Yep, it’s inevitable. Another week has come to an end. In health news this week:
- Saturday is World Prematurity Day, which is very close to my heart since my son was born 12 weeks too soon. The US isn’t doing a great job in preventing prematurity, we’re currently 113th in the world in numbers of preterm births (?!). According to the World Health Organization, 15 million babies are born too soon every year. That’s more than one in 10 births — and more than one million of these babies die shortly after they are born. The WHO and the March of Dimes estimate that three-quarters of preterm babies who die could survive without expensive care if a few proven and inexpensive treatments and preventions were available worldwide.
- Turns out that doctors with less than ten years experience spent an average of 13% more than more experienced physicians. I like this study because it looks at how physicians — instead of patients — are responsible for escalating healthcare costs. This isn’t something that you hear very often. =
- Drug makers called “compounders” are to blame for the recent meningitis outbreak caused by fungal contamination in a steroid prescribed to people with back pain. These companies (like Ameridose, the company responsible for the tainted steroid in question) are essentially unregulated by the FDA. They have been supported by many in congress because their products are often an affordable alternative to huge drug manufacturers. One argument about regulation was that states should be left to do it themselves. This confirms my theory that whenever a government official makes a states’ rights argument, it is cause for concern.
- A study of pregnant Medicaid recipients in 14 southern states found that African-American women were more likely than to have longer hospital stays and pregnancy complications. The study estimated that eliminating disparities in adverse pregnancy events could save between $114 and $214 million annually in Medicaid costs in the 14 states studied.
- Access to contraception is a human right. Even the United Nations says so.
Have a great weekend! Meet you back here next week, when I’ll be posting about healthcare in-sourcing, premature birth, and sharing an interview with a wonderful doula and author!
When I was pregnant, I was in the hospital for 2 weeks before I gave birth. When my son was born, he was three months premature and weighed only two pounds. Less than 24 hours later, I was given my walking papers and sent home.
To say I experience postpartum anxiety and depression is a bit of an understatement. The experience left me shaken and shattered. On the exterior I think I appeared to be handling it well (maybe not, but that’s the image I thought I was projecting), but at home I clearly wasn’t. Whenever I closed my eyes I saw a nurse roughly handling my tiny child’s naked body. I was plagued by the thought of them touching him with their cold hands. At work I was terrified every time the phone rang, sure that it was a doctor calling to tell me that my baby had died. I would wake up in the middle of the night and not be able to stop crying. I couldn’t concentrate long enough to read a sentence, cook a meal, or even have a decent phone conversation.
Luckily, the hospital where I visited my baby every day did a good job of monitoring mothers for postpartum issues. Luckily again, my partner was attuned to my mental state and made me get the help I needed. I ended up visiting a psychiatrist and got medication which I’m convinced to this day saved my life.
My son is almost four, and it’s just this year that the haze has begun to clear. The past four years have been fantastic is so many ways, but one morning not that long ago I woke up and I finally felt like myself again. It was shocking. As this article describes, postpartum depression can last along time. It’s not just the baby blues. It’s not just not being able to get out of bed or wanting to hurt your child. It’s not just ennui experienced by bored, white middle class women. Postpartum depression is complex, it manifests itself in many ways, and it affects women around the world.
Postpartum mental health issues are, I think, among the most hidden and most taboo. There are a few very brave celebrities who have spoken about their experiences (Alannis Morissette, Brooke Shields), but women are still bombarded with the message that they should ease gracefully into their new role.
One thing that initially stopped me from wanting to get help was a fear that my child would be taken away from me, particularly as a gay woman. My child was in the hospital, and I was worried that if I exhibited anything less than stellar behavior, the social workers and doctors would decide that he couldn’t ever come home with me. To this day, I rarely tell anyone about the experience. It’s too scary to admit. It means failure, it means weakness, it means the threat of losing my child.
The scope of reproductive health issues that women face is so large that it can’t possibly fit under the umbrella of family planning. Postpartum depression is one of the most common complications of having a baby, but we don’t see it addressed nearly enough in discussions about reproductive health.
Among the many things that Obama’s Affordable Care Act will put into law is the H.R. 20 — Melanie Blocker Stokes Mom’s Opportunity to Access Health, Education, Research, and Support for Postpartum Depression Act.
What does Mitt Romney have planned?
I didn’t post here yesterday because I was hard at work writing up a piece about Call the Midwife for Bitch Magazine’s blog. If you’re interested, you can read it here.
Today is World Food Day.
There’s always something when it comes to children and food.
They can be unbearably picky. They can be greedy. They can miraculously survive on different combinations of white flour, sugar and food coloring for months and months on end.
