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The U.S. Department of Health and Human Services, Department on Womens Health, is having a contest to choose the cover photo for an update of its Easy Guide to Breastfeeding. I popped over there when I saw the notice on Twitter and thought the choices weren't very interesting. They are generic photos, none of which clearly show a latched baby. I decided not to vote because I didn't like any of the three choices. There was something just plain vanilla about all three.
Elita over at Blacktating has a great post on why I saw vanilla. Mother and child in all three photos are white. Not only do I agree with her on the impropriety of having only white babies to choose from but I find some of the comments to her blogs disturbing. Go over and have a look.
Even if one thinks it is legitimate to chose a representative baby by the skin color of the majority of babies born in the U.S (a questionable criteria, in my opinion), take a look at the U.S. Census Bureau data on the "race" of women who have given birth in the previous twelve months for 2006-08. Add up all the people who identify as non-white in some way and compare that number to the number of those who identify as white. "Average U.S. mom" is not "white."
In the three photo choices, both mother and child are white. I don't have the statistics (I don't find either the U.S. Census or the website for the Census Bureau particularly user-friendly), but I suspect the number of non-white babies born in the U.S. is even higher than the number of non-white mothers. So making both mom and baby white is even more inaccurate if we are using the "average dyad" criteria for choosing the appropriate government document cover photo.
I am not arguing that there is any particular physical characteristic that makes one photo a better choice than another. I don't think the mother or child have to be part of the majority race (if indeed the U.S. still has one). I would vote for the photo I think is more beautiful or most what I associate with breastfeeding. I would chose the photo that seems most realistic or perhaps even most interesting or most compelling. But if the U.S. government is truly asking people to make a choice, we have to be given choices. "White, white or white"? No contest.
A recent episode of the PBS program Frontline was called "The War on Vaccines." The title alone should have been the tip off that the producers' goal was to inflame and incite – to assume this was an entirely adversarial discussion between diametrically opposed viewpoints. But I knew that my colleague Jennifer Margulis, Contributing Editor at Mothering where I am Politics Editor, was interviewed on the program so I felt obligated to watch. I knew also the show would feature pro-vaccine zealot Paul Offit – as famous for his vehement opposition to all questioning of vaccines as he is for the money he takes from vaccine manufacturers.
Imagine I insert an ominous voiceover here. In case you don't have time to watch the entire Frontline report, I can give you a feel for the experience. For all fifty minutes, you are constantly reminded the discussion – oh, just suspend your disbelief and accept there is a discussion – is life or death for every child. Make sure you are really worked up about dying toddlers because the Frontline producers want to make sure you have an opinion about vaccines at the end of the show that is linked to the images you see on the screen and hear in the voiceover. We are moved and motivated by the sights and sounds in film. Having worked in television production I know how this works but I think any discerning viewer can figure that out. If this were not so, we would all just read the paper.
One of the opening scenes in Frontline's "The War on Vaccines" is about a helpless innocent baby coming into the world waiting for mommy to do all she can to keep her safe and healthy. You see through a car windshield the sign for Doylestown Hospital but, if you watch this online, the section is called "A Visit to Ashland, Oregon."
"A new life begins," says the ominous voiceover. Little Rachel Murphy is coming into the world. But wait. Mommy is on her back in an operating room at Doylestown Hospital with a curtain between her and the birth. Yup, she is having a cesarean section. "It's a girl!" says a member of the team pulling Rachel out of her mother's uterus which has been surgically lifted from her body. "AW!" says Rachel's mother who can not see her own child. The very serious narrator comes back and explains that little Rachel had been born into "a world filled with countless germs." Then we have a series of camera shots of Rachel being handled by medical staff, in a cart being wheeled down the hall, getting her first vaccine at an hour old (according to the ominous voiceover) for Hepatitis B (a form of Hepatitis contracted primarily through sexual intercourse or I.V. drug use, so use of this vaccine assumes either Rachel's mother is infected or Rachel has been pretty busy in her first hour outside the womb). Some time more than an hour after all of this has taken place away from Rachel's mother, we finally see a camera view of Rachel and her mother together – her mother still flat on her back post-surgery.
