Thursday, September 30, 2010

Bullying Takes Another Life

Tyler Clementi was a Rutgers University first year who friends describe as "a terrific musician, and a very promising, hardworking young man."  But last week, he left a note on his Facebook page: "Jumping off the gw bridge sorry."

What happened to turn this promising, talented violinist into a suicide statistic?  The answer may not surprise you.

Shortly before his death, Clementi asked his dorm roommate for privacy.  His roommate, Dharun Ravi, consented, but covertly turned on his webcam before leaving.  He later tweeted: "Roommate asked for the room till midnight. I went into molly's room and turned on my webcam. I saw him making out with a dude. Yay."  Two days later, he followed up, "Anyone with iChat, I dare you to video chat me between the hours of 9:30 and 12. Yes it's happening again."  Ravi went on to broadcast the live stream on the internet. 

Dharun Ravi and Molly Wei, both 18, have been charged with two counts each of invasion of privacy.  Ravi has also been charged with two more counts of invasion of privacy for taping the second encounter.  It is a fourth-degree crime to collect sexual images without consent, and transmitting them is a third-degree crime that could lead to a five year prison sentence.

The whole story makes me sick to my stomach.  I can't even begin to imagine the shame, the feelings of over-exposure, that drove Clementi to feel like suicide was his only option.  Being videoed in a more socially-acceptible, man-woman encounter would be bad enough, but having your sexuality exposed, being literally dragged out of the closet to hundreds of perfect strangers, is enough to make anyone feel as though there's no good way out.  It is a stark reminder of how prevalent bullying is and how dire the consequences can be.

My heart goes out to the friends and family of this young man whose life was taken far too soon by a society that saw his personal life as a side-show prank, an entity to be hunted and exposed, instead of a human being deserving of privacy, respect, and love.

Tuesday, September 28, 2010

My Complex Relationship with ACOG

ACOG is once again throwing its weight around on home birth, this time using shocking yet  largely meaningless language to scare women from making informed decisions about birthing options.

An ACOG position statement claims home birth "triples the neonatal death rate" and accuses home birthing women of "plac[ing] the process of giving birth over the goal of having a healthy baby."  This statement in and of itself is problematic, as surely you'd think a highly respected organization of doctors realize that processes usually dictate outcomes.  A home birthing woman who is under the care of an experienced medical professional (a midwife) is likely to experience a low intervention birth in the comfort of her home.  Because childbirth is a natural process as old as time itself, our bodies are fully capable of creating, growing, and delivering new live into the world.  In most cases, this process is going to happen on its own, and the results are going to be healthy.

Which is not to say I don't see the place of medical science in prenatal and neonatal care.  Complications arise, and it is important for home birthing women to be able to make informed decisions about when home birth is and is not a healthy option.  Additionally, the midwife needs to be able to step in and suggest a transfer when she feels the situation has gone beyond her ability.  When these complications arise, whether they're in the prenatal or neonatal period, we are fortunate enough to live in a society that can handle the problem and work diligently towards good outcomes for both mom and baby.  (Though, our track record on this isn't as good as it should be, nor is it up to par with the rest of the developed world, but that's another post.)

However, a culture that assumes there will be problems and therefore micromanages the entire process from start to finish is outright harmful to women, their babies, and their birthing experiences.  Additionally, many of these routine interventions cause more problems than they prevent, and if they weren't being carried out solely in a hospital environment, I guarantee we'd see higher neonatal mortality rates associated with them as well.  I could go on and on, but I'll let The Business Of Being Born explain:



But getting back to the statement by ACOG.  All of my work around debunking myths perpetuated by the anti-abortion camp (strangely enough with much information via ACOG) has taught me the difference between relative risk and actual risk.  When the antis say abortion increases your odds of developing breast cancer by 50%, they're talking about relative risk.  When they say the Pill increases your chances of experiencing heart attack or stroke by 50%, they're talking about relative risk.  And all of their research is coming from meta-analysis, a method of data interpretation which is not appropriate for determining cause and effect. 

ACOG knows this, but it doesn't stop them from utilizing the very same tactics as the antis, though ACOG's enemy is home birth.  Their expert statements on the purported abortion-breast cancer link debunks the claims of anti-choice researchers by specifically stating that meta-analysis is not appropriate in determining cause and effect, and relative risk is not basis for overtly issuing scare-tactics disguised as medical research.  And yet they turn right around and use research they know to be flawed in order to demonize home birth.

The American College of Nurse-Midwives issued this statement in response to ACOG's claims regarding home birth: "We are puzzled by the authors’ inclusion of older studies and studies that have been discredited because they did not sufficiently distinguish between planned and unplanned home births — a critical factor in predicting outcomes."  ACOG's language in and of itself is meant to skew the reality of home birth risk.  When they say the neonatal death rate is tripled, they are discussing a relative risk.  From Medscape writer Andrew Vickers:
In place of a "tripling in death rate," the more informative statistic is the absolute increase in neonatal death associated with home birth. On the basis of the results tables, it is possible to calculate that this turns out to be 1 neonatal death per 1000 women who choose home birth. However, the results tables show that those women would also experience some benefits, including 40 fewer premature labors, 45 fewer cesarean sections, 140 fewer vaginal lacerations, and 140 fewer epidurals.
Vickers goes on to say that, truly, weighing the cost-benefit ratio between infant mortality and maternal morbidity can seem, well, dark.  But it's something each and every pregnant family does every day when choosing birthing options, deciding on a care provider, creating a birth plan, and making decisions about where and how they will bring their children into the world.  Every obstetrician does this, too, when faced with a prenatal patient who is experiencing a complication.  Maybe that's the issue ACOG is having with home birth, that it becomes far more the family and not the doctor who is in charge. 

