things we should be afraid of but aren't - that it's crazy to fathom it all.

While I do vaccinate my children, I am increasingly wary and weary of the mass hysteria surrounding vaccinations. Admittedly it can happen on both sides: the non-vaccinating crowd offers up just as many horror stories as the vaccinating crowd does. I don't agree with assumptions that 'no vaccine ever saved anyone,' nor can I stand the "If there's a vaccine or a pill out there to cure my XYZ, I'm going to take it!" I guess I stand firmly, skeptically, in the middle.

When my daughter was just eight weeks old, my old pediatrician practically begged with me - downright pleading - to at least consider the hepatitis B vaccine (which I had declined at the hospital). Knowing that I didn't meet any risk factors (and had already been vaccinated as a healthcare worker), I wanted to say no, because at the time my daughter was already in the throes of a nasty milk protein allergy that I wanted to get to the bottom of first. But my ped practically wouldn't let me leave the office. 

I declined the rotovirus, and she said, "Well, at least get the hepatitis B." It was almost like she was saying, "Just get one shot. Any shot. As long as you get something." 

This summer my daughter sat on the exam table at the peds office, the poop nearly scared out of her because she had to have the dreaded "shot!" She was missing four shots, one of which was my eternally non-favorite: the chicken pox vaccine.

The book (published,
ironically, around the same
time the vaccine came out)
says chicken pox is a
"normal childhood illness."
I'm surprised the CDC
hasn't lobbied hard to
take it off the shelves. 

My daughter, being almost five, was - according to my research - the prime age for when chicken pox usually happens. I asked, almost facetiously, "Don't you think that if she was going to get it, she would have had it by now?"

"Oh nooooo," The Pretend Doctor stated, rather dramatically. "Because then if they get them as adults they're much worse and they can end up in the hospital." (insert horrified expression here)

I wanted to blurt out hysterically, "Are you kidding me? That's your idea of informed consent?" I thought back to the information I'd looked up on chicken pox and the shingles, and also to those people who I had actually known in my life that had shingles: all three of them. One was going through the obvious stress of the death of her son, and even in her pain (both physical and emotional), seemed to be pulling it together. The other guy is just a stress ball as it is, and I think the third person likes to really play up how miserable she is/was/will be whenever something wrong is going on.

None of these people, in my estimation, ever had to go to the hospital. And I'm pretty sure none of them are dead.

While it's true that chicken pox can be quite ugly if you get it as an adult, I question how the chicken pox vaccination is going to remedy that. I don't know if anyone can conclusively say how long the shot's immunity is supposed to last, and even when given a booster shot, that pretty much means they'll be fully exposed to potential illness around the time they reach adulthood. But...what? That means they'll stand to get it when it's more prone to cause complications, right? How can that be?

But wait - you can get another booster shot as an older teen or adult. Or you can just get the wild virus as any kid prior to 1995 would have done and be done with it, resulting in (for most) lifelong immunity.

Aside from the short-term costs of missed work days (assuming there are some), the cost of acquiring lifelong immunity the good old fashioned way (assuming you were a normally healthy kid) is pretty inexpensive. The cost of the vaccine (anywhere from $80 to $120, depending on where you live, multiplied by the number of boosters you receive) is not.

And like other vaccines, even if you get the shots, you might still get the chicken pox. These children in Michigan experienced an outbreak despite the vaccine, which has many wondering if it's a new mutated strain taking hold.

There are also some who believe the chicken pox vaccine is creating significantly more cases of shingles in adults, because their natural exposure to the wild virus is severely curtailed - whereas before it was actually an immunity booster.

My problem with the chicken pox vaccine started, however, when my oldest was around a year old. I had never done much research on it, but at the time, it didn't make much sense to vaccinate a child for what was perceived as a "normal childhood illness." As I raised questions, the nurse - holding my son's arm, needle poised - basically said, "Too late now," and proceeded to inject him. (I think this was after a brief "He won't be able to go to school if he doesn't get this," spiel.) Looking back on it now, why the hell would anyone proceed if it's obvious the parent is not completely on board with the idea? Put down your needle and say, "I think you should talk to the doctor about this and we'll vaccinate him when you've made your final decision." Not say, "Too bad for you. We're doing it anyway. Just get the damned shot."

That's the idea about some vaccinations that doesn't sit well with me. Unfortunately, when people start to ask questions others in the "Let's Vaccinate Everyone!" camp cry foul and start pouring on the sob stories, making you feel like a (stupid) bad parent that doesn't know anything, whose opinion can be swayed with the blowing of the wind. Well, I have news for you - vaccinating your kid for everything, all the time, might not be such a hot idea, either.

It struck me not long ago that the primary motivation behind the chicken pox vaccine was not so much to save the 100 or so kids who die yearly from chicken pox complications - it was to prevent lost sick time because fewer households include a stay-at-home parent. You can't prevent every illness, and will sacrifice lost work time for a variety of reasons throughout their childhood. The face of parenthood has changed in the last 30 years or so, with more kids in daycare, fewer stay-at-home parents and lower breastfeeding rates, which means vaccine manufacturers stand to gain a lot of money off of people who want their children to get sick as few times as possible, so as to prevent any disruptions in routine. I guess I can agree with that, but to a point.

