maternal health

There is a Plan B for Birth Control and Health Care Plans

birth control healthcare plans Every Thursday, I will republish my best articles from Since Technorati redesigned its website and is under new managements, tens of thousands of articles that were previously published on the site are no longer available. I have been given explicit permission to republish my work on my own website.

Last Friday, the White House announced that there will be no wider exemption for religious groups regarding the Affordable Care Act, which requires that “preventative care” be fully covered, with no co-pay, under new insurance plans, and the Department of Health and Human Services accepted recommendations that put all forms of contraception in that category. Beginning August 2012, new insurance plans must fully cover women's preventive care, which now will include yearly wellness visits, breastfeeding counseling and equipment, and screening for gestational diabetes, domestic abuse, HPV, sexually transmitted infections (STIs), and HIV, in addition to the birth control and sterilization. This latest announcement grants only a one-year waiver they can apply for while figuring out how to comply with the law. Naturally, the U.S Conference of Catholic Bishops is against the new regulation, particularly the clause on birth control, as it conflicts with Catholic tenets.

As Reverend Peter Laird presents in his counterpoint, “The position of the Catholic Church on artificial birth control is well-known, though not always well-understood. Our teaching is founded in a conviction that every human act is meant to witness to the truth about God and man…The church does not consider birth control a right of health care, much less a good for human flourishing, because pregnancy is not a disease.

The new regulation does come with a “conscience” clause, an exemption that applies to non-profit employers that have the “inculcation of religious values as its purpose, that primarily employ fellow believers, and that primarily serve people who share its religious tenets.” This defined exemption would not include Catholic hospitals and probably won’t include Catholic Charities and Catholic institutions of higher learning. Thus, the new regulation has not been well-received by the Catholic community.

However, research from the Guttmacher Institute shows that 98 percent of Catholic women have used contraceptive methods banned by the church, compared with 99 percent of American women who have used these same methods at one point in time. The statistics aren’t much different. It’s fine that Catholic doctrine is against birth control, but with so many Catholic women violating this part of the doctrine, the church really ought to expend its energy on reaching out to its members instead of retaliating against the federal government. The study does not specify how many of these women are aware that using birth control is against church doctrine, so it’s impossible to determine how many are using birth control in spite of church doctrine, or because they don’t know that it’s against church teachings. It’s also possible that Catholic women are choosing to violate this part of the doctrine in order to avoid an unwanted pregnancy, and the confronting the choice of violating the church’s stance on abortion.

I don’t fault the church and other Catholic organizations for not supporting the federal regulation, but I don’t’ see how it jeopardizes the overall mission of these organizations, or the essence of being Catholic. I’m sure being Catholic is much more than avoiding birth control, like being a person for others and living simply. Plus, the new federal regulation says that all health plans much cover sterilization and contraception. That doesn’t mean that a woman will, or must, access that free contraception. As Laird says,

“Absent sufficient regard for rights of conscience, the birth control mandate will force all men and women -- and all employers -- to carry health "benefits" that violate the sincerely held religious convictions of many.”

I don’t deny that these benefits violate the religious convictions of many, but doesn’t it only count if those who believe such participate in this violation? Does mere availability automatically equal a violation all its own, even if no one took advantage of this availability? This regulation presents an opportunity for the church and Catholic employers to make its community aware that the use of sterilization and contraception is against church teaching.  Of course, another option is to revoke health insurance for all employees, but no one needs to be that drastic here. If anything, the regulation allows for the accommodation of non-Catholics at Catholic employers while encouraging Catholics to follow church teachings. As Laird puts it:

“Organizations such as Catholic universities and hospitals, social-services agencies and Catholic Charities, because they serve people without regard to religious affiliation, would be forced to provide contraceptive and sterilization services. In other words, we would have to stop being Catholic if we wanted to serve all men and women, as Jesus did. It would also require Catholic organizations to employ only Catholics, which may be at variance with both federal and state discrimination laws.”

After all, Catholic employers cannot legally exclude non-Catholics from its workforce, and Catholic Charities certainly wouldn’t exclude non-Catholics from its services. Therefore, there’s no imposition or forced adoption of Catholic teaching. Also, the regulation only stipulates the provision of them in health care plans, not necessarily by the institutions themselves. This means a Catholic hospital or clinic can refrain from carrying birth control and providing sterilization services to the people they serve. This would also mean that any non-Catholic that works in these places, that wishes to use birth control, would have the choice to do so. This regulation doesn’t infringe on the Catholic identity of institutions in anyway.