The reality is that birth is normal, and in the case of many women, home birth is an option that can be as healthy (if not moreso) than entering into a high-intervention hospital system where their bodies will be micromanaged.  It is up to each woman and her family, not ACOG or the government, to make informed decisions about their birthing options, and they need to be able to readily find information that is evidence-based, unbiased, and accessible.  Shock-doctrine headlines like "Home Birth Triples Neonatal Death Rate" is not any of the above.

P.S. How offensive is it for ACOG to charge that women only choose home birth because it's "trendy" and in-vogue??

Monday, September 27, 2010

Who's The Terrorist?

Today's post will take the form of a picture game I just made up.  It's called "Raided vs. Not Raided."  Let's see how ya do...

1. Which picture represents a movement has been targeted by the FBI for suspected material support for terrorism?



2.  Which sign has led to FBI investigations?






3.   Which message has prompted the FBI to raid the homes of several Minnesota and Chicago residents?


4.  Which activist can be seen getting high-fives from several police officers?



5.   EXTRA CREDIT.  How likely are the targets of the FBI raids to be arrested and charged with any offense, small or large?

Answers:
1.  A.  The latest FBI raids involved peace and justice activists who were suspected of supporting "terrorism" in Palestine and Columbia.  Minnesota resident Jessica Sundan told the press, "I don’t know what they’re looking for, but I do know that I’ve been an outspoken activist for peace and justice, opposing U.S. government intervention in other countries, including Colombia, which was one of the places listed on the warrant."  The picture on the right depicts a tea party activist threatening armed resistance. 

2. B.  The FBI also raided the home of Hatem Abudayyeh, director of the Arab American Action Network, whose banner is shown on the right.  The photo on the left is a recent shot of an anti-abortion protester. 

3.  B. Citing connections with "Colombian terrorist organizations," this week's FBI raids also targeted immigrants rights activities.  The sign on the left is from a National Organization for Marriage rally.

4. A.  The man with the rifle is at an anti-Obama rally where the president was speaking nearby.  The man in the picture on the right is anti-war activist Hatem Abudayyeh, also targeted by this week's FBI raids.

5.  Highly unlikely.  Historically, raids on anti-war, peace, and justice activists very rarely end in arrest or provide any incriminating evidence.  However, these raids are meant to send a message to social justice advocates everywhere: keep it quiet and non-threatening, or we may be at your door tomorrow.  On the flip side, I have yet to hear of any FBI investigations on the men who bring guns or warnings of guns to conservative rallies, whereas unarmed peaceful activists are regularly targeted by local and federal law enforcement.

Sunday, September 26, 2010

Doing the right thing is tricky.

I'm getting flak for issuing an apology where an apology was due.  I guess no one said doing the right thing was easy?

Here's what happened: I had heard that there was a crisis pregnancy center in Asheville called "Asheville Pregnancy Support Services," or APSS.  I received a negative testimonial about the place about two months ago, so I listed it as a deceptive health center.  Such a listing prompted a man to picket the center, the way we do in Greensboro at the Pregnancy Care Center.

Two days later, I received an email from the owner of FemCare, Western NC's only abortion clinic.  She told me that she had heard from APSS's CEO that there was a picketer who said he was affiliated with CPCwatch.org, so she followed the breadcrumbs to me.  What she wanted me to know, however, is that APSS is not a deceptive health center.  It is run by pro-life women, but they do not do any biased options counseling, their ultrasounds are conducted by medical professionals (RNs, mostly), and they don't use false research and scare tactics to dissuade women from choosing abortion.  Basically, they help women who are carrying to term.

After confirming that I had, in fact, been contacted by FemCare's owner, I took a closer look at the testimonial we received about APSS.  I realized that it was a pretty generic CPC experience, which is likely why I just believed it outright.  Upon closer inspection, I found that the IP address used to send the testimonial (via the website's contact form) was from Iowa, and the email address provided is no longer in use.  Somebody was toying with me, either get a center listed or to prove that CPC Watch doesn't take care in fact-checking our sources.  I take full responsibility for the latter.

I had to check my biases.  Just because a center is staffed by pro-life individuals doesn't mean that they are offering bad counseling or biased information.  I wrote the CEO of APSS, issued a public apology on our blog, and 24 hours later I had received a large amount of inflammatory emails, but this time from pro-choicers.

I've been struggling with whether or not I should even respond to these messages.  I don't think it's wrong to apologize to an anti when an anti deserves an apology; surly, providing false or misleading information about a pregnancy center is no better than CPCs dolling out false and misleading information about abortion clinics.  Our supporters didn't feel that way.  I got more than one message that included something akin to "fuck 'em all" regarding pregnancy centers that don't provide abortions.  Another accused me of being "one more spineless liberal who is going to let what little momentum we have slip away," as apparently I'm "bending to the will of the antis" and "will concede everything in the name of 'common ground.'"  Ouch.

My question is, why do pregnancy centers have to provide, or even refer for, abortions?  From what I've seen, APSS is 100% open about what they do and do not refer for.  I have little issue with their operation, especially after conversing with Western NC's only abortion doctor. I don't think any center has to provide or refer for abortions.  So long as they're not undermining choice by giving out false or misleading information, not using scare tactics to dissuade women from making informed choices, not making women convert to Christianity to "earn" baby supplies, and not harassing them, I don't have a problem with the place existing.  Hell, my local Planned Parenthood clinic doesn't provide abortions, are we gonna picket them?

Admitting my mistake has had little to no effect on the picketer, who is, for lack of a better term, batshit crazy.  He refuses to believe there's nothing deceptive about APSS and told me outright that the fact that they don't link the abortion clinic from their website means they "deserve" to be picketed.  He also refuses to just take his picketing elsewhere, as apparently Asheville is "pro-choice turf" and therefore APSS has no right to exist.  