But the first knee-jerk reaction is to lay blame on the parents, as this mother did, because her leukemia-stricken son couldn't attend daycare since at least one child was unvaccinated. This is basically failing to admit that no vaccination is 100 percent effective, and really - when you're dealing with the unique and individual immune system it's kind of a crap shoot. The mother has no idea why that child isn't vaccinated, or what he's not vaccinated for - could he have an allergy to something in the vaccine? Did he have a previous bad reaction? And really, considering her son's potentially dire condition, why is she putting him in a daycare situation anyway?

The bottom line is that we are vaccinating children for something that is merely an 'inconvenience' to parents. At what point do you draw the line? We now have an entire generation of parents who think chicken pox is some horrible 'disease.' Seriously?!

When we look at the reported number of deaths from chickenpox, there is probably a lot more going on behind the scenes than people will admit. Can there be complications? Apparently so - but what they aren't telling us is why. Are these children immunosuppressed? Do they have other underlying illnesses?

As far as the effectiveness of vaccines, that's another one that's up for debate. It's not known, for instance, how long immunity from a polio vaccine lasts, yet people say that if we don't vaccinate, "millions of children" will be subjected to potential antigens within a year. Yet, if you read a little on smallpox from the CDC, we stopped vaccinating for it in the late 1970s because it had effectively been eradicated. But wait. I thought polio had been eradicated from the US as well. So why are we still vaccinating for that, but aren't for smallpox?

Interestingly enough, I recently read that then Vice President Dick Cheney wanted to start vaccinating for smallpox again because he was worried that bioterrorists would get their hands on it and turn the virus loose on the population. President Bush said no, because he was worried that people would die from just being vaccinated. (Approximately 1-2 % of people die from the vaccine.) Finally, someone who is willing to admit that vaccines can carry some risks, potentially death. And yet, when sporadic cases of Guillain-Barre syndrome show up in the population after flu vaccines are administered, as they have been doing since probably the 1970s, the industry is unwilling to admit there is a link and basically shrugs it off.

A few years ago there was hushed talk about a pertussis outbreak going around. Stupidly, I didn't think much to ask about it because "hey, my kids have been vaccinated for that!" One of my husband's students - who was previously unvaccinated - ended up getting it and the campus was in an uproar. The nurse went off about how his wacko parents were against vaccinations and were giving him daily "vitamin injections" or something or other, and at first I was upset, too. Until I realized that even if he had initially been vaccinated, it wouldn't have mattered, because it likely would have worn off on him by that time. As a result, that kid now has, researchers believe, lifelong immunity - instead of potential gaps in his immunity from the vaccine.

One of the biggest things that make me question vaccines are the outrageous marketing campaigns waged on us by healthcare professionals and the pharmaceutical industry. Overly dramatic ads run constantly; even Jennifer Lopez is in on the act. (I picture someone off-camera saying, "Now use your saddest, most dramatic face!") With that kind of melodrama it has to make you wonder about their motives, most of which include a lot of dollar signs - you can't help but notice the great financial rewards drug manufacturers stand to gain from developing these vaccines.

A nauseating billboard down the street from my house 

When it comes to informed consent about what we're giving our children, it needs to be more than just "Vaccines are safe! Vaccines are necessary!" Understanding how diseases work and why is tricky enough, and it doesn't help when your doctor doesn't even fully understand the implications of having such a vaccinated population - and how there can be drawbacks to seeing otherwise normal illness as a serious event. Our philosophy on illness has changed so radically as to seek to prevent nearly every little sneeze or sniffle with a pill or injection, which can have many negative repercussions, including the idea that "Because I agree to accept the potential risks of doing this, you need to do the same."

It seems like when there are perfectly good low-cost, natural remedies available, they are passed over in favor of vaccinating or taking more pills. In combatting the seasonal flu, covering your coughs and sneezes, as well as washing your hands, is often one of the best, easiest and cheapest ways to avoid getting sick; you can't deny that. Eating healthy, taking vitamins and getting enough sleep are also important to staying healthy, but our Pill Generation increasingly ignores these guidelines in favor of some injection or other to prevent this and that. In a probably not-so-new twist, drug companies are turning to legislators (Gardasil mandates) to essentially force, or at the very least coerce, you to use their product - especially in the face of  declining profits - instead of promoting ways to lower your risk factors.  (Like washing your hands and covering your cough will work for flu, there are perfectly plausible ways to lower your risk of getting HPV - that not too many people want to talk about).

As they say, "An ounce of prevention is worth a pound of cure."

Dramatic ad encouraging parents and children to be vaccinated for whooping cough

Gardasil and the systematic destruction of Michele Bachmann

As the election season draws closer, there is a lot of media attention on Minnesota Republican Michele Bachmann - namely a systematic destruction of her career a la Sarah Palin - because of Bachmann's views on the controversial HPV vaccine, Gardasil.