Why must this issue of birth control be treated as such a black and white issue? This issue of sterilization and contraception seems like an opportunity for religious education and tolerance instead of the religious intolerance that it’s perceived to be. Overall, this federal regulation doesn’t say that Catholic teaching is wrong, or that Catholic institutions cannot be Catholic institutions. It doesn’t stipulate that birth control must be offered to all who walk through those doors. It just needs to be part of the health care plan. Good Catholics can still be good Catholics by not using that part of the plan. Non-Catholics can still have this choice available to them if they wish. Just because the choice is there to choose birth control doesn’t mean that one must, should, or will choose birth control.

The Texas Senate is Back in Session

maternal health abortion bilAnd I Am Prepared to Stay Up All Night to Watch the Shenanigans

The Texas Senate reconvened at 2 p.m. today, and have been debating since then about HB2, the anti-abortion bill that received national attention for Sen. Wendy Davis' filibuster a couple of weeks ago. It's been two-and-a-half hours since I started "watching" (I'm more listening and getting other things done), and the Senate has just finished going through 20 amendments to the bill (all of which have been tabled, although some of them were very good and sensible amendments). Nothing is happening right now, but a vote is expected to happen today, and this session is predicted to end "late in the evening". It's possible debate could continue into Saturday, but it's unlikely that any filibustering or parliamentary maneuver could stop it this time.

I Think This Stuff is Quite Fascinating

It really is, and it's also very productive too. It's neat to hear all the different sides of the issue, all the little points you need to think about when putting together and passing a bill, and all that happens when our representatives convene in session to get something done. I just finished Citizenville: How to Take the Town Square Digital and Reinvent Government (great book, and another book off of my summer reading list), and the closing argument in that book is that it will be up to local governments to collaborate amongst each other to improve transparency and to utilize data and technology to make government better and to make it engaging. It's events like this that bridge this gap and make government engaging. It'll be the local issues, state governments, and city governments that are going to be the ones to take the town square digital and to reinvent government.

I wouldn't say entertaining. There's a lot about this that isn't entertaining, but I'm not here to be entertained, even on a Friday night. Even though this bill and this issue is only about Texas right now, it's very likely it will go beyond Texas. It's projected that abortion-rights groups will file a federal lawsuit as soon as Perry signs the bill into law. I'm interested in seeing how this issue will progress as it moves to the national level, as well as how the technology and the activism will remain as well. So many previous cases and issues have moved from the city and all the way to the Supreme Court, but if this lawsuit and this issue does get to that level, I'm interested to see how social media and technology play a part in relaying what's happening.

What Can We Do About Women's Health and Women's Rights?

Although the big issue here is abortion, I can't help but think about what else needs to be address when it comes to women's health and women's rights. There are many other issues, such as maternal health, domestic violence, economic empowerment, and equal pay, that matter as well and still need to be addressed (I came across this article in the St. Louis Post-Dispatch from April. Pretty good stuff. I like the points on women with chronic conditions, because I don't think this has been studied or tracked all that much. I also like that St. Louis is being proactive about this.). What to do? What to pick? How do you address it?

This whole thing is actually tiring. My guess it will end in two hours, probably more, but my guess is that it will end at 1 a.m. my time. But, I am learning stuff and feeling productive and I still think this whole thing is pretty awesome. It's also pretty awesome that they've been at it this whole time and they didn't even take a much of the break.

There Should Be Live Feeds for Every Single Legislative Session

Sen. Wendy Davis It's after midnight, so the Texas special session should be over. But, the live feed is still rolling and 160,000+ people watching are wondering what's going on here. We're all wondering why people are still moving around, why the tape is still going, and why people aren't just walking away and going home. The latest from AP is that the Republicans were able to pass the restrictions, although it's unknown if it stands because the vote started before midnight but it did not finish. Even though the session was supposed to end at midnight, it's technically still open until it is closed by the chair, so now it's a lot of procedural arguing or who knows what. I'm actually sad that I didn't watch more of this thing.

As what's going on is getting figured out and settled, I think there should be a live feed for every single legislative session, no matter what's on the table, whether or not there's a filibuster, and whether or not it's a special session or just a good 'ole normal session.