Coordinating projects like this can really be a double-edged sword.  I fully support a woman's right to carry a pregnancy to term (duh), even if abortion seems like the best option given her situation.  We can go back and forth all day long about how her decision is tainted with the biases inherent in a patriarchal system, whether or not she's wrong about an embryo being a sentient life form, or what we would do in her situation (think about the debate surrounding Juno here).  But at the end of the day, we want women to make the most informed choice they can, and after that we need to support it.  Isn't that what "pro-choice" is supposed to mean, after all?

Thursday, September 23, 2010

Something to think about

I like looking at reproductive issues in a holistic, family-centered way, but unfortunately this doesn't always do the situation justice.  Many women face unintended and challenging pregnancies alone, and they take care of it alone.  Contrary to popular belief, the woman-as-island idea is not a feminist one; feminism was founded on sisterhood, community, and cooperation.  I partially blame American individualism for what I see as a huge step back for modern feminism: the idea that women ought to be self-sufficient, overly individualistic, and not ask anything from anybody.  We as a society lack positive messages about needing to rely on someone else, unless of course it's a sort of traditional, patriarchal reliance like we see in heterocentric marriage.  Women (and men) who take advantage of public assistance have the stigma of being "freeloaders" and a drain on society.  Even on a personal level, many women feel the need to remain stoic and not ask anything from anybody, including friends and family.

I think it's the fear of being labeled a freeloader that gets women, especially women of color who have a long history of being labeled "Welfare Queens," to the point where they do not ask for help from anybody, no matter how trying the situation.  Maybe some women just feel like they can't bother others with what they've always been taught are "trivial" problems, even if it takes every ounce of personal strength to face the situation on their own.

But I've gotten way off topic.  I read an entry on Every Saturday Morning's blog that made me think:

who's fight is this?

When approached by the CPC harasser, the man really puts the situation in perspective: "If God sends me to hell for doing my duty to my family, then so be it. I’ll suffer forever as long as my family is safe and taken care of."

So much of what we do as reproductive justice advocates is directly for  women who are facing difficult and confusing decisions. And often that's the way we see it because that's all we see, as many women go through these things alone. But a more holistic approach is something I can definitely get behind: while we continue to do what we do first and foremost for women and girls, so often we are also doing it for the men in their lives and possibly even their children. Often, what we do is not just for the women but for their families.

Something to think about. 

Wednesday, September 15, 2010

Antis misrepresent Planned Parenthood data, as usual

The following was first published at ChoiceUSA.
------------

Just another day in the life of an anti-choice wingnut: the American Life League and Jill Stanek are both reporting that, according to 2008 data, Planned Parenthood does little more than offer abortion services.

While the American Life League takes measures to state (albeit vaguely) that they are only reporting on Planned Parenthood's services to pregnant women, Jill Stanek makes no such effort. In her piece, Planned Parenthood: Abortion virtually only service, Stanek presents several pie and bar graphs to display the discrepancy between pregnant women who receive abortions at Planned Parenthood clinics and pregnant women who receive prenatal care and adoption referrals, adding smugly, "You may need a magnifying glass to spot the adoption and prenatal care bars."

I wonder why that could be? Maybe because Planned Parenthood clinics are virtually the only abortion providers in many communities. They are not adoption agencies and they don't claim to be, nor are many clinics capable of providing prenatal care. Rampant survey bias here, and it clearly suggests something that the anti-choicers just can't seem to get their heads around: women aren't stupid. Think about it. If I'm pregnant and am planning a birth, I'm calling a midwife or an obstetric practice. If I'm pregnant and thinking about adoption, I'm calling an adoption agency. If I'm pregnant and considering abortion, well, I'm most certainly calling an abortion clinic! This "stunning revelation" by the American Life League only proves what we already knew: that many Planned Parenthood clinics provide abortions.

More interesting is the reality of the data that ALL and Jill Stanek are "reporting" on. The official report, a fact sheet on services provided by Planned Parenthood affiliate clinics in 2008, reveals much more than how many women received pregnancy-related services at Planned Parenthood clinics. In 2008:
  • 35% of medical services went to providing contraception to men and women.
  • 34% of medical services went to STI/STD testing and treatment.
  • 17% of medical services went to cancer screening and prevention.
  • 10% of medical services went to other women's health services, such as pregnancy tests, prenatal care, midlife health care, and infertility treatment.
  • 3% of medical services went to abortion procedures.
    The other 1% involves primary care, adoption referrals, and additional service. Additionally, Planned Parenthood clinics regularly provide non-medical services to the community, including education, support, and outreach. In other words, ALL and Jill Stanek are running with grossly misrepresented data. Never mind that the largest chunk of Planned Parenthood's medical services go directly towards preventing the need for abortion in the first place; no, that fact doesn't adequately fit the agenda of the antis, and it certainly doesn't help them paint a picture of a Planned Parenthood that only exists to profit off of women's abortions.

    In all fairness, the American Life League report does address the other services, but only to highlight the fact that Planned Parenthood has seen an uptick in abortion services and a downturn in preventative care clients:
    "Despite the increase in abortion, Planned Parenthood showed a decline in a number of other areas, including a drop of four percent (almost 100,000 visits) in its primary customer base – female birth control customers ... The latest Planned Parenthood data are in keeping with the testimony of former Planned Parenthood clinic director Abby Johnson, who has publically [sic] testified that Planned Parenthood is intentionally trying to increase its abortion business."
    Once again, the American Life League proves it has little expertise in the interpretation of survey data. Failing to recognize cause and effect, ALL jumps to the unfounded conclusion that the data indicates that Planned Parenthood has some underlying agenda to get women pregnant and lure them into the clinics for abortions. Such conclusions suggest that ALL might be lacking in the social awareness department and are woefully unaware of the economic downturn that became severe during the very year this data was taken.