Wow. The joy of birth in America. Strangers will handle you, wheel you around, and pump you full of chemicals – some of which are toxic – before you even get a chance to meet your mother. That world full of countless germs? Well, that would be the hospital. Some of Rachel's protection against these germs have been washed off of her before she can get a whiff of her mother's breast where the colostrum is waiting for her. A hat has been put on her head which she does not need because her mother's body could provide warmth and the exchange of scent between Rachel and her mother could help an already challenged breastfeeding relationship.
Next we have some Centers for Disease Control party line on the benefits of vaccination followed promptly by, with a dark lowering of the voiceover's tone, the announcement that some communities in America are resisting the CDC advice and have much lower rates of vaccination. I could be wrong about what appears to me to be a misleading connection between little Rachel Murphy's birth and Ashland. If you didn't see the hospital sign, you don't know where Rachel was born. I think one could easily think, hearing Ashland, Oregon named as a pocket of vaccine renegades, that Rachel was born in that community. So in case you were confused, here is a little geography lesson Mr. Ominous Voiceover omits.
Doylestown Hospital is in Doylestown, Pennsylvania. Doylestown is about an hour north of Philadelphia. Now I don't necessarily have a preconceived notion about any particular hospital's c-section rate. And I will look carefully if a hospital offers a birthing center. Birthing centers often (though with decreasing frequence nationally) have midwives and lower rates of c-section. However, if you hit the home page link on the Doylestown Hospital website for what purports to be that hospital's "birthing center," you come to a page with a huge graphic of people in white coats and surgical scrubs under the headline "Maternity Care Reinvented." Below the cluster of white coats and surgical scrubs is the tag line, "Doylestown Hospital Welcomes CHOP Newborn Care at Doylestown Hospital." CHOP, for those of you closer to Ashland, Oregon – that renegade town that is 3000 miles away from Doylestown – is Childrens Hospital of Philadelphia, the professional home of … you guessed it, Paul Offit.
As a not so amusing side note, I glanced over at the "birthing center" physicians to see the name of the surgeon who cut my third son out of me at a different hospital. I have two profound memories of that man. One was the frightening tower of formula cases behind him in his office. He was such an unpleasant man I tried to mentally will the boxes to fall and crush him. I asked him about all that formula and whether it wouldn't be better to encourage women to breastfeed their babies rather than assume they will formula feed. He snarled his response: "Would YOU want to nurse quadruplets?" He was a specialist in multiple births (the reason I had been coerced into being seen by him). I replied, "I certainly would want to try." He made a disgusted sound and refused to discuss it with me anymore. The other memory I have of that doctor is what he shouted to me as he was scrubbing in for that dreaded third c-section. "This is a tubal as well, right?" He and I had never had any discussion of his performing a tubal ligation and I had hoped to have more children. "NO!" I shouted back, more than a little frightened that he might have asked this question after I was unable to respond. His response was his usual sneer. "You would do this again?" I think I will remember forever glancing over at the array of scalpels a nurse was counting while I was being prepped, thinking violent thoughts along with "what an asshole."
Back to Frontline.
Jennifer Margulis has written a blog post I highly recommend about what she sees as the failings of "The War on Vaccines" and I highly recommend you read it. At least two of her complaints are mine as well. All of the doctors and government officials shown in the final cut of this Frontline are opposed to any variation from the CDC recommended vaccine schedule. The conclusion one is forced to draw is that there are no physicians – particularly no respected physicians – who challenge the statements made by Offit. Not only is that untrue but if you read Dr. Jay Gordon's blog post concerning this Frontline piece, you find out that he was interviewed for hours as was Dr. Robert Sears. As Gordon describes in great detail, the producers made a deliberate choice to exclude these respected doctors who offer a different viewpoint from either extreme presented by Frontline.
Another dangerous and professionally irresponsible choice made by the Frontline producers was to entirely exclude discussion of the ideological space in between Offit's "all vaccines on the CDC schedule no matter what" position and the "no vaccines ever under any circumstances" position erroneously attributed to Margulis. There are many parents and professionals, like me, who believe that every parent must examine each vaccine and each child and decide whether the benefits of a particular vaccine outweigh the risks. This is called "selective vaccination" and I have been practicing it with my children since my eldest son was a year old.