What a Way to See what Our Elected Representatives are Doing

Yes, these things are open to the public and we can just sit in and listen, but most of us can't do that. We have jobs to go to, children to raise, and errands to us. Many of us can't take the time out of our day to drive down to a legislative session and to hear what's going on. However, with a live feed provided by news organizations, video bloggers, and even non-profits, more people would be able to listen and to hear what our elected representatives are voting on. We would be able to hear what these people are saying and hold them accountable to their votes and to their constituents. We could watch or listen passively while we're at work, or be able to catch bits and pieces in between things.

More People Would Be Engaged in Government

Senator Wendy Davis, who started the filibuster, announced that she was going to do this only the day before. LOOK  AT THE TURNOUT AND THE BUZZ! Not only was the gallery filled the entire time, but thousands upon thousands of people watched the live feed from all over the world. Imagine what kind of engagement we would have if legislative sessions were available in this format all the time, where representatives could announce what they were doing to rally support or people could come together if they new certain issues were going to be introduced. If this was accomplished in a matter of hours on the issue of abortion, then throngs of people could also show up for other issues as well. Even if it just opens up one additional way for people to know what our local representatives are doing, and what kind of legislation they are working on, that's a huge step forward for us when so few us vote or pay attention to what these people are doing in the first place.

It Helps When Crap Like This Happens

Reports are currently conflicting, as the Republicans say the voting started before midnight, but Democrats and reporters are saying it started after midnight. Many people are confused, as it was thought the last roll call vote was on ending the filibuster, not about voting on the bill. However, it looks like the bill passed, according to news reports from several organizations. Although, this is probably not the end of this, as legislators and the people will protest this bill and the shaky circumstances in which it was passed.

Well, the live feed is over now. I think I'm going to go to bed.

What Do You Do When Your Blog Post Goes Viral?

what do to when your blog post goes viral That is the question I have been asking all day, ever since my article trashing the reviews that were trashing The Business of Baby (which I finished and still find fantastic. Those people complaining about the potty training and vaccine chapters were making a mountain out of a molehill. I mean, you have to admit, the disposable diaper industry did a darn good job of creating a demand and a market for their product. It's no conspiracy. The bottled water industry did it, and their competitor is free. I can believe that another industry was able to accomplish the same thing.)


My post went viral. I've already tripled my traffic for yesterday, and yesterday's traffic was 10 times the previous day's traffic. I have no idea how to handle this situation. I've enjoyed watching the numbers go up all day and replying to people who tweet my article and comment on it, but I feel I need to be a little more proactive than that. I've tried looking up online what my best course of action is here, what others have done when their blogs and blog posts went viral. All I pretty much got was tips and tricks on how to create content and how to make content go viral. I think I've already cracked the code on that one.

So, what does one do in this situation? Do you write more posts on this topic? Do you continue doing what you are doing, since you did something that worked and resonated with people? Do you create a whole new site or blog on this topic, and tell everyone to go there? Obviously, the one thing you aren't supposed to do is nothing, because after a while all those people are going to go away. You don't want the people to go away. You want to make this an all-the-time thing, not a one-time or sometimes thing. I don't know what the right course of action is here. My business coach had challenged me on Friday to create a maternal health site, to get it going for one month, and then to come back with the feedback and with the results. I feel like I've gotten results and feedback, and I haven't even built the site yet (my plan was to do that tomorrow, and get at least one post up this week).

On a minor note here, blogging is fun.

Thank You Very Much, By the Way

thank youBefore I forget, I want to thank everyone who's contributed to this really cool event. I thank the hundreds of people who read my post and visited my blog. I thank the people who've taken the time to share the post and to get more people to read it. I thank my friends and family who've read my blog before this whole thing, and have been just as excited and amazed by the buzz. None of this wouldn't have happened without all of you. Thank you so much! Hopefully, I can continue delivering great content that keeps you engaged and entertained.

As you can probably tell, much of my time today has been consumed by this. It's been incredible to watch the numbers, hoping I'll figure out the best next step for me and this blog and this topic. I do still have work to do and a business to build. Perhaps this is a huge sign telling me where I need to go next and what needs to be done here. Maternal health in this country strikes a nerve with people and gets them going.