Many were not happy when Texas governor Rick Perry voted to push through legislation that would make it mandatory for the vaccine to be administered to Texas school kids. Some, including Bachmann, criticized him for being 'sold out' by the vaccine's manufacturer for the tidy sum of $5,000. Perhaps, but I'm not so sure. I think he was just drinking the Kool-Aid prepared for him by Merck - the same crap doctors, nurses, and just about everyone else feeds to us when it comes to making informed decisions for our kids.

The other day I decided to flip on the TV and watch a little Fox News, only to see a group discussing Bachmann and her 'radical' views on Gardasil on Greg Gutfeld's segment. One contributor said she couldn't understand what the big deal was and called the vaccine a "wonder drug for women," and made a reference to schools requiring vaccines anyway - so what's the big deal about this one?

During a news break just a few hours before, the news anchor made Bachmann sound like a complete moron for daring to question "science." Everyone is trying to make her look as pathetic and idiotic as they did Sarah Palin, nitpicking and ridiculing at every turn.

She's the candidate everyone loves to hate - and no one wants to admit that they agree with. Dr. Manny Alverez, a Fox News contributor, stated his piece on their website that he has to 'side with Governor Perry' on this one, but doesn't agree that it should be mandated by the government. He also goes on to say that it isn't 100 percent effective at preventing or treating all strains, and thinks Perry made the wrong move by endorsing it. Well then, it doesn't sound like you are siding with Perry at all, does it? Did I read that correctly?

He latches on to her claim that a parent told her it caused her child's mental retardation after she received the vaccine. True or not, he isn't making any mention whatsoever of the potential side effects of this or any other vaccine, a completely legitimate argument not to vaccinate. Bachmann never said she personally made the claim, only related the story of someone else that did - and Merck immediately, unsurprisingly, went on the defensive.

Basically what I have noticed is that they are completely ignoring the issues surrounding Gardasil - whether they're political, philosophical, medical or spiritual - and ganging up on her to destroy her credibility and her reputation. No one mentions anything about side effects or potential complications, or that it ideally should be administered to children as young as nine years old.

Apparently Perry's legislation did include an opt out* for parents, but that also seems to be publicized little. Some argue that bureaucratic red tape could make it difficult or virtually impossible to refuse, combined with pressure from districts to go ahead with it. The word 'mandate' implies that parents don't have a choice when really they do, but I bet Merck and others involved want you to think you don't - sort of the "if you can't beat 'em, you might as well join 'em" approach.

What everyone except Bachmann seems to be missing is the idea that yes, this threatens personal liberty - that of the child in question and that child's parents. The state, to some extent, does intervene in our lives, in the sense that we would be arrested if we were doing our children bodily harm. Unfortunately to some, not vaccinating your child constitutes as 'bodily harm.' Where do you draw the line?

As a result, the State of California is giving children as young as 12 years old the power of informed consent to be given Gardasil, without their parents' knowledge. Groups that support the legislation include the ACLU, ACOG, and Planned Parenthood, and opposition is considered "largely faith-based." (I find it laughable that the ACLU, of all organizations, is basically saying only the rights of certain people - in this case, not the parents - count.)  I find this probably the most alarming, least-talked about aspect.

As parents, we know how hard it often is to refuse vaccinations at the doctors' office that we might philosophically disagree with, and are frequently pressured by pediatricians, healthcare workers, school nurses, friends and family to vaccinate for everything, without question. How then, do you expect a 12-year-old to adequately make that decision? And why are they essentially ignoring the rights of the parents? What happens if a well-informed child tries to refuse? And if children are fed scare tactics to get the shot, but know their parents don't approve, isn't this essentially a situation of the school district (and the state) pitting the child against her parents?

Apparently this legislation is part of an already existing bill that enables children as young as 12 to seek treatment and testing for STD's without parental permission. (Click here) The thinking is that those kids who are too afraid to talk to their parents will get the treatment they need. Unfortunately, I think that is only feeding the problem.

The core issue at the heart of the state-forced Gardasil vaccine is that parents are not often adequately talking to their kids about sex. Period. Kids know little information about what constitutes sexual contact, and parents admit to not having appropriate conversations with their children about it. The state, in an effort to curb STD and pregnancy rates in teens, has no doubt decided to do the parents' jobs for them - figuring that if they don't, we will.

The problem is, many parents do educate their  children about the reality of sexual relationships and the dangers of STDs. In many circles this vaccine, and our overall sheeple mentality on vaccines in general, is that it will fully protect our children 100 percent of the time. Even though some suggest educated teens do wait longer to have sex, there is still the idea that "teens are teens" and will do this sort of thing, so why not provide a safety blanket of sorts. Others think that safety blanket is not enough, and it might fool teenagers into thinking they have a green light to engage in even riskier behavior.