I allowed doctors to vaccinate my now nearly sixteen year old son on the CDC schedule when he was born. There were many fewer vaccines on the schedule back then, I trusted my carefully chosen pediatrician and did as I was told. But, as is my nature, I did my research and as I read more studies I began to question whether he needed all of the shots and whether he needed them at the times they were being given. Tetanus may have been the first one I questioned. I have a particularly violent physical reaction to the tetanus vaccine so I was worried that he might as well. I researched how one gets tetanus and wondered whether my child, with his access to clean water, disinfectant and a tetanus shot if he has an injury so deep one can't be sure washing alone will protect him – well, why did my son need to risk the reaction I get to the vaccine? Then I read a study about the MMR vaccine. I don't even remember what it was about but I remember it was in Lancet, a journal one's pediatrician should be expected to read. I asked my pediatrician a question about the study and he said he knew nothing about it. I wanted to discuss my concerns with him before making the decision to give the vaccine to my son. The pediatrician was surprised I thought the decision was mine to make. And then he said it. With a patronizing laugh he said, "Your Medline privileges should be revoked." I was not amused. That was the day I decided my children would be selectively vaccinated. I would be the one who decided whether my children needed a particular vaccine at a particular time. I would do something public health officials can't do. I would look at just one child in his own unique environment with his own unique biology and family history. I would assess the risks and benefits of each vaccine for each child.
If you let the imagery and ominous tone of Frontline's "The War on Vaccines" wash over you, you would never know that parents could make intelligent and safe decisions for their own children. You would never know there are doctors who support parents' ability to do this. You would think that I make my parenting decisions based on what I see on YouTube. In fact, I chose selective vaccinating before I had even heard of YouTube. I read peer reviewed medical journal articles and consider the advice of a wide range of medical specialists including Dr. Jay Gordon and Dr. Robert Sears. The Frontline producers would have you believe that parents taking control of the medical care their children receive is a bad thing.
In between the interviews portraying extreme and irreconcilable views, along with the frightening images of sick children, there is interspersed B roll of children in a gymnastics class. Hmm. Is gymnastics there to lighten the mood by showing happy children at play? Or is it there to suggest the metaphor of risky behaviors parents encourage their children to engage in? After all, the chances of my child dying of chicken pox is far lower than the chance of my child being seriously injured as a gymnast. Or are the producers trying to leave us with that uncertainty – is that child flying through the air going to land safely or break her neck? Regardless, it is just manipulative.
So what do you think? I am not going to give you a poll and don't encourage you to participate in Frontline's two choice poll. On my blog as in life, you have more than two choices. I'd like to hear how you make your decisions about vaccination. If you saw the Frontline episode, I'd like to hear how balanced you think it was. And if you just want to to write about vaccine decision making and/or how media portrays it, let's hear it.
According to the Chicago Sun-Times, Jennifer and Scott Spiegel are suing the hospital in which Ms. Spiegel gave birth because she was accidentally brought the wrong baby to breastfeed. I haven't found a copy of the legal Complaint seeking damages in excess of $30,000 for the couple, but in every interview with the Spiegels I can find there is no allegation that their baby was harmed in any way.
Switching babies is a serious matter. If babies are not properly identified, they can be given the wrong medication or sent home with the wrong family (lest we forget Kimberly Mays). All the more reason for babies to be born at home whenever possible and to room-in with their mothers when they are born in hospitals. And I believe that Jennifer Spiegel
was exhausted and worried. She wondered, "Was he with someone else? Where is he?"
If someone brought me the wrong baby, I would wonder whether my baby was with someone else. However it appears that baby Logan Spiegel was not harmed in this mix-up. Jennifer Spiegel was brought a baby other than her own son, breastfed him, the error was discovered, and Logan Spiegel (who was never nursed by anyone other than his own mother) spent the rest of the stay in his mother's room.
So where then is the damage?
Jennifer Spiegel says her obstetrician told her there was only a slim chance of the baby or her passing each other a disease or virus.
Let's examine that sentence for a moment. If we remove the part about her passing disease to the baby, would we still be talking about even a "slim chance"? Isn't the "slim chance" of disease transfer from her to the baby and not from the baby to her? And she is the one suing for damages?
But wait for it. The lawsuit needs to state the damage.
Jennifer Spiegel, a first-time mother, didn't sign up to feed another woman's child, the lawsuit says.