I’m thinking about this today because my son hasn’t been feeling well. On Wednesday he threw up in the morning, and then again in the afternoon. He went to sleep early, and seemed okay when he woke up, but then he was upchucking all over again the next day. He’s stopped throwing up now, but he still says he feels sick. He refuses dinner yesterday night, choosing instead to languish on the couch while we all watched Lars von Trier’s
not really that child appropriate Melacholia.
When it comes to throwing up, I always worry. He was born 12 weeks premature, which is notoriously hard on the digestive system. He was so small, just two little pounds. He had terrible acid reflux as a baby, making digestion and burping very painful. It’s been years since then, but whenever he catches a stomach bug, it brings back those memories.
It makes me obsess about food.
He’s small, and I worry that he’s losing weight. After he stopped throwing up and eased back into regular food, I bought peanut butter ice cream, and protein shakes. I scrambled some eggs with half-and-half, and took him out for French fries and a grilled ham and cheese sandwich soaked in butter. And then I worried that I shouldn’t be letting him eat meat because what if he gets E.coli? Or mad cow disease? Or salmonella?
But then I have a reality check.
In 2011, almost 7 million children under the age of five died, most from conditions that were preventable or treatable with access to simple and affordable interventions. A full third of childhood deaths are related to malnutrition.
Malnutrition is a cycle. Women who don’t get enough to eat give birth to malnourished children, and the cycle continues. Furthermore, men tend to have more access to food than women, and women are the ones who are look after the children in most settings.
Not having enough food is mostly prevalent in Sub Saharan African and Southeast Asia. In the US, we don’t worry really about malnutrition.
The number one killer of children in this country is accidents. That’s a whole other level of worry. You can put a helmet on your child, or make sure you keep an eye on him when he’s on the monkey bars. You can buy a great car seat, and put a fence up around the pool. There are lots of things you can do to keep your child safe, and they probably won’t die from an accident.
But malnutrition? That’s a whole other ballgame.
There are 20 million young children around the world don’t have enough to eat or don’t have access to clean water; and for every child who is sick, there is a mother experiencing a personal crisis. Before I had a child, I couldn’t really understand this. But I’ve seen my baby with no fat on his little body, eyes sunken, bum like two deflated balloons. I’m haunted by it, but I know that the chances of us revisiting those days is slim.
My kind of maternal anxiety is a luxury.
I don’t watch much TV.
Don’t get me wrong: it’s not because I don’t love sitting on the couch and passively receiving information from the screen. It’s just that I’m way too cheap to pay for cable, which means we only get PBS, Fox, and Univision. I hate Fox and I don’t speak Spanish, and I’m not a fan of Rick Steves. So most of the TV I watch is children’s programming on PBS. Otherwise, I rely on Netflix and DVDs from the public library for my evening entertainment.
But last Sunday night, for some reason I turned on the TV, and was pleasantly rewarded with an episode of Call the Midwife.
Have you seen this?
It’s an hour-long drama about midwives in the 1950s in London. And it’s so good! In my wildest dreams I could have never imagined this program would be on television. It’s been airing in the UK for a year, but PBS just picked it up here (is this what makes Mittens want to defund the station??).
Created by writer Heidi Thomas –who wrote a screen adaptation of Middlemarch and is doing a remake of BBC classic Upstairs Downstairs– the program follows four young midwives in East London who work with the nursing nuns at Nonnatus House. They deliver 80 to 100 babies a month.
In the first episode, we’re introduced to Jenny Lee, a new midwife. She rides a bike. She delivers a preemie. She treats a woman with syphilis. And although she is initially disgusted by the syphilis and overwhelmed the sheer number of pregnancies, by the end of the episode she characterizes the women she serves as heroes who endure tremendous hardship but always keep going.
To me, the show functions partly as a public service announcement for the health benefits of contraception and safe, legal abortion. The woman who gives birth to the preemie has 24(!!!) other children. The patient with syphyllis miscarries her 13th. These unending pregnancies ravage women’s bodies, age them before their time, and add to seemingly insurmountable poverty.
But what was a woman to do?
At the time, there was no accessible birth control, no family planning clinics, no way to really limit pregnancies in a safe and effective way. It makes me wonder what those Republicans who want to restrict contraception have in mind for the future. Would they see this ceaseless procreation as a type of utopia? It’s hard to imagine anyone actually advocating to make contraception less accessible.
Opposition to family planning technologies cannot possibly have any public health benefit. That means that opposition to birth control can only mean one thing: opposition to gender equality. For women, having control over our fertility is the baseline for equality. Without control over your fertility, you have no hope of social equality. Period.
That doesn’t mean that I’m jumping up and down with joy because Bayer has decided to make contraceptive implants more affordable for women in poor countries, or that I’m an unapologetic supporter of DepoProvera, or that I think that the contraceptive patch is the best thing since sliced bread. It doesn’t mean that I don’t see issues with many family planning interventions. But although I have plenty of reservations about hormonal birth control, and sometimes question the zealousness with which international development organizations approach family planning initiatives in other countries, I am 100 percent certain of one thing. Female-controlled birth control is a fundamental right.