    In September of 2009, the Guttmacher Institute reported that about half of women surveyed said they are delaying getting pregnant or limiting the number of children they have due to economic concerns. The report, A Real-Time Look at the Impact of the Recession on Women’s Family Planning and Pregnancy Decisions, did report that more women were being careful with their birth control, which does not adequately explain why Planned Parenthood would see a downturn in female contraception patients. However, 12% of women said they were thinking of switching to long-term contraceptives such as the IUD to cut costs.  This would mean fewer visits to their providing clinic. Additionally, 18% of women on the pill reported inconsistent use as a means to save money; this could easily lead to an increased need for abortion, not to mention fewer clinic visits to procure contraception. The report also suggests that many women might be struggling to access contraception:
    "Twenty-three percent of surveyed women report having a harder time paying for birth control than in the past ... Nearly one out of four women report having put off a gynecological or birth control visit to save money in the past year ... Forty-two percent of employed women agree with the following statement: 'With the economy the way it is, I worry more about taking time off from work to visit a doctor or clinic.'"

    But again, if you're an anti, it's probably just easier (and convenient) to blame the evil abortion chain. Reality has never been a strong suit for their camp, after all.  But, while we're playing with graphs:

    You "might need a magnifying glass" to see the Stanek bar.

    Saturday, September 11, 2010

    Safe Surrender laws continue to fail, women still shamed from receiving care

    This morning, the staff at the Winston-Salem Planned Parenthood arrived at work to find a suspicious storage container outside the clinic.  Not taking any chances, they phoned police for a security scan.  When police arrived, they found a deceased newborn baby girl inside the storage container.

    Planned Parenthood released this statement:
    This morning our Planned Parenthood staff found an unidentified storage bin outside the health center and immediately called police. We are fully cooperating with law enforcement as they conduct their investigation. Our hearts and prayers go out to all involved in this tragic situation.
    I shutter to think what might have led someone to leave an infant to die outside of a vacant clinic.  But I can imagine.

    We live in a climate where women are shamed on just about every reproductive front: shamed for using contraception, shamed for getting pregnant, shamed for choosing abortion, shamed for choosing adoption, and shamed for becoming single mothers. Safe Surrender laws do not adequately remedy the many occurrences of women giving birth in secret and leaving a child to "hopefully be found."

    I am not allowing myself to believe that some anti left a dead baby outside of a Planned Parenthood clinic, though it did briefly cross my mind.  I truly believe a frightened woman gave birth and left her daughter near the clinic in hopes that she would be found and cared for.  Or just found and dealt with.  Instances of women giving birth in secret then leaving their children to hopefully be found are not all that rare.  But make no mistakes: instead of demonizing the women who endure the agony of unassisted childbirth and immediate abandonment, we should be demonizing the endless shame cycle that each and every reproductively-capable person experiences on some level, regardless of the choices she makes.

    There is no excuse for denying women access to any reproductive health care that she deems right for her. When they feel like they have no choice, many women take drastic measures, often alone and unattended, and the results can be devastating. I find it significant that the mother chose to leave her baby outside of a clinical organization that works tirelessly to combat the epidemic of her situation.  But again, it was sadly too late for her.

    Thursday, September 9, 2010

    Concord man charged in clinic violence plot

    According to the News and Record, Justin Carl Moose of Concord, NC has been charged by federal authorities for providing information meant to aid in the bombing of a North Carolina abortion clinic. 

    Moose is a supporter (at least) of the extremist organization Operation Save America.  When OSA held a national event in Charlotte this past July, I went to Family Reproductive Health to successfully hold off the antis and defend the clinic.  It was there that I first encountered the man who goes by "Moose."  He was one of the more aggressive protesters.  Several times, he ran from across the street directly at the clinic's gate as if he meant to run straight through.  At the last moment, he stopped, turned to all of us defenders with our cameras rolling, yelled that we were pathetic, and went back to his fellow demonstrators.  He did this at least three times before a Charlotte police officer told him he would be arrested if he did not stop.

    Moose currently makes all of his information available on Facebook, which is where the initial complaint originated.  According to the complaint, he is being charged with "violating Title 18, United States Code, Section 842(p)(2)(B), Distribution of Information Relating to Explosives, Destructive Devices, and Weapons of Mass Destruction."  If convicted, he faces up to 20 years in prison up to $250,000 in fines.

    Throughout his Facebook page, Moose alleges that he is a "freedom fighter" with little to no disregard for the law.  This is interesting because he also rants on and on about Islam, jihad, and acting against organized terrorism.  I guess it only counts as terrorism if it's based in a system of beliefs that are different from one's own?  Most troublesome, however, are his interests and "likes."  An admitted "right wing extremist," Moose is a "fan" of the Army of God, a radical fringe organization that supports and condones the murder of abortion providers and boasts such members as Eric Rudolph and Paul Hill.  He is also a fan of a group called "Pardon Scott Roeder," referring to the man who shot and killed Dr. George Tiller last year. 

    In his bio section, Moose lays out exactly where he stands: "End abortion by any means necessary and at any cost ... Save a life, shoot an abortionist." An August 23 post reads:
    "To all the feds watching me: You can't stop what is in motion.  Even if you bring me in, my men will continue their mission.  Furthermore, I will not go peacefully.  Do you really want another Waco?"
    One wonders if he did, in fact, go peacefully when he was detained on Tuesday.  

    An August 2 post links viewers to a website that contains information about the addresses of abortion clinics and their employees (some including the employees' home addresses) with the instructions, "Do with it what you wish."  The remainder of his page is a smattering of anti-Islam rants, Islamaphobic jokes and jibes, and links to gun and ammo websites, one reading, "Check out the flamethrower ammo!"  An August 24 post reads:
    "I ask of all my associates this September 11 to not go out and burn a koran [sic].  Who not go out and burn a mosque!  That'll show those camel humpers who's boss!"

