Adding to my Public Policy Toolbox

There are lots of proposals for improving public health and infant mortality rates. I've had a package in mind for a while and it generally includes:

federally paid maternity and paternity leave
tele-commuting, work from home and flex time options for workers
incentives to employers to provide on-site child care to employees
subsidies for stay at home parents
homeschool resource and support centers in every community
Family Child Interaction Learning Programs to encourage school readiness and parent/child attachment

But today I learned of a new one. Taught to me by none other than Feminist Guru of our times, Gloria Steinem. In this article, she mentions the Caregivers Tax Credit which as she describes,

"we can also pass legislation to attribute an economic value to care giving at replacement level (whether care giving is raising children, talking care of elderly parents, AIDS patients; whatever), make this amount tax deductible in a household that pays taxes, or tax refundable in households too poor to pay taxes (thus substituting for the disaster of welfare reform). This Caregivers Tax Credit unifies the so-called soccer mom and the welfare mom because both benefit. You can find out more about this legislation, which just expands the refundability principle we won in the Child Tax Credit – though a lot of people don’t know they’re eligible; you should publicize that – to care giving."

She also links to the website: http://caregivercredit.org./about.php which includes the opportunities to sign up for the campaign newsletter, an endorsement form and an invitation to write to your representatives in Congress to support the creation of this new tax credit.

There is also a survey that you can take where you can report your thoughts on this tax credit and if its something that you would benefit from.

Vitriol Over Breastfeeding Research

The recent study from the Journal Pediatrics is getting a lot of coverage. In response there have also been a lot of public comment on it. Feminist Breeder summarizes the vitriol that is being expressed in response to it.

Most breastfeeding advocates, and moms who don't advocate but breastfeed happily or even ever comment on the good side of breastfeeding has heard the defensiveness that is sparked immediately from a mother who has used formula with her baby for whatever reason. (Can you tell that I have?)

A friend recently described what this is like to be on the receiving end of the defensiveness, and since she captured it so well, I'll link to her it (hope you don't mind Aimee!). Though she was talking about fertility, its very similar to discussions regarding breastfeeding and formula usage.

When speaking about breastfeeding or giving encouragement or advice to help someone continue breastfeeding, it is not condemning those who do not, yet it it stating what is factual: breastfeeding is better. Its the norm. It is right in the vast majority of circumstances. Stating fact is not a reflection on a person. Defensiveness is not necessary. There is compassion for those who struggle or regret or do not regret and feel comfort in knowing it was the right decision for their family, or who have "the serenity to accept the things [they] cannot change."

For whatever reason that is faced that leads a mother to supplement or to turn entirely to formula, the fact does not change that breastfeeding would be better. Its not said to make anyone feel guilty. Like a quote shared by a friend, "Ideals are stars to be guided by not sticks to beat ourselves with."

When breastfeeders are saying these facts, we are not disrespecting you. We are not dismissing your experiences. To quote Aimee from above:

I just ask for the same respect. I invite you to share with me your struggles and feelings about trials you have to endure. We can build understanding even through our differing challenges and being dismissive of each other's circumstances will only erect barriers between us.

But beyond all that, there is more to the issue. For many women it is not about choices, but its about making the best out of the circumstances they are faced with. On the Feminist Breeder's post, I responded in support of Shannon Drury, a member of the Mothers & Caregivers Rights’ Committee of National NOW, who said this:

They pretended to care about why more women don’t breastfeed, but they never mentioned the totally [expletive removed] obvious: THIS COUNTRY LACKS THE POLITICAL WILL TO ENACT FEDERALLY MANDATED MATERNITY LEAVE. Forget pumping stations. Forget “some women just can’t,” which as you pointed out is crap. GET ON THE STREETS AND DEMAND MATERNITY LEAVE FOR EVERYONE. Everyone. Everyone. Everyone.