I don’t watch much television, but for the next several weeks, I’ll be glued to my set on Sunday nights.
I’d love to hear your thoughts. Do you watch the show? Do you like it?
It’s been an amazing week. I wrote an article for Bitch Magazine’s website. I gave at talk about breast cancer advocacy at my local library. I tweeted with Breast Cancer Action during the presidential debates.
There’s been a lot of interesting stories in health news this week, like most weeks. Here’s my round up!
- Looks like free birth control leads to fewer abortions and fewer teen births.
- Bayer is reducing the cost of their contraceptive implants to distribute to women in poor countries. What do you think? Is this a good thing?
- California makes it illegal for psychiatrists to offer young people a cure for homosexuality. Definitely a good thing.
- The NYT Motherlode published an interesting first-person perspective on post-partum depression.
- Mitt Romney told a lot of lies about his healthcare plan during the debate.
- I like this research because it blames racial discrimination for causing health disparities instead of reporting that health disparities exist between white folks and racial minorities. The study is particularly close to my heart since it is about low-birth weight babies (my son was just under 3 pounds when he was born).
- Hobby Lobby doesn’t want it’s employees to be able to get emergency contraception, so they’re fighting tooth and nail to be allowed to ban coverage of Plan B from their health plan. I wonder if they cover Viagara?
That’s all for now. Thanks for reading, and see you next week!
Last week, Jessica Valenti, feminist blogger and author, expressed her frustration that a major news organization proposed she dish about her experience with “shedding the baby weight.” After she pitched a serious story examining the rhetoric of motherhood paraded at this month’s political conventions, the editors responded:
We’re doing a lot of coverage around Jessica Simpson’s efforts to lose the baby pounds, and we’d love to hear from Jessica Valenti about what it was like for her to shed the weight.
It’s a suggestion that is clearly an insult to a professional writer who analyzes issues of reproduction, motherhood and sexuality. But from a public health perspective, it’s an opportunity to reflect on the mainstream discourse about maternal child health.
Proposing that Valenti write about losing weight becomes even more insulting considering that she had preeclampsia which led to an emergency C-section and meant she gave birth three months early to a child who weighed only two pounds.
I was hospitalized after a routine exam showed I had dangerously high blood pressure Andrew and I assumed it was all an overreaction because I didn’t feel sick. Even though the doctors were telling us I wouldn’t leave the hospital until I gave birth and that I might need to deliver in days, we didn’t really buy it. We even pooh-poohed the neonatologist who spoke with us about what we should expect having such a premature baby. We planned as if I would carry Layla to term, bringing DVDs and books to the hospital and starting to create a schedule of visits from family and friends.
I can relate.
Like Valenti, I gave birth three months early. My water broke at 26 weeks due to preterm premature rupture of membranes (PPROM). I too was told I wouldn’t leave the hospital until I gave birth, but my partner and I didn’t really buy it either. We’d planned to give birth at home.
I hadn’t read much in the news about prematurity, and to be honest, I tended to avoid reading health stories pertaining to pregnancy. Reporting about pregnancy and health can be frustrating. Is dieting during pregnancy safe? Does having a fever during pregnancyincrease your risk of giving birth to a child with autism? How can you work with your pregnancy cravings for nachos and ice cream instead of against them?
On the other hand, maternal health issues concerns like preeclampsia, or even debilitating morning sickness are real, serious and important but often lie outside the public discourse about pregnancy. Even during routine prenatal care, discussions about prematurity or even postpartum depression and anxiety are often lacking.
We have much to be thankful for in this country, of course. Few women in the US die in labor. Major issues like vesico-vaginal fistula have largely been eradicated, and availability of blood transfusions, sterile conditions, and trained providers mean that giving birth in the US is safer than it is in many parts of the world. And despite our flawed medical system, most pregnant women are even eligible for state-subsidized health insurance.
Still, the US does have an unforgivably high infant mortality rate, and a 2010 Amnesty International Report claims that two women a die die giving birth in the country. One in every eight babies born in the US will be born before term, which costs the health system millions of dollars. Worldwide, 13 million babies are born too soon.
Yes, shedding the baby weight is a concern for many women after giving birth. But there are so many other important health concerns for pregnant women that barely even get a mention.
Wouldn’t you like to see more quality reporting about prematurity, preeclampsia, and other issues related to pregnancy? What do you think about reporting on pregnancy and birth in the US? Have you seen reporting about maternal health in other countries that is better (or worse!) than it is in the United States? Is there anything maternal health organizations could do to encourage more reporting on important health issues pertaining to pregnancy and birth?
Let me know your thoughts and insights!