    An August 3 post links readers to a how-to website on TATP explosives, complete with Moose's own specific advice on using TATP to manufacture a bomb.  Another links to Ted Kaczynski's manifesto, with fellow radicals singing his praises ("Kaczynski has a brilliant mind in my personal opinion").  One from August 18 glorifies the murder of Dr. Tiller and reads, "Make a bomb and light the fuse, another Hero in the news.  The monster dead, with whole in head.  His end was made and babies were saved," again followed by praises from fellow antis.  Unfortunately, I don't believe his cheering section will also be investigated.

    Moose is scheduled for a detention hearing in Greensboro, NC on September 13 at 2:30pm.  My guess?  Look for an influx of antis in our neighborhood very soon.

    Be careful out there, everyone, especially those of you who work directly in women's health.  Trust women!

    Updated: 9/10/10 at 5:00pm

    Moose's Facebook page has been taken offline, either by law enforcement, a family member, or Facebook itself.  I know that law enforcement sometimes removes internet content that they plan on using to argue a case, but Moose was also in obvious violation of Facebook's Terms of Use. 

    Wednesday, September 8, 2010

    Paxil, withdrawal, drug addiction, etc.

    So the other day I did something stupid.  (Surprise surprise.)  Once again, I waited too long to send in a refill request from my psychiatrist, and due to the holiday weekend they didn't call it in in time.

    See, for the past decade I have been a consistent Paxil user.  It's not something I love, but the alternative is not pretty.  When I'm taking the drug, I'm balanced, I sleep well, and I function.  Without it, I'm a wreck: panic attacks, severe agoraphobia, listlessness, and unbearable anxiety.

    Paxil is apparently "non-addictive."  Which is to say, it is not addictive in the sense that alcohol, cigarettes, cocaine, heroin, and many prescription narcotics are addictive.  The companies that make the drug and the physicians that prescribe it are careful to make this distinction, and for good reason.  The withdrawal symptoms that occur when a user doesn't take their Paxil for even one day are similar to those of a junkie jonesin' for a fix, but because the chemical specifics of Paxil dependency are different than those of diagnosed addiction, proponents of the drug repackage the symptoms as "discontinuation syndrome."

    I don't care what you call it, personally.  While I have never been addicted to a mind-altering substance or narcotic, I can say with confidence that the symptoms I experience when I do not take Paxil make me feel like nothing more than a junkie.  My entire day is difficult when I don't get my Paxil, even if I'm able to replace the missed dose early on (as was the case this morning).

    I don't like how it makes me feel.  As I usually take my Paxil right before bed, the first withdrawal symptom I notice is insomnia.  It is incredibly difficult to sleep, as my body is used to receiving 20mg of paroxetine prior to sleepy time.  When I do get to sleep, I wake often due to bad vivid dreams.  But the worst comes the morning after: I can't wake up, my eyes are heavy, and when I do finally get up I am overtaken by a severe dizziness that feels like vertigo.  I feel heavy on one foot and light on the other.  I get dark circles under my eyes.  I'm hungry but can't eat; sometimes I get nauseous.  I'm emotionally on-edge, I lash out at people for no reason, and I'm prone to crying spells.  There's another weird symptom, too, that I've always described as a "sugary feeling" in my veins, like every blood cell is hyped up on sugar.  I've heard others describe this feeling as a mild electrical shock.  The spells are short-lived but occur every few minutes, especially when moving around.

    These are not the symptoms that led me to take Paxil in the first place.  Paxil treats my anxiety/panic symptoms very well, and several failed attempts at stopping have taught me that it takes three-four days without the drug for my body to fall back into that panic-attack-ridden despair.  No, the withdrawal is something entirely different, something I had never felt before taking Paxil (and, of course, then not taking it). 

    I feel like a junkie, that's all I can really say about it.  This morning, I anxiously called my pharmacy to ask if the doctor's office had phoned in my refills yet.  The woman said they had, and the immense relief and joy I felt could only be compared to a drug addict finding her next fix.  "Yes, it's ready," the pharmacist told me.  "Oh thank god!" I exclaimed, already feeling my withdrawal symptoms subsiding.  The pharmacist laughed a bit and hung up, fully expecting me to arrive in her line within the next few minutes.

    The remainder of they day is difficult.  My body slowly gets back to normal after I take my missed pill, and I get a placebo effect almost immediately.  But the difficult night behind me means my day is slow and low-energy.  It takes me a couple of days to completely repair the damage done from one night of withdrawal.

    Don't get me wrong, I prefer this to the alternative.  But the fact that Paxil is one of the most commonly prescribed psychiatric drugs is troublesome.  Thousands of people are drug addicts even when they've been assured they aren't; I don't care what you call it... if it looks like a duck, it's a duck.  It feels like addiction, and so it is.  That we're still finding out new and frightening side-effects and "discontinuation symptoms" of Paxil is equally troublesome.  I've been taking it for a decade and no one can even tell me what the long-term effects are.  It's great to not be locked up inside my house having rampant panic attacks.  I just wish there was another way that worked for me.

    Friday, September 3, 2010

    What To Expect: Horrible Things!

    It's become pretty commonplace for pregnant friends to ask me for advice.  I don't mind this at all, even if they do not want my services as a doula.  In general, I would recommend that any questions regarding maternal-fetal health be brought up with the health care provider, but I'm always happy to provide additional discussion or alternate outlooks on any given issue.

    Not wanting to infringe on the woman's own wishes for her baby's birthday, I try to avoid placing my own personal biases into advice that might not be relevant to her.  My best advice to any woman that's planning a birth is just to trust your body.  In 99% of all pregnancies, there is no reason to assume something is going to go horribly awry.  I do believe that women and their families should put a "worst case scenario" segment into their birth plans, but after that's said and done with, I'd recommend they leave it behind and not think about it again unless something happens.  Even if she is planning on having an epidural ahead of time, I want her to know that her body is likely still fully capable of dilating, effacing, contracting, and birthing on its own (it may take a little longer, and pushing might be a little less effective, but it's far from impossible).  I know of too many moms who underwent a cesarean surgery for "failure to progress" after only a few hours of active labor.  The act of simply trusting oneself and trusting the age-old process of childbirth means a woman will be more attuned to her body (even if she can't feel anything from the waist down) and will be more trusting of her decision to utilize any number of medical interventions, including cesarean surgery.