In order for the vaccine to work, it's suggested that patients receive three doses, and some are speculating that often the girl doesn't get the remaining two vaccines. You're considered more at-risk for HPV if you've had multiple sex partners, or been with someone who has. Additionally, the younger a girl is when she starts having sex can also increase her risk. The irony in this is that culturally, we seem to condone teen sex or even embrace and tolerate it in an effort to remove the stigma. Combined with the fact that many parents do not adequately inform their teens about the potentially life-threatening repercussions of sexual relationships, this is like setting a trap for our children and then pushing them into it. Even so, is that really up to the state to decide?

In the meantime, legislators had to disclose that Merck personally paid them to push legislation through. And at $360 for a trio of doses, that's a lot of money the drug manufacturer stands to gain.

The Gardasil problem joins a number of other ones surrounding our medical community. What once started out as an altruistic approach for the common good, now the boundaries are blurred as more and more people want to take initiatives to force that "common good" on others. Forced or coerced vaccinations are just the tip of the iceberg; it's not unheard of for women to be forced into cesareans by court order, or for cancer patients who refuse treatment to be ordered to do so. A UK woman with severe hospital phobia and "learning difficulties" has been the subject of just such a debate, and was ordered into surgery to save her from potentially fatal cancer. What does it take to deem a patient unfit to make their own medical decisions? Probably not a whole lot.

Because Bachmann is essentially questioning the motives of the medical community and others' blind trust in it, I think it will be hard for her to wade through the mire of opponents. I'll also be waiting to see if Merck personally decides to take action to shut her up already regarding her claims on Gardasil, or if the media will essentially take care of that problem for them.

I'm seeing an interesting turn of events, though - perhaps what will amount to parents on both sides of the political and faith-based spectrum siding with Bachmann because she is such an outspoken opponent of this policy.

More reading:
Judge criticizes council for trying to force contraception on woman - The UK Telegraph
One More Girl - Truth About Gardasil documentary
Bachmann's Vaccine Theory pulls GOP to Jenny McCarthy Territory 

*The Association of American Physicians and Surgeons, Inc. issued this statement on Perry's approach to state-mandated Gardasil, as copied and pasted from the blog, "A Time for Choosing:"

“Opting-Out” of HPV Vaccine WILL NOT WORK for Many in Texas

Governor Perry is misleading legislators and families in Texas by claiming that they will be able to “opt-out” of having their 6th grade daughter vaccinated with the vaccine for the sexually transmitted virus HPV. For many families currently, the exemption isn’t worth the piece of paper it is printed on. Besides the simple fact that parents should not have to get permission from the state to make informed consent medical decisions for their own children, here are four reasons why “opting-out” of state mandated vaccines doesn’t work for many families in Texas:

“Opt-out” or Conscientious Exemption to Vaccination Process is a Bureaucratic Nightmare

To get the exemption form, parents must first submit a written form to State Health Department in Austin which forces the disclosure of the child’s full name, birthdate, and mailing address. The Health Department takes those written requests and creates yet another form on which they print the child’s same personal information that the parent had to send to health department, and the Health Department sometimes takes weeks to mail out these forms inevitably disrupting the child’s school attendance. The Health Department only sends the forms by U.S. mail, and once the parent receives the forms, they must be notarized within 90 days of submitting them and then repeatedly resubmitted every 2 years even though there is no expiration set in statute.

[1] Because the Health Department further eroded parental rights by publishing more rules getting rid of provisional enrollment for exemptions, (families used to have 30 days at the beginning of school to get their paperwork in), now schools participate in aggressive misleading education campaigns touting “no shots – no school” while not informing families of the exemption or the instructions how to obtain it.

Private Schools Deny Admission

The Texas attorney general issued an opinion in April of 2006, ga0420, that states that private schools do not have to accept the conscience exemption to vaccination in Texas Law[2], and many private schools do not. For example, the Dallas Diocese for Catholic Schools policy number 5024 states, “Schools will comply with immunization requirements established by the Texas Catholic Conference Education Department. Conscientious objections/waivers are not accepted in schools of the Diocese.” [3] Every new vaccine mandate causes more children with valid legal exemptions to be denied their private school education.

Doctors Refuse Medical Care

Even though you may be able to get a piece of paper from the state health department affirming your right to refuse state mandated vaccines for your child, just try and find a doctor who will honor it! According to a recent study published in the Archives of Pediatrics and Adolescent Medicine, 39% of pediatricians surveyed said they would throw kids out of practices who are not vaccinated. [4] PROVE has documented this rampant problem of doctors dismissing families utilizing a vaccine exemption in Texas to the legislature in previous sessions. Please review our report entitled “The Erosion of Public Trust & Informed Consent through Immunization Harassment, Discrimination and Coercion” prepared for the House Public Health Committee in 2005. [5]

Insurance Rates Rise and Accessibility Affected

Responsible parents who have secured health care coverage for their children will be forced to pay higher insurance rates whether they want the HPV vaccine or not. Even if you “opt-out” of the HPV vaccine mandate for Gardasil by Merck by securing a conscientious exemption waiver, there is no way for Texas parents to “opt-out” of the corresponding rise in their insurance premiums. § 1367.053. (a)

(2) of the Insurance Code REQUIRES that any vaccine required be law must be covered by insurance. [6] This first-dollar coverage requirement results in corresponding direct hiking of insurance premiums to meet costs, and for a vaccine as expensive as this one, an HPV vaccine mandate risks putting premiums for basic health care coverage out of reach financially for even more Texas families. Additionally, we have received complaints from families where insurance companies are harassing parents with letters and discriminating on coverage based on whether or not the child has had all their state mandated vaccines.