Let's Face It: Maternal Health in this Country is Crap

The Business of Baby bookI'm currently reading "The Business of Baby", which is on my summer book list, and I think it's absolutely amazing so far.  Maternal health is abysmal in the United States, and someone has finally done the dirty work to figure out why and to make conclusions as to what should be done about this. Amnesty International called the status of maternal health in this country a human rights crisis, and it's about time this message will be heard by millions of people. However, I might be the only one.

The book hasn't received the most positive remarks from book reviewers and other readers, and their reasons for hating this book are nonsensical. These book reviewers (I'm not even going to start on the reviews on Amazon. At least not today) are wrong about this book because critiques are made that are not only unwarranted, but also simply distract from the main message of the book. Maternal health sucks in this country, but that premise doesn't matter to these people. Never mind that below is the status quo that author Jennifer Margulis tried to investigate:

  • The US is ranked 49th in the world for maternal health.
  • Of the 4.3 million babies born in America each year, more than 25,000 will die in their first year.
  • 1/3 of women in the US undergo a c-section.
  • Only 24 states require hospitals to report adverse maternal outcomes to the state government. Only three of these states require this information to be public.
  • Most states have no system in place to investigate maternal deaths.

Instead of being outraged and taking an honest look at these problems (you do agree that they are problems, right?), these reviewers scoffed at how she presented her arguments, the evidence she presents, the sources she used, as if none of this can possibly be true. For example, this review from the Oregonian said a few things that simply don't make a lot of sense. For example:

Margulis builds her argument mostly on individual parents' anecdotes, without providing context for whether they represent common experiences. Many of the anecdotes seem to have been selected purely for their shock value.

The reviewer write off these anecdotes as uncommon, unusually shocking, or uniquely tragic. For anecdotes that are supposed to be exceptions, there are a hell of a lot of them. In just the first chapter, she featured 10 different women who had issues with their prenatal care. This doesn't include the obstetricians, nurses, midwives, studies, and reports that she cited and quoted in that same chapter. The book is 10 chapters long, and it's not as if she only features those 10 women throughout the whole book. Context isn't needed here to show whether or not these are common experiences. The sheer number of anecdotes from all around the country, from women of all sorts of backgrounds and all walks of life, is enough to show that this is a common experience. The shock value is in that these women are representative of something larger, and aren't just case studies of one or two instances where someone was incompetent or where a perfect storm of events caused harm. The reviewer goes on to suggest:

Margulis' mission could have been much better served if, instead of collecting as many anecdotes as she could get, she had chosen three or four families from different parts of the U.S. and with varying healthcare setups to follow through pregnancy and baby's first year.

Really? How is this approach supposed to do a better job of providing context for common experiences? Wouldn't this approach make it easier for Margulis to choose anecdotes for shock value and to choose families whose stories would fit into the narrative the reviewer is arguing Margulis is trying to spin? Nothing says that with this follow four families approach, that Margulis could actually follow 10 or 20 families and then cherry pick the ones she wants. This reviewer actually had the nerve to say that Margulis cherry picked her anecdotes, but instead of finding as many as possible and to illustrate a common experience, the author should have cherry picked from the beginning by starting with three or four preselected families and told whatever story came from there. This criticism makes no sense.

These reviews also have horrible attitudes that prevent us from making meaningful progress on maternal health. The reviewer in the New York Times didn't like that the author suggested that we may trust doctors so much that we don't question or go against what is considered routine when it comes to pregnancy, childbirth and raising an infant. She goes so far as to say, "Has she not heard of Dr. Google? Today it’s easier than ever to educate ourselves about health and disease and to find communities of like-minded people online." Because, you know, we don't then take that information to our actual doctor and get his or her opinion, and do whatever our doctor orders. We make our own diagnosis with that information and treat our infants all by ourselves.

She also didn't like that comparisons were made to other industrialized nations who were doing better than us on this issue:

She also approves of anything used by Scandinavians; she spends many pages praising the health outcomes of women in Norway and Iceland, without delving deeply into the demographic and economic differences between America and such countries.

Demographics and economic differences shouldn't matter when it comes to maternal health! Every woman should be given the utmost care when it comes to giving birth, no matter their skin color, education levels, income levels, language, background, occupation etc.