    That being said, two of the suggestions I would give any pregnant couple are not so open-ended: avoid Pitocin like the plague, and steer clear of What To Expect When You're Expecting.

    What gives me the right, you might ask, to say that after proclaiming your dedication to not infringing on the family's wishes?  Well, I don't have the right.  But I do have the knowledge to know that Pitocin does more harm than good if its use is not medically indicated (which it rarely is before the postpartum period).  As for the What To Expect books, well, that is the subject of today's blog entry.

    In short, What To Expect When You're Expecting encourages the opposite of trusting one's own body.  The book paints a frightening picture of the birthing process, leads readers to expect that something will go horribly wrong, and blatantly encourages the routine use of medical interventions that might in fact impede the body's ability to progress normally. 

    Amazon.com contains conflicting reviews on the book itself, with most reviewers either giving it 5 or 1 stars.  The positive reviews contain language like "everything you want to know about pregnacny [sic]" and "lots of great information."  Another still gives the book five stars even though "a LOT of it may not pertain to you because it discusses a LOT of complications that you can have ... It can make you a little paranoid..."

    The negative reviews go a bit more in-depth:
    "This book assumes that pregnant women are idiots, and talks to them accordingly. It's full of cutsey [sic] language, puns, and linguistic tics that drove this English major up a wall. In terms of content, it contributes to our culture's position of "better safe than sorry" when it comes to kids - kids and pregnant women must be protected from anything and everything that might be the slightest bit upsetting. It does not provide any information on the research behind their advice, assuming that the pregnant woman is too stupid or lacking in self-control to make an informed decision for herself upon being presented with the facts, relying instead on making across the board recommendations on all kinds of things for which there is no scientific basis."
    A father writes a review warning of the paranoia the book caused him and his family during his wife's pregnancy:
    "...this will be the worst book that your significant other can read and will make your life utterly miserable for the next nine months. It's been over four years since I had to deal with this serie's [sic] 3rd edition and I still can't stand the sight of it.

    "It may have been intended as a self-help guide, but its alarmist tone and condescending attitude leads this to act more as a bible for every worst-case scenario imaginable. After spending a few hours perusing this book's contents, your wife, girlfriend, whomever will become so overworked and paranoid that every little ache, pain, and irritation will become a sign of the baby being born with a forked tongue and three heads. The diet your partner will be instructed to keep is impossible for any human being alive to follow. She will be told to try and avoid ... damn near everything it seems like."
    Reading complaints about What to Expect being paternalistic didn't surprise me.  The first time I picked up a copy at Ed McKay's, I recall thinking it seemed more like an instruction manual than an informative text.  Which is odd, because surely anyone that knows a thing about the process knows that no one pregnancy is the same, that there is no standard way to own one's body, and that there are infinite variations of normalcy in any given healthy mom-to-be. 

    What To Expect is likely on the shit list of a wide range of birth professionals, be they obstetricians, midwifes, doulas, nurses, etc.  I chalk its popularity up to its undeserved good reputation and great marketing.  Still, great marketing doesn't mean great product. 

    Okay, so What to Expect is evil.  What, you might ask, should we read instead?  Glad you asked!  :)

    It all depends on what kind of information you're looking for.  If you just want to replace What To Expect with another plain-English book minus all the fear mongering, I'd recommend either:


    Pregnancy, Childbirth, and the Newborn (4th Edition) by Penny Simkin, et al.
    In its recently-released 4th edition, this book contains basically all the information contained in What To Expect without all the fear, guilt, and negative outlook on the childbearing year.  The language is plain-English and easy to read.  It contains diagrams, illustrations, and charts for quick reference.  Contrary to popular belief, this is not just a book for women planning a natural birth.  There are whole sections dedicated to laying out the benefits and risks of each medical intervention, laboring in bed, effective laboring and bearing down with an epidural, and induction methods.  PC&N informs instead of instructs and offers a wealth of suggestions on how to be an active and informed participant in the birth of your child no matter the circumstance.

    Our Bodies, Ourselves: Pregnancy and Birth, by the Boston Women's Health Collective.
    I can feel your eyes rolling.  I don't know how, but somewhere along the way the Our Bodies, Ourselves series became synonymous with overly-crunchy man-hating feminists.  Or, for many women in my generation, the book brings people to laugh, "That's that health book my mom had!"
    And it's fair enough.  OBO is, indeed, written from a feminist and self-aware perspective.  My question to you is, why is that a bad thing?  OBO is truly the antithesis of What To Expect: it encourages women to take ownership of their own bodies instead of being told what to do/not do, it offers suggestions for a variety of different scenarios and needs, it takes into account issues of race, class, income, gender identity, physical ability, and it's outlook on the functions of the female body are genuinely positive.  Plus, like PC&N, Our Bodies, Ourselves: Pregnancy and Birth contains just about everything you need to know about the childbearing year, empowering the reader to make informed decisions about her body.  What's so bad about that? 

    If you are planning a natural birth, avoiding What To Expect is even more important!  The best reads I can recommend for those even considering an unmedicated birth are:

    The Official Lamaze Guide: Giving Birth with Confidence, by Judith Lothian and Charlotte DeVries

    People tend to associate Lamaze with the ubiquitous breathing technique: "Hee-hee-hee-hoooo!"  In actuality, the Lamaze technique no longer encourages patterned breathing as part of contraction rituals unless it helps mom.  Leave your biases at the door and pick this baby up... it's a wonderful read.
    This book can be summed up in one phrase: childbirth is normal, it is not a disease.  Encouraging women and their partners to embrace the single most normal thing in the universe, the book offers tips and tricks to handling the challenges of labor and encourages families to choose natural childbirth for the better health of the mother and the baby.  Easy to read, written in plain-English. 