Has the woman's right to choose gone too far?

When it comes to abortion, I often find myself with one leg straddling each side of the fence: while it's never a choice I hope to have to make, I think it's a deeply personal issue that's between a woman, her doctor, the baby's father, and God. Unfortunately, because of our "right to choose," have we often eliminated everyone but ourselves in that equation? Is it really just about us, and no one else?

Like many women, I don't know if I could make that decision even if it meant dire straits for me. Most mothers would willingly sacrifice their lives for their children, but anymore we are being told that's only okay some of the time. If you want the baby, that's okay; if you don't want to keep the baby, then forget everything and put yourself first. If there is a fetal anomaly, they tell us, it's murky but usually perfectly acceptable to abort based on test results that indicate something might be wrong. Many terminations for fetal anomalies take place because of a problem that is incompatible with life, and I guess I can understand that.

But the "right to choose" starts crossing gray areas when you abort for disabilities that can be corrected: club foot, for instance (a birth defect both myself, my father and my son were all born with). Cleft palate is completely correctible but might leave some obvious scars, but hasn't stopped some people from aborting anyway. Where do you draw the line? At some point, are we engaging in more social engineering to create 'the perfect child?'

That said, I'm not really here to debate abortion in and of itself, just some of those areas where we're unsure - like in this case: mothers who "reduce" the number of fetuses they're carrying for social reasons.

But here's the kicker: Jenny, the mother, is older (which predisposes her to multiples) and she was undergoing fertility treatments - another almost surefire way to guarantee you'll be taking home more than one bundle of joy from the hospital.

Ever since I read that article, I just can't seem to wrap my head around that idea. If you're ill and birth control failed, I can understand that. I've known at least one friend - an evangelical Christian - who terminated an essentially non-viable tubal pregnancy because it could have killed her. But this - just because you only wanted one child and think you can't handle any more than that? I don't get it.

Jenny didn't want to look at the ultrasound screen during the "procedure," because this is "no blob of cells," this is an already formed fetus at around 12 weeks old, with finger- and toenails forming. A tactic often used by the pro-life movement, it puts a face on the child you're carrying, and often resulted in women changing their minds about going through with it. After all, if you don't look at the screen, you can't see movement, the baby sucking its thumb or hiccuping.

A fascinating debate unfolded in the comments section of this article, and many people - even some who claimed to be pro-choice - were left shaking their heads in disgust. It also caused many pro-choice advocates to rethink their stance on the right to choose, and how that right has essentially turned into something much, much different than originally planned. I applaud their ability to perhaps reexamine their stance and question the moral and ethical lines that this issue has crossed.

As the sole bearer of a pregnancy, it seems we have taken that power to extremes and used it in ways that give us unimaginable power over another human being - and not just the potential life that we're carrying. While the pro-choice culture seems to do everything in their power to demonize "sperm donors" as uncaring and uninterested (which many of them are, admittedly), I've heard from many heartsick dads who desperately want the woman - the mother of their child - to reconsider before having an abortion. They want to raise the child, even terminating the mother's rights if that's what she wants, so they can be the dad they feel responsible for being. But they're basically told "it's the mother's right to choose, buddy" and that he has no recourse whatsoever in seeing his offspring into this world. Because it's her womb, he's basically shit out of luck.

On the flip side, there are those women who unintentionally get pregnant and want to keep the baby, but the father does not. Perhaps both of them thought they were protected by birth control, and were using it correctly but something obviously failed. Should he be forced into being a father, even after taking reasonable measures to protect himself? If neither party expected the birth control to fail, even after using it responsibly, then what? I have no real answer for that one. But I bet the court system does: it's called child support.

When a father wants to walk away, we hear "he needs to man up and take responsibility for his baby." But just by virtue of the fact that she has all the right "parts," the same does not apply to her. 

Jenny is just one of many who virtually strong-armed her doctor into performing the procedure, and still "resents" that a doctor refused her. How can she ethically force someone else's hand to be part and parcel to her idea of a "perfect" family? Is it fair, or ethical? Do these people even care?

As far as Jenny is concerned, I see a common line of bizarre reasoning pop up when she voices her concerns: how will I have enough love for all my children? I don't want to neglect my older children and be a "second rate" parent, whatever that means. How will I be able to provide for those children? Those fears are not uncommon, even among mothers of singletons. And yet, once that child (or children) is born, you suddenly forget all about that and focus on your child. And no doubt, you just do it. I know my kids would probably be thrilled at the idea of having two babies in the house, but it seems few think of consulting the remaining siblings in the family. What if they say, "Sure mom, that's great. We'll do whatever we can to support you?"