I added to her comments by saying, what I discovered when studying family policy in my master's program. I'm sharing here what I posted there highlighting the policies I feel are necessary to provide the level of social support needed to acheive a 90% exclusive to 6 months breastfeeding rate:

"Beyond choice, and physical difficulties is the need for public policies that are designed to respect a woman’s ability to breastfeed and care for her baby exclusively. Paid, extended maternity leave is necessary to establish the breastfeeding relationship. At home subsidies for stay a home mothers would also be appropriate here (Sweden is essentially doing this for up to 1 year). After that requiring employers to allow mothers to pump milk at work and NOT making them clock out to do so, providing on site childcare, and flextime/telecommuting options are important steps in maintaining the breastfeeding relationship beyond 6 months. Insurance paid for lactation consultants, public health campaigns on the ease of increasing milk supply via oatmeal and herbal tea, expanding the WIC give-aways of breastpumps are all ways to assist mothers in having success breastfeeding.

I’m sick of the partisan politics that maintain that parents are expected to “pull themselves up by their boot straps” and “do the best they can with what they’ve been given” and “suck it up.” That does not a healthy nation make. Charity, benevolence, compassion and kindness need a more central part in our public discourse."

The Human Microbiome Project

The same friend who told me about outsourcing health care told me about a fascinating research project that he is working on as an employee of a bio-tech company on the East Coast.

You've heard of the Human Genome Project which catelouges all the genes in the human species. This is a little different: they are looking at all the organisms that live in the human species.

The average human body, consisting of about 10 to the thirteen power (10,000,000,000,000 or about ten trillion) cells, has about ten times that number of microorganisms in the gut. Somewhere between 300 and 1000 different species live in the gut,[3] with most estimates at about 500. These microorganisms are helpful the human existence: the microorganisms perform a host of useful functions, such as fermenting unused energy substrates, training the immune system, preventing growth of harmful species, regulating the development of the gut, producing vitamins for the host (such as biotin and vitamin K), and producing hormones to direct the host to store fats. However, in certain conditions, some species are thought to be capable of causing disease by causing infection or increasing cancer risk for the host.(see references on wikipedia.org)

The Human MicroBiome Project is trying to figure out what all of those microorganisms are, just as the Human Genome Project sought to determine all of the genes in our genome.

The process is not a pleasant one, definitely a study I would not sign up for. Participants are given a strong antibiotic that kills all of the microorganisms living in the digestive tract, and then they are asked to collect stool samples over the next weeks as the flora repopulate in the gut. Then the lucky lab techs get to analyze the stool samples.

Many holistic oriented, health conscious people, especially mothers, are aware of the importance of maintaining healthy intestinal flora for proper immune and health functioning. The Human Microbiome Project has the potential to make that information for well-known and accessible to the public, providing evidence for the importance of microorganisms in association with health and disease with applications across the medical and healthcare fields.

Outsourcing Health Care

A friend informed me of a new concept that has implications for childbirth: outsourcing healthcare. Evidently, there is a new trend for insurance companies, to cut costs, to send patients outside of the United States with cheaper healthcare services for procedures, etc. The example my friend told me about was patients being sent to India for heart transplants. While there, patients are given "gold-star treatment", first class flights, nice hotels, limos to and from the hospitals, gift baskets, etc.

I have heard about the birthing mother's receiving celebrity treatment for extra cash-- $15,000 for continuous labor support provided by an obstetrician, extra special hospital accomdations, incentives, etc. but outsourcing takes it to a whole new level.

Next, will there be reports of U.S. insurance companies sending birth women to India, France, Spain, etc for gold-star scheduled inductions to decrease costs?

In order for that outsourcing to be effective in the case of labor and birth, the birth would have to be scheduled, otherwise women might be living out of hotels for 2-6 weeks waiting to go into labor. I can't imagine how that could still be cost-effective. So let's assume that a woman is put on airplane at 38 weeks and the induction is schedule for a day or two after arrival.

Would that be cost effective?
Do we need to see more inductions of labor and scheduled c-sections?
Would those births be granted dual citizen status?
How would the birth stats be reported--in the country of birth or in the United States?
Will this be a new trend or will common sense prevail?

YAY BYU!

I found this article quote on Hathor the Cow Goddess's page:

First I want to say, Yay BYU for funding, sponsoring and conducting research on the importance of breastfeeding. You don't have a medical school, and the women in the church associated with you frequently wean their children early, but you are taking the issue on. Good on my alma mater!