I'm trusting the Chicago Sun-Times for the phrasing. I really hope the Complaint doesn't really refer to breastfeeding as something one "signs up for."
What does seem clear from what is publicly available now is that this is a lawsuit about being damaged by nursing another woman's baby. And I find that offensive and implausible.
There was a mistake made here. One that had the potential to be quite harmful but in fact harmed no one. If there is an Illinois lawyer reading this, I would like to know what the state regulatory scheme does to hospitals that make such potentially harmful mistakes. But was Jennifer Spiegel damaged by having breastfed someone else's child? Or was her husband Scott, who appears to be both plaintiff and plaintiff's lawyer in this case (heads-up on that folks, when we lawyers represent ourselves it is usually because we can't find another lawyer willing to do it)?
I'll be watching this one. I'm afraid this will be a sad display of greed and the mischaracterization of breastfeeding another woman's child as traumatic.
When I was pregnant with my first son, I gave myself permission to eat as much as I wanted. On some level I decided "you're eating for two now" could reasonably be interpreted as "you're eating for twelve now." Having had a long history of binge eating and binge dieting, being pregnant gave me a margin of error I had never allowed myself (if you have ever weighed yourself before getting in the shower because dry hair is lighter than wet hair, you know what I mean). By the time I was ready to give birth, I had justified my way to a 50 pound weight gain. I consoled myself with the prospect of the sudden weight loss giving birth would bring. The average baby weighs about 8 pounds, I figured, and the placenta and assorted fluids had to weigh another 4 or 5 (yes, I looked up the weight of the average placenta) so in just a few hours I would take off at least 12 pounds. Cool. But then I would still be 35 pounds overweight. I panicked. Then I read that breastfeeding burns calories. Yes! I knew I would breastfeed – had never considered not breastfeeding. Now, breastfeeding came with weight loss benefits. Yay and pass the Doritos.
I knew exactly how much I weighed the day I gave birth. I know this because I made a point of weighing myself before leaving the apartment for the hospital. I don't remember the number now – I've had therapy – but even in hard labor, I was thinking about getting thin. I didn't get back on that scale for five days. The birthing center "squat and leave" birth I had planned became a cesarean section, a post-operative infection, and aspiration pneumonia. My new son and I (and my baby daddy who slept on a convertible armchair in my room) were in the hospital for four long days. Even after getting home, my priorities had shifted enough that getting on the scale was not the first thing I thought to do. But I thought of it on the second day home.
I had been through hell. Not only had a baby, placenta and assorted stuff been surgically removed, I had done a great deal of vomiting and no eating. I figured I must have lost a ton of weight. I got on the scale with very high hopes. I got on and off the scale four or five times. I asked baby daddy if something bad had happened to the scale while we were in the hospital. Somehow I weighed four pounds more than I had before giving birth. My weight loss master plan had been foiled by being on an I.V. for four days. I was more than 50 pounds overweight. Oh. My. God.
While I admit I figured out the number of calories I burned each hour I breastfed, I didn't do anything differently in my breastfeeding relationship in order to lose weight. I read lots of stories of women whose weight just fell away. I heard of women who were struggling to keep weight on. I was not one of those women. There was a time I felt betrayed by the breastfeeding weight loss myth. In the end, post-partum, as during every other period of my life, I lost weight through diet and exercise. Okay, truthfully just diet.
There has a been a fresh run of news stories about breastfeeding and weight loss. I don't know why – perhaps yet another tall, thin, actress attributed her rapid return to svelte to her breastfeeding and not her personal trainer. I always wonder why these stories are considered news. Are these stories about breastfeeding and weight loss so popular because it encourages women to breastfeed? Do women really make the decision not to use formula because they think breastfeeding leads to rapid weight loss? Wouldn't that just be sad? Or is there just titillation in reading about Angelina Jolie's breasts?
It makes me angry – no amount of breastfeeding was ever going to turn me into Angelina Jolie. Did I want breastfeeding to help me take off the weight I shouldn't have put on in the first place? Yeah. Would I have made a different infant feeding decision based on whether breastfeeding helped me lose weight? Of course not.