Some of the comments came from parents of twins, one mother flatly stating, "I wouldn't wish twins on anyone." That makes it sound like a death sentence; as if anyone who conceives twins is doomed to failure and can't possibly take on the task. Culturally we've come to see children as an inconvenience, and something about these women suggests that they want to control the conception, the pregnancy and the birth, right down to the letter. Perhaps these are the mystery women we keep hearing about that want to schedule their inductions and planned cesareans around their work schedule? I'm sure they exist, somewhere.

Yet, women living in the 21st century have more access than ever to toys, television, video games, high-tech cribs and all kinds of stuff to keep kids busy. Strollers, Moby wraps and Baby Einstein were completely unheard of in our grandmother's generation. I once told my dad, "I don't know how your mother did it with seven children and no stroller or playpen." He just laughed - because that was what you did - you just did it. Because they were your children and you loved them. I think we have this idea that every woman everywhere was tied down to the bed during ovulation every month so that she would immediately become pregnant with 14 children during the course of her lifetime. While there are women in my distant lineage who fit that description - probably a baby every 18 months or so - they weren't all that common. I think we take that information and apply it to our own lives, in a modern sense, and think "Dear God, how insane is that? How could you possibly handle all those children?" Since we can't travel back in time to ask Great Grandma Mabel herself, we probably won't really know the answer to that question.

The one major problem I have with Jenny's situation is that she never gave it a chance. You can assume, based on how high energy your toddler is (come on, what toddler isn't high energy?!) that you couldn't do it. I would venture a guess that yes, it's pretty tiring and emotionally draining at first to raise twins, just like it often is with singletons. In retrospect, some singletons are probably even more "work" than twins would be - but you can never know for sure. When I think of the people I know who, before modern ultrasound, didn't even know they were having twins until mom suddenly got the urge to push one more time - I think, "Ha - you think you've got it bad?!" At first, it's a shock, but then you step back, reexamine your priorities and pull your head out of your ass and say, "Okay, I can do this." Especially since I basically predisposed myself to this "problem" to begin with.

I question her motives for terminating based on what her life is like now, before having another baby - because our typical American culture is so beyond spoiled that real, true poverty is virtually unheard of for us. Perhaps for some they are truly scrimping and saving as much as they can; for others it means they'd have to get rid of a third car and send their kids to public school instead of private, and well, that's just unacceptable. I know at least one couple who are struggling through adoption, and I speculate it's because they do not want to risk having their own biological child due to his hereditary heart defect. Are their fears grounded? Probably. But instead they have chosen not to create that life in the first place, rather than take a chance and then renege like Jenny seems to have.

There are some who believe if an abortion is sought, it should strictly be used for dire circumstances. There are also those who believe, as one commenter did, that a woman should have a right to choose at any time during her pregnancy. As we saw in the recent murder case of Dr. Tiller, he often aborted babies very late in pregnancy, often near term, which probably makes even some of the most hard-core activists squirm. As it should - because, we can argue, that at that stage in the game a baby can survive, even with some theoretically minor complications, but still have a quality of life. If they were all medical terminations, you'd think whatever was so life-threatening would have claimed the mother's life before 40 weeks gestation. To me, Jenny's situation is more like a designer pregnancy - where parents and doctors can basically socially engineer the "perfect child." One OB in the article says she would definitely terminate if an anomaly were found; and reducing a pregnancy is just engineering that family size to better suit your supposed wants and needs. How is it really any different than say, sex selection in India or China - which is still based on cultural beliefs and expectations, just different ones, perhaps.

It's easy to say, as Jenny did, "don't judge" - which sounds, anymore, like code speak for "Don't judge me, because I don't want to be held accountable for my actions," however morally repugnant they might be. We certainly "judged" women like Susan Smith, Andrea Yates and Casey Anthony for their part in the deaths of their children - who, one can argue, at least had the opportunity to live a life, no matter how short. Like one commenter said, "What's the difference if you give birth to twins and then stab one of them?" A few weeks, maybe months. The behaviors we observe on ultrasound at 12 weeks aren't much different than those seen in a newborn, except that they can live and breathe outside the womb.

When you have even pro-choice advocates questioning their stance, it becomes clear that the "freedom to choose" has become completely manipulated and abused, to the point where it has morphed into something totally different than what it originally set out to be. And now, as a result you see almost a callous lack of appreciation for human life - which you can't deny at 12 weeks gestation. I've seen much of that same coldness in many teens facing pregnancy today.

It seems like Jenny's biggest problem is that she sees life as a guarantee, when it really isn't: there is nothing saying that she wouldn't miscarry the remaining baby, experience a still birth at 38 weeks, or her husband wouldn't drop dead of a heart attack the day after she came home from the hospital. Some in the article talk at length about all the risks of having a twin pregnancy, yet in the same breath we tell women, "Pregnancy is not an illness!" And I'm sure many of the supposed risks and fears Jenny and others were gripped by would, like they often are with everyone else, never be fully realized. Like the last couple mentioned in the article, who were both expecting twins at the same time, they reduced and then later miscarried anyway. They have to ask themselves, was it all worth it? Are we really exercising our right to choose, or playing God?