Next, the issue of breastfeeding can also be framed as a social issue relating to public health. The book Baby Matters presents a ponderance of research showing that not breastfeeding or weaning early contributes to many of the childhood illnesses that can sometime be perpetuated into adulthood, including mental health issues.

Three out of four new moms try breast-feeding over the bottle, but most of them have quit by the time the baby reaches six months, a new study shows.

Breast or bottle? (Francesco Tonelli for The New York Times)
A report from Brigham Young University shows only 36 percent of babies are breast-fed through six months. The American Academy of Pediatrics recommends breast-feeding through the first year.

The data are based on a weighted sample of more than 60,000 children, collected from national immunization surveys compiled by the Centers for Disease Control and Prevention. Although the data are focused on childhood immunization rates, questions also were asked about breast-feeding, giving the researchers a representative sample of nursing patterns in the United States.

The researchers found that children who were most likely to be breast-fed for more than six months typically had mothers with higher levels of education and income. Married women and those who lived in Western states were also more likely to breast-feed. Hispanic women and women born in other countries were also more likely to breast-feed.

Returning to work, being a smoker or living in the Northeast decreased the likelihood of long-term breast-feeding. Notably, low-income women who participated in the subsidized Women, Infants and Children program, which provides food, milk and formula to mothers and young children, were also more likely to stop breast-feeding sooner.

“Breast-feeding promotion programs encourage women to start but don’t provide the support to continue,” said Renata Forste, co-author of the report, published in the August issue of the Journal of Human Lactation.

Framing Birth As Public Health, Reproductive Rights Social Issue

In a previous post, I shared the legal connection between informed consent and birthing choices. Sara Ainsworth in the Seattle PI article, framed women's birthing choices as legal issues relating to reproductive rights, patient's rights, as well as the public health concerns stemming from the risks of Cesarean births.

Framing is a process of developing communications that change the way that people think about social issues. People tend to have existing intellectualized constructs that provides their interpretations of events and issues. Sometime those dominant frames are called "pictures in our heads," "mental shortcuts." (Source: Frameworks Institute)

Effective framing, combined with field building can bring out social change where coalitions of social policy advocates work together to effectively communicate about their issue.

I learned about framing policy issues in my graduate coursework from this summer. For that purpose, my cohort members and I worked on framing early childhood education as a social issue. However, my involvement in the birth community has led me to change my focus to framing birth issues as social issues that need policy changes that benefit infants, mothers and families, instead of the current system where its the obstetricians and insurance companies who benefit.

The dialouge about social frames has gotten started and the Northwest Women's Law Center has joined it. Who else will?

Will a think-tank (a policy, research and advocacy organization) ever be formed for birth issues? What type of effort is needed to accomplish the desired changes?

As one can tell, I'm not content to sit at my computer and bemoan all that is wrong with childbirth in the United States, as Rixa says.

Legal Rights to Informed Consent in Birth

This article from the Seattle PI "High rate of C-section births is health concern for women" was a breath of truth and reality of what women are facing with birth.

This is the first time, in a news media outlet, that I've seen hospital practices framed as coersive and trying to manipulate women's birthing choices. And the first time I've seen the abuses of the fields of obstretrics frames as a health issue, as well as a legal issue regarding reproductive rights and patient's rights.

One particularly persuasive quote from the article, says:

Such reasoning inappropriately views a pregnant woman's decision about her and her baby's needs as suspect, and it ignores her legal rights as a patient. All pregnant women, whether they view birth as a natural event only rarely needing medical intervention, or whether they willingly accept medical assistance with the birth process, have the legal right to informed consent and to direct the experience of bringing their children into the world.

The issue needs increased awareness. It goes beyond the talking point of VBACs and coerced Cesearans although those are grave concerns that need to be addressed. Please post comments to the PI article.