The great Amy Spangler wrote this piece about the scientific evidence concerning breastfeeding and weight loss. It is short and to the point. Breastfeeding can result in an average weight loss of 4.4 pounds. This is a good thing but in the long list of ways in which breastfeeding is superior to formula feeding for both mother and child, it is no big deal. So how about more breastfeeding journalism that matters and less that creates unrealistic expectations for us just plain (chubby) folk.
In a dark chapter of Canadian history, the Dionne quintuplets were a more popular tourist attraction than Niagara Falls. Back in 1934, the first known surviving quintuplets involved no reproductive technology – ethical or unethical. The Dionne girls were the product of one egg, fertilized during sexual intercourse, splitting into five embryos. What happened after they were born was a different matter and this is where the parallel to the Suleman octuplets begins.
The Dionnes were poor uneducated farmers who already struggled to support their five living older children (a sixth had died). The Ontario government made the Dionne girls wards of the state and put a staff in charge of their care, which, in accord with the science of the day, meant isolation from germs, including those which might be carried by the girls' mother with whom they were allowed minimal contact.
Back to the Sulemans. If you want to find criticism of how these children came to be, it is everywhere. I too will watch the investigation of the fertility specialist who implanted all of these fertilized eggs and the medical specialty now scrambling to prove it can police itself. Nadya Suleman chose to have all of these children while the Dionnes did not. But the Suleman children did not chose how they were made any more than the Dionne girls did. And the Suleman children will not be able to control the way they may now be exploited any more than the Dionne girls could.
Looking at The Suleman Family Website [available in the morning of 2/16, by evening this site was down] and reading about public relations reps. and reality shows, I am reminded of Quintland. Between 1934 and 1943, an estimated three million tourists visited this Depression-era theme park in northern Ontario where these five little girls lived on display like zoo animals. The Ontario government and local business made a half billion dollars from this circus, little of which came to the girls. When, after nine years of litigation, the girls were returned to their family, they were sexually abused by their father who also marketed products with their name and image. Still the public was more interested in owning a Dionne Quintuplet doll, than protecting the Dionne girls themselves.
The Dionne quintuplets should serve as a cautionary tale but fetishizing multiples continues. Not lost on the surviving Dionnes themselves, they wrote an "Open Letter" in 1997 to the parents of another set of multiples. It is a document which should be read by Nadya Suleman, and the Duggers, and Jon & Kate. It is a plea from three old women whose lives, and those of the two sisters who predeceased them, were destroyed by the greed and prurience of family and community:
Multiple births should not be confused with entertainment, nor should they be an opportunity to sell products.
Now, who should be responsible for taking care of the Suleman children? We all should, just as we all should be responsible for all children. But there are people who bear a greater responsibility for these fourteen kids (yes, I mean all of Nadya's children) than I do and I think they should be ahead of me in line when the orthodontia bill needs to be paid. Of course, Nadya herself, who somehow thought money and child care would fall from the heavens to maintain her baby habit. But behind her, let's put the man who provided the sperm if indeed he either supported or did not forbid its use to make all of these children. Let's follow the sperm donor with all the medical personnel who were involved in the implantations. Why should any of these people be allowed to remain aloof from the consequences of their actions? If you are going to play a role in creating a baby, you should change diapers, buy food, pay bills, schedule and attend doctors visits (I am guessing a lot of doctors' visits). Any idea of the time commitment involved in occupational therapy alone? I do. Alot. Nadya Suleman has one autistic child. How many of the newest eight will have special needs?
I don't condemn Nadya Suleman for having children without being married or having a mate. I don't condemn her for being unemployed. If she hadn't been unemployed before she had kids, she likely would have been either unemployed or underemployed after she had kids. In the U.S. there is very little support (economic or other) for mothers. I will condemn her if she exploits her kids.
I condemn both her and the medical professionals who took her money for treating children like just one more thing you can buy. The Suleman octuplets came into the world as commodities, sold to a compulsive shopper by greedy technicians more concerned with selling the product than the physical or psychological well-being of anyone involved.
How about now we turn our attention to making sure these children, and all children, are well cared for. One way we can do that is by refusing to watch the reality show or buy the octuplet-endorsed diapers. Just say no. Let's turn our attention to all mothers who need help supporting their children and discourage parents from supporting large families by selling them. Babies aren't just more stuff. And parents have to be something better than pimps.