Is brain-damaged mom "still" a mom?

I was reading the news online last night when I came across this article about Abbie Dorn, a woman who experienced catastrophic brain damage during a cesarean section to deliver her triplets. As a result of medical error, she lost oxygen for at least 20 minutes. While the details of the birth have not been disclosed, as a result she is in her parents' care - and the triplets are with their father across the country, after he divorced his wife in the year following their birth.

As others have already said, this case is very reminiscent of Terri Schaivo's, with the exception of having children, of course. Terri was a young woman who also suffered brain damage, and her parents were fighting to care for her, even in her near-vegetative state. Her estranged husband (who by that time had moved on with his life and had a fiancee and children), strangely, had rights to terminate her care and did so, causing her to essentially starve to death after a 13-day struggle. In Abbie's case, at least her parents are caring for her, and I'm not sure why that wasn't the case with Terri.

Abbie's husband feels that their children would be better off not seeing their mother, perhaps alarmed by her compromised state. He is also arguing for child support monies to come from her huge malpractice suit that is currently funding her care. He has reportedly kept them from their grandparents and allegedly hidden pictures of their mother from the children, saying that he doesn't want them to feel guilty about their mother's circumstances because it was their birth that caused it.

According to the article, the grandparents wanted their son-in-law to bring the children to see them regularly, as any grandparent would. Apparently until the four-year-old children saw their mother at the end of last year, he had not done so until that point.

I can't think of anything more sad and pathetic than the father's behavior in this situation. Admittedly there is no chance of his wife recovering the way she was before, which means it totally changes the nature of their relationship. To some people, that's okay, and they will continue to support their spouse regardless. To others, a divorce or annulment is also understandable as they are young and have an entire lifetime ahead of them, perhaps remarrying and having more children. Either way, though, it doesn't change that these grandparents have grandchildren whom they've barely seen, or held, until they turned four.

A friend of mine married quite young, and before he turned 30, he became a widower. His young daughter was barely a preschooler when her mother died, and yet she regularly sees her maternal grandparents in the summer. As awkward as it might be, considering her father has remarried and had another child, he still believes that his daughter needs to have a valuable relationship with her grandparents, as most people would. It seems that only when there's already bad blood existing between the grandparents and parents do the grandparents' rights get terminated or curtailed severely, which makes me wonder about the relationship Abbie's husband had before this even began.

Considering that often when there is a custody problem - say, if the parent is unfit to raise their child - they often place the child with its grandparents. And yet, grandparents have little if any rights in any state when it comes to their grandchildren, even though they are often willing and able, and are an interested, blood-related connection to the child. In this case, Abbie's parents realize that she will never be able to raise her children, but that still doesn't mean she - or they - shouldn't deserve to see them.

Aside from the rights of the grandparents, this issue raises questions for me - namely, the idea of personhood and the rights of the disabled - not to mention the triplets' right to see and know their own mother. The question "what would she would have wanted?" comes up, both in Abbie's case and in Terri Schiavo's. Terri was very young when her brain injury happened, and it's easy to say that a 20-year-old would not want to live with what others perceive as a "low quality of life," which is a relative term, at best. But when it comes right down to it, perhaps Terri would have wanted to live, and be in the care of her parents, surrounded by compassion and people who loved her. I'm sure Abbie would never say, "I don't ever want to see my children," if she could predict such a terrible outcome. Considering Abbie's current state and the orders of the judge (who originally sided with the dad), it's like they're saying Abbie is not really a person with any rights, just because she's severely brain-damaged. She gave birth to these children - how can you even begin to question, "Is she a mom?"

Ironically, when the triplets were allowed to finally see their grandparents last year, lawyers for both sides agreed that the visit went well. So then what's the problem?

Some have wondered just how "religious" the father is that he can deprive the children of their mother, by hiding her picture and refusing to talk about her to them. I'm sure it's painful and uncomfortable, but I don't see how his actions - or the court's - can possibly help this case.

In seeking money for child support from her estate, he's essentially saying, "Grandparents, I'm going to sever all ties and keep your grandchildren from you, but I want your settlement money to help raise them." Had he maintained more of a relationship with them, perhaps he would have been rightfully entitled to some of that money, including probably had childcare support from them. Talk about burning your bridges.

A new trial is set for May 13.

More here:
Judge to Decide if Paralyzed Mother Abbie Dorn Deserves Visitation Rights - Huffington Post
Stand Up for Abbie Dorn - A FaceBook-based advocacy group
Terri Schiavo - Wikipedia article

SF Circumcision ban: Be careful what you wish (vote) for

Could government involvement
make your parental rights go up
in smoke? 

It seems that whenever California disagrees with the safety on something, they ban it. First incandescent light bulbs; then it was the toys in your child's Happy Meal. Now the City of San Francisco is engaged in battle over whether circumcision of male newborns should be illegal. If the legislation were to pass and you violate the ban, you could be jailed.