Why should poorer women receive poorer care for their pregnancies and their babies? Why should Hispanic women or Asian women receive a different standard of care, or be pinpointed as the cause for the disparity (as if white and black women never ever die during childbirth)? Why should women with less education be subjected to substandard care or be given less information about their options? These are not valid reasons to excuse what is happening, or reasons to ignore these problems. These reasons are not valid to say this is why things are the way they are, so too bad for those who have a botched c-section or lose their child within the first year of life. No kid or healthy pregnancy for you. Essentially this reviewer is saying, "America has minorities and poor people, not as many as Norway or Iceland, so that's why our maternal healthcare sucks in this country."

Never mind that Margulis made the comparisons to industrialized nations because, well, we are an industrialized nation and we kind of suck at this maternal health thing. Singapore and Japan and Australia are doing better than us also, and they aren't Scandinavian. Qatar, Kuwait, and the United Arab Emirates are also not Scandinavian, and those three countries are also ranked higher than us. Does it really matter who's doing it right? The point is that all these other countries get it and we don't. If Norway and Iceland are getting it right, then we should be taking a page or two from their book and figure out what they are doing right, not shooing it away because those countries aren't as ethnically and socioeconomically diverse as ours. Obviously this is an issue that is beyond demographic and economy, because countries all around the world with all sorts of ethic backgrounds and demographics are getting this right.

This reviewer concludes her opinion by saying:

Just because something is for sale doesn’t necessarily mean it’s suspect. Caveat emptor has been good advice for a very long time; I advise you to apply it when considering whether to buy “The Business of Baby.”

True, not everything for sale is a bad thing. However, if we aren't taking any time at all to ask questions, to be suspicious, and to make sure that the products and information we are purchasing are safe and the best product/information possible, then we aren't being good consumers. If we don't do this, then we are letting marketing and corporate messaging dictate what we think about these things, letting the pushy used car salesman bully us into a sale because he's the only one speaking out (and everything he's saying is good, so the car must be amazing, right?). This book does an excellent job illustrating that there are a lot of "consumers" out there who weren't satisfied with the level of service they received from the hospital and from the obstetrician, who felt bullied by that salesperson, who bought the car because they were told walking wasn't a viable option, who trusted what they were told even though it wasn't the entire story. In any other industry, with any other product or service, all of those circumstances would be unacceptable. Those customers would have every right to complain, and those businesses would have to deal with the consequences.

For some reason, when similar concerns are address by men and women against for-profit hospitals and obstetricians (both of which are businesses, by the way. They do make money from this, whatever motives you want to establish to that revenue earning), it's all unfounded and plain ole demonizing. Let's not hold doctors, nurses, and these systems accountable and see if there are ways to deliver better service and to make more people happy. Let's not at all speak of alternatives, like natural birth, because when people receive horrible service from an establishment, they ought to stay there and not take their money elsewhere.

Why Worry about the Critics?

I am not only outraged by what I've learned so far in this book, but I am outraged that there isn't more outrage. I don't understand how the contents of this book can be written off as hogwash, as one-sided pseudoscience that has no possible sliver of truth to it. I don't understand how anyone could read this and just say, "Ah, whatever." These complaints and critiques are distractions from the real issue at hand: that it is safer to give birth in 48 other countries, and most states have no way knowing what's going on and what could be done to make thing safer. These reviews don't dispute that problem, or the fact that something must be done. Just that everything Margulis suggests or points out as a possible reason isn't the way to go. Things are bad, sure, but let's not try any of these ways or think about, well, the entire pregnancy or the first year of life. None of that could possibly be the source of the maternal health problem.

I fear that reviews like these, and the others out there, are discouraging people from learning about this issue and taking action. The last thing I want, and the last thing our country needs, is for the message to be that there is no problem. There's no need to do anything. There's no need to investigate maternal deaths. There's no need for any review process to hold people accountable and to know what doctors and hospitals are doing. Women should have c-sections always, whether or not it's a high-risk pregnancy. Pitcotin and epidurals and induced labors are the only way to do it. Vaginal births should be a thing of the past. There's no need to do anything to improve maternal health because 49 is fantastic. The U.S has always been happy about being 49th.

We all know that is not true.

Two women die every day giving birth in this country. According to the CDC, half of these deaths are preventable. Each year, 1.7 million women suffer a complication that has an adverse effect on their health.

Why aren't we complaining about that?