Most mothers either want or need to both mother their children and work for a wage. It always surprises me that some find that a controversial statement. It is pretty hard (though some try) to dispute the economic necessity of waged labor for mothers in the U.S. (where I live) today. I won't go down the "but what if she doesn't need the money" road – that way lies mommy wars.
In order to mother and earn a wage, mothers must have their children with or near them most of the time. There, I said it. No, I don't mean that women who can't have their children with them are not mothers or that they are bad mothers. I do mean that while they are away from their children, someone else is doing the mothering acts. And most mothers have very little choice in the matter.
I was pleased to see an article in The New York Times about workplaces in which mothers may bring their children every day. It makes me very happy to see workplaces in which children are welcome. I am excited by the work of Carla Moquin and the Parenting in the Workplace Institute. I am thrilled that The New York Times, which so often gives arms to the mommy wars, published an article in which children in the workplace is portrayed as positive and viable. What bothers me is the title of the article: Maternity-Leave Alternative: Bring the Baby to Work. What the title and some of the content suggests is that bringing children to work eliminates the need for maternity leave.
I owned my own solo law practice when I gave birth to my first son. Whatever maternity leave I was getting, I was creating for myself. I don't consider the federal Family and Medical Leave Act a vast improvement over my situation, though if I had had FMLA time (twelve unpaid weeks), covering my court dates would have been someone elses problem. I hired a friend to cover my court appearances for thirty days from my due date, got the phone number of a nanny agency recommended by the local bar association, and set up a portable crib in my office. My plan was to go back to the office thirty days after giving birth bringing my son who would sleep peacefully in the portable crib and I would hire someone per diem to come to the office when I had to go to court. No problem. I had everything under control and had saved up so I could go without income for a month. I filed my last brief three days before I went into labor. During early labor, I took a conference call.
And then life happened.
Four days into my "maternity leave," I was still recovering from thirty hours of back labor, a cesarean section, aspiration pneumonia, and a post-operative infection. My healthy son was in the NICU on antibiotics "just in case." (No, I still don't understand why.) I would have difficulty walking for months because, unbeknownst to me at the time, my broad ligament had been cut during the surgery. I was lucky – my son's father had three weeks of paid vacation time he could spend at home with us (when we finally made it home). Even though my son had been given some formula in the NICU, I started pumping in the hospital and when we could finally be together he latched on without a problem. And he stayed latched on. When his dad tried giving him pumped breastmilk in preparation for my return to court, he would have none of it. Though he had taken a bottle in the NICU, he never would again. I arranged my schedule so I was never away from him longer than three hours. When I took him to my office, every time I lay him in the portable crib, he screamed non-stop. Soon he started to scream whenever I walked into my office. So I started working from home. I signed on with the nanny service which guaranteed that the nanny would show up at the appointed times (initially a few days a week) or the owner would come in her place. And then the nanny was late. And then she was just "FTA." FTA is a court clerk designation for a party who doesn't show up for trial – "failure to appear" which could get you a bench warrant for someone's arrest. No such remedy with a nanny. When my nanny was FTA, I tried reaching the owner of the agency for that guarantee that she would personally come. She didn't answer her pages. I was screwed.
Slowly but surely I cut my practice down to part-time from home. My mother-in-law stepped in as emergency childcare. Yes, I needed a workplace to which I could bring my son but first I needed maternity leave. I needed time for my body to heal. Even if I had had the birth I wanted, I still would have needed peaceful quiet time to be with my new child. He and I needed to nurse and sleep and rest and play and not worry about clients or judges or conference calls or bills. We needed to be mother and son and nothing else. Not necessarily forever. But for a while.
Should every mother have a workplace to which she can bring her child so that they can have access to each other throughout the day, breastfeed, snuggle, play? Absolutely. Children will be happier and healthier and mothers will be more productive. Older kids can spend some days at work with the other parent as well. But first mothers need paid maternity leave. I am not saying maternity leave is more important than children in the workplace – I am saying it is different. Bringing a baby to work is better than forcing a mother to leave an infant for long work days but it should not be used as an excuse to deny women paid maternity leave. A mother's wage-earning work life is likely to be long. There are a lot of years left to bring kids to the office.
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