This is not meant to turn into a debate over whether the act of circumcision is right or not, as both sides of the argument, in their own eyes, have a very valid point. This is a debate over whether an entity other than the parents and the doctor - in this case, a city government - should be allowed to have a say in what you do with your child.

In this case, it seems that Lloyd Schofield - the guy who is bringing the debate to the forefront - thinks it does indeed take a "village to raise a child." Should that village have a voice in your parenting decisions if this issue is on the ballot?

I think that if this measure passes, it could be a mixed victory for circumcision opponents.

Whether you think it's right or wrong, it's really not your decision to make. Whether it's for cleanliness issues, a matter of religion or just because, when it comes down to whether it should be done or not is not a decision the public at large should have a say in.

In certain cases, it is definitely not recommended - such as when the baby's health is compromised. If the parents aren't aware of the dangers, it should be a joint effort of parents and the doctor to be educated on the risks and potential benefits, and the doctor should say up front, "Your child has this condition, and if you're considering circumcising him, perhaps you should reconsider."

When you talk about banning something like this, it is essentially ramming the ideology of one group down the throats of those who don't agree, and if the shoe were on the other foot, you can bet that wouldn't go over too well.

Take, for instance, the birth of Ruth Light, whose parents are currently engaged in endless court battles to regain full custody of their daughter. Ruth was born in a breech presentation at home, and experienced a brief shoulder dystocia, but was otherwise declared healthy and recovered from it. Her parents, being cautious and wanting to make sure she was well, took her to the hospital after her birth, where the physician declared that she was fine.

However, somewhere along the way a well-meaning, perhaps uninformed hospital worker decided that Ruth's birth problems could have been avoided had she been born in the "safety" of a hospital via cesarean, and children's services were dispatched. Ruth was removed from her parents' custody as a result.

Compare the home birth debate to the circumcision debate for a moment: one side says it's safe, and presents few complications when managed well. The other side says it's dangerous, presents complications that could result in death, and should be outlawed.

In both cases, there have been studies that declare it reasonably safe. And there have been studies that say it's dangerous and should be avoided at all costs. Which one should we believe, in either case?

Ultimately, yes - it's a human rights issue on one level, I'm not going to argue with that. But it's also a parents' rights issue, and as the caregivers responsible for that child, they are going to make choices on behalf of their children that could affect their lives, whether perceived as great or small. Atheist or Christian, meat-eating or vegan, we make choices for our kids every day, and dismiss them as just merely decisions that we make in raising our children the way we see fit. The choice not to vaccinate? Perceived as dangerous by some, there are currently laws on the books - as mandated by the government, in certain states - to have your daughter receive the Gardisil vaccine. Considering there have been reports of injury and even death regarding the vaccine, should you be forced by the state to vaccinate your child anyway? Or should you exercise your parental authority on behalf of your child?

Ultimately, whether you like the idea or not, you can't stop people from doing what they want to do. I'm guessing that any parent could simply locate a doctor outside the San Francisco city limits and get their child circumcised, if they felt that strongly about it. This same type of legislation could be used against parents, essentially weakening or severing altogether their authority to make decisions for their children.

Given our currently litigious society and the escalating role of government in our lives, and I can see this getting out of hand very quickly. In some ways, the Orwellian aspect of it has already taken over: forced c-sections, VBAC bans, pregnant women kicked out of bars because it's potentially risky to their unborn child (even though the mother in question didn't consume alcohol). (Let's not forget that some medical authorities consider it safe to drink wine occasionally while pregnant - are we going to publicly shackle women who adhere to this idea?) Where do you draw the line? Who's kid is this, anyway?

Why not outlaw formula feeding because it's dangerous and unhealthy and is inferior to breastmilk. After all, some babies have died from it - whether from contaminated water or from the very product itself. Piercing your infant daughter's ears? Doesn't matter if it's for religious or cultural reasons, it should be outlawed because it's for vanity reasons, can cause infection, and is not medically necessary. How about co-sleeping, because some people think it's dangerous? How about banning epidurals because they could potentially harm the baby? We could go on and on.

Those Happy Meal bans were instituted because the city wants McDonald's to put in healthier foods. Does that mean it'll soon extend to limiting parents' right to take their kids to McDonald's? Should we limit them to one visit per family per month in an effort to force them into healthier eating? Or how about we place them under house arrest and jail them if they don't feed their kids all organic, nutritious food once they're in the privacy of their own home?

Regardless of where we stand on the issue itself, I just wish people could see that involving government in the matter is not necessarily the best course of action. Beating someone over the head with your argument will not effectively convince them to rethink their stance so much as it will perhaps make the other side look like a bunch of crazy zealots. Nor will it help to infringe on the religious views of parents who circ for those reasons (separation of church and state, anyone?). A wide-scale education campaign, perhaps - starting in your obstetrician's office - is perhaps a kinder, gentler idea that will win more parents over and leave more little boys intact.

More reading:
'Intactivists' to San Francisco: Ban Circumcision 
San Francisco Circumcision Ban Unconstitutional, Professor Says
The 'Crappy Meal,' from Comedy Central: meant to be funny, but an interesting look into what the city can and can't force people to do