    Ina May's Guide to Childbirth, by Ina May Gaskin
    Full disclosure: this book is crunchy!  A long-time lay midwife and generally badass lady, Ina May Gaskin is a natural childbirth guru that wants to change the way we think about birth.  With all the horror stories about birth that we see day in and day out in books, movies, TV shows, and newspapers, the positive birth stories told throughout the text are a welcome change.  Additionally, contrary to popular belief, she is not 100% anti-medicine.  There is a whole section of Guide to Childbirth that details moments where advances in medical science and hospital births have been positive.  She leaves that section to the end, however, since she still ascribes to the belief that birth is normal and, most of the time, it is safe to allow it to happen on its own.

    For more in-depth, research-based information on pregnancy and childbirth options, I recommend:

    The Thinking Woman's Guide to a Better Birth, by Henci Goer
    This book is not unbiased, and it doesn't pretend to be.  Goer is a natural childbirth advocate who wants her readers to know what they're getting into before they utilize a medical intervention.  Using up-do-date research and statistics, Goer breaks down pregnancy myth after pregnancy myth to bring us a comprehensive look into the American childbirth industry.  She challenges the notion of "necessary intervention" in complicated labors, the "perils" of home birth, and perhaps most notably, restrictive hospital policies that usually do more harm than good to the health of the mother and baby alike (such as restricting food intake).  What's most notable, she does it all without being overly accusatory of women who make the informed decision to have a medicated birth.  Informative and a good read, but a bit cut-and-dry in the language department.  Highly recommended for women who want to learn more about all that stuff they do to you while you're in labor.

    What about the mens, you ask!  There are plenty of great books for them.  Dads and partners are fast becoming active participants in the births of their children, leading more families to report heightened satisfaction with the pregnancy and childbirth process, increased dad-baby bonding, and a sense of accomplishment that is shared between the whole family.  While any of the above books are great read-alongs for expectant couples, anyone planning on supporting a woman throughout childbirth has got to get his/her hands on...

    The Birth Partner, by Penny Simkin
    I cannot speak more highly of this book!  It includes all the "basics" on each stage of pregnancy and childbirth including interventions, plus a number of things dads/partners/doulas can do to support mom through the whole process.  The book's format is easy to navigate, with each pregnancy/childbirth scenario having its own section with different sub-sections: "How the mother may feel, "How you may feel," "How you can help," "What does the caregiver do?" and "What does the doula do?"  Awesome tips and tricks for partners to be active and informed (including how to give awesome foot rubs, ladies! cha-ching!).

    Thursday, September 2, 2010

    Dr. Carhart: Who Do You Want to Decide?

    Today, RH Reality Check featured a piece by Dr. LeRoy Carhart, one of two American physicians currently offering later-term abortions, regarding the Hyde Amendment:
    ‎"As a physician who has been providing abortions for decades, I can tell you that the issue of abortion doesn't exist in black and white; it's all shades of gray. When it comes to the issue of later abortion, arbitrary lines are just that, arbitrary. But not only are these limits irresponsible, they are dangerous. Restricting a woman's right to obtain an abortion at any stage in her pregnancy is an outright siege of her body by the state."
    Dr. Carhart is one of my favorite people.  He risks his life daily to provide a controversial yet vital service to women and their families.  He endures threats on his life, his clinic, and his practice.  And through it all, he still has the energy to be an outspoken supporter of reproductive freedom. 

    Read through the piece, if you will.  In it, you will find account after account of women who desperately needed Dr. Carhart's help.  These women and their families have sold family heirlooms, pawned their cars, and gone into tremendous debt just to be able to have an abortion; ironically enough, the delay caused by them "chasing the fee" meant that they had to travel even further distances and pay hundreds of dollars extra for a more invasive later-term abortion.  In some cases, Dr. Carhart recounts, many women who finally arrived at his Nebraska clinic weren't able to legally have the abortion because the pregnancy was not life-threatening and the fetus was viable. He wrestles with the complex moments where a woman is overjoyed to find her fetus carried significant defects, because it means she could legally terminate the pregnancy.  You can see why he has such a firm grasp on the complexity of the issue.

    If the anti-choicers truly cared about not terminating a pregnancy after the arbitrary points where they push restrictive legislation, they would be 100% against the Hyde Amendment.  But they don't.  They don't care if a fetus is 2mm or 5 inches.  They don't care if it's still in its embryonic stage or if it's around 20 weeks gestation.  They use the graphic images of later-term abortions because it makes a better point than the microscopic product of pregnancies terminated earlier on.  The legislation to restrict the later-term procedures are just an entry point, an excuse to dig their fingers underneath the rock of legal abortion so they can overturn it altogether.  The same goes for mandatory delays, biased counseling, and TRAP laws. 

    The antis have little (if any) interest in the human aspects of abortion.  And I'm not talking about "when does a fetus become a human," and I'm certainly not talking about their belief that embryos deserve personhood status.  The antis like to play pretend that they're "compassionate," that they don't want women to undergo abortions because they think it will "hurt" them.  They have precious little compassion for these women, which is why their version of "supporting the woman" involves shouting desperate pleas while following them between the parking lot and the clinic entrance.  Or why they have to misconstrue research and make up mental disorders to disuade women from making an informed choice.

    It's not the woman they're concerned about, it's her role as an autonomous human being.  They don't want her to have that.  If they did, they wouldn't have the knee-jerk reaction to engage in manipulative "counseling" when they hear the stories like the ones shared by Dr. Carhart.  They would realize that, often, dealing with an unplanned pregnancy has no winning solution.  They would allow themselves to separate the value of the fetus from the value of its carrier.  But they don't.  Because they don't trust women.

    The campaign against Dr. Carhart has been nothing short of genius.  Like his late colleague Dr. George Tiller, Carhart's name has been smeared, his practice slandered, and his livelihood dismantled.  The antis have painted a highly pervasive picture of LeRoy Carhart, one that is not at all representative if you speak to the women and families who have been helped under his care.  Unfortunately for them, Dr. Carhart is not one to sit back and take it. 

    Wednesday, September 1, 2010

    "Everything I need to know about Islam..."

    I find the New Left Media's in-the-field interviews with the Tea Party to be incredibly enlightening.  Now of course, I understand that there are factions of the group that aren't ignorant red-necks.  There are many well-educated capitalists who just plain ol' don't like Obama because they ain't up on their Marx and think he's worse than Stalin (funny, I haven't heard tell of any big socialist push). 

    Then there's the rank-and-file, once again exhibited beautifully by NLM just letting people do the talking for themselves:



    The most interesting thing, however, is the expose on anti-Islam sentiment.  It's frightening, really, that people can be so ignorant, so racist, so xenophobic... if this is truly the "voice of America," I'm sad for my country.  There is a moment at 9:38 where a man says, "I learned all I needed to know about Islam on 9/11."

    The first thing that came to mind was an article that was published recently on The Onion:

    Man Already Knows Everything He Needs To Know About Islam

    It's one of those things that's both hilarious and tragic: hilarious because The Onion captured and lampooned the sentiment so brilliantly, tragic because they didn't have to go to any great lengths to make it ridiculous.

    To respond to the gentleman (?) in the NLM video...

    What if I were to say that I learned all I needed to know about Christianity on May, 31, 2009? Or March 10, 1993? Or July 27, 1996? Or January 16, 1997January 29, 1998? What if I then decided that, by virtue of your religious convictions, you must be an anti-abortion terrorist and should therefore be shunned by society? Or that you must be a member of the Westboro Baptist Church?

    What if you heard an Iraqi saying he learned everything he needs to know about America between March 20, 2003 and the present?

    What if a Native American said she learned everything she needed to know about white people in 1492?

    A gay man saying he learned everything he needs to know about heterosexual men on October 12, 1998?

    Just admit you're a crotchety old man that's completely unwilling to to accept that you're not the only human being on the planet.  Also a racist.

    Call It What You Will

    The following is a ChoiceUSA cross-post.
    -------------

    In her 2008 book Abortion and Life, author and activist Jennifer Baumgardner recounts a situation that led her to take a more critical approach to the language surrounding abortion:
    "I had my own moment of truth during my fifth month of pregnancy ... I was speaking to a group of Barnard College's Students for choice when I referred to that object in one's uterus when one is pregnant as a 'baby.'

    "A nurse practitioner who was speaking after me interrupted: 'Fetus, you mean. You said baby, but it's a fetus.'

    "'Oh, right,' I stammered, blushing. 'Oops.' I felt foolish, caught in an ignorant mistake. Later, though, I realized that I had always thought of my pregnancy as carrying a baby -- that was the word I wanted to use -- and I was forcing myself to say 'fetus' out of fear. If I said 'baby,' that meant I wasn't pro-choice, or with the program, or knowledgeable."
    As is usually the case, I found myself nodding fiercely while reading Baumgardner's take on the situation.  She was pregnant herself, thought of her fetus as a baby, and was completely caught off guard when she was basically accused of anti-choice pandering because of a simple word choice.  Now obviously, context might have dictated that "fetus" was a better word for Baumgardner to use in this scenario, but her point stands: why does it matter?

    I don't think anyone could question Baumgardner's merit as a pro-choice activist.  After all she's done for reproductive freedom (and the feminist movement at large), the NP's correction of her language was probably less of an accusation about her beliefs and more of a clarification on what she was talking about.  But again we must ask, why does it matter what she chooses to call her own pregnancy?

    As a birth doula, I don't use the term "fetus" unless I'm using it as part of  a technical term like "fetal heart monitoring" or "fetal position."  (Unless, of course, I happened to be working for a woman who used that term herself, but honestly, when have you ever heard of a pregnant woman calling her someday-baby a "fetus?")  It's not my job to make a political case out of one family's situation, so why would I go out of my way to use a clinical term when I'm not a clinician?  I can imagine how that would sound: "We can get the fetus into a better position for birth if we move this way."  "You're doing wonderfully, you'll be meeting your fetus in no time!"  "Lovely work, mama, just let that fetus descend through the pelvis."  Technically, this language is accurate, but think of how cold and distant it would sound to an expectant mother!

    In referring to her own body, Jennifer Baumgardner has every right to call her pregnancy what she wants to call it.  If we're pro-choice, shouldn't we embrace that decision as well?  We all know it's a "fetus" or an "embryo" (depending on the stage of pregnancy).  That's not the point.  The point is, if women have the right to own their bodies, they have the right to call it what they will.  Correcting a pregnant woman when she calls it a "baby" is no better than the antis forcing the terms "life" and "baby" down the throats of vulnerable women when they're considering abortion.  Sure, we may have the medical terms on our side, but the pro-choice fight isn't just a fight for medical science, it's a fight for people and for self-realization.  The right to realize oneself as a mother at the moment of implantation is as important as the right to never realize oneself as a mother at all.

    It is understandable that many advocates for choice might be turned off by anyone using a non-technical term for a pregnancy.  After all, such language has become a staple of our movement.  "It's an embryo, it's a fetus, etc."  These short statements provide concise counter-arguments in moments where you aren't likely to delve into the big, deep questions about fetal life and its value versus the life and will of its carrier.  In a wholly political context, terms like "embryo" and "fetus" are technically accurate and therefore kosher. But for individual cases where a woman's pregnancy comes up in conversation, choice advocates should remain open to co-opting the language of the woman, viewing the pregnancy as she views it, and allowing her to choose for herself what it is she's carrying in her belly.