Childhood Vaccines: Questions All Parents Should Ask

Conscious Woman. org sponsors online seminars, called "webinars" on a variety of topics that are relevant to parents and women, particularly in their roles as mothers. They provide easily accessible, affordable information and evidence based research on topics like natural birth, circumscion, breastfeeding, vaccines, midwifery and being an effective advocate. As a stay at home mom, I am able to participate without interfering with my child's schedule as I can use a portable phone and headset to listen to the presentation and view the slide shows on my computer with internet connection.

I first became acquainted with Conscious Woman when I discovered that they were offering a series on Postpartum Mood Disorders, which Post Traumatic Stress Disorder after childbirth is one. I took the two part series to learn about my condition, what I could do to heal and move forward, as well as to learn about the academic research on the topic so I could be an effective advocate for change.

The most recent series I participated in was Childhood Vaccines: Questions All Parents Should Ask I was very glad to participate because, like many other parents, I have been concerned over the rumors about vaccines causing autism, asthma, chronically ill children, even death and other neurological disorders.

From the Conscious Woman website, here is an outline of the material presented in the webinar:

Part I: Myths vs. Realities
This workshop will explore common misconceptions regarding vaccination efficacy, and how tests are conducted to determine vaccine safety. Questions that will be addressed include:

What are the present legal requirements for mandatory vaccinations?
How effective are vaccinations?
Are vaccinated children healthier than non-vaccinated children?
Are vaccines safe? Do the benefits of vaccination outweigh the risks?
How is vaccine research conducted? How thoroughly are vaccines tested? How long are test children observed?
What is congenital rubella syndrome? Does the rubella vaccine prevent it?
Do vaccines cause meningitis?
Tedd will also discuss transplacental immunity and how it relates to current vaccination practices.

Part II: The Shots
Many parents still consent to routine vaccinations - believing that the “removal” of thimerisol (mercury) has taken away the major risks associated with the vaccines - without considering whether vaccines contain other toxic ingredients and what their potential side effects may be. This workshop will focus on the following questions:

What’s in a vaccine?
Are there benefits to infectious diseases of childhood?
What is herd immunity?
This workshop will explore the controversial research on SIDS and vaccinations, the relationship between polio vaccine and cancer, and whether or not polio has disappeared as a result of the vaccine. Epidemiology of childhood diseases, mortality and morbidity, and the Hygienic school of disease will also be addressed.

Part III: Risk and Conflict
This workshop will involve an exploration of Juvenile diabetes, Crohn’s disease, autism, post-encephalitic syndrome and a multitude of other chronic diseases and conditions that are associated with vaccinations. The focus will be on how conflicts of interest have played a significant role in the introduction and proliferation of unnecessary and harmful vaccinations into state immunization requirements and ultimately - into your child’s body.

This workshop will conclude with a discussion of the age old debate between expressive and suppressive healthcare.

The series is being offered again, in three parts starting June 8, with part two on June 22 and part three on July 6. Its a very good way to spend a Sunday morning: learning while in your jammies.

What did I learn from the series?

I learned that there is not enough research to dispute the claims that vaccines cause autism, or death; therefore making putting their safety into question. Until vaccines are proven (by quality, reliable research) to not cause injury to children, I will not feel comfortable following the recommended immunization timetable published by the Centers for Disease Control. It seems to me that pharamceutical companies, doctors and public health officials are not addressing parent's concern about safety and effectiveness, instead are running smear campaigns implying that parents whose children suffer vaccine injury are seeking to blame someone, and those who chose not to vaccinate are irresponsible and neglectful parents.

Educational Guide to Plastic Problems

Here's another topic that as a mother gets my attention. When I hear that plastics (that are used in most all children's toys, feeding utensils, and food packaging) contain dangerous chemicals that lead to adverse health effects, I start listening and finding out what I can because I want my children to be healthy, protected from dangers, especially those that are present (unknowingly) in my home.

I found this guide to be helpful in educating me about what is contained in plastics and what their effects are.

Smart Plastics Guide

I hope that guide is helpful to other parents!

Ban the Bags (cont)

In the newest issue of Mothering magazine, an article added more information on the history of "Ban the Bags" a movement that would restrict hospitals, and infant formula makers from distributing free samples of formula to new mothers. The reason for this ban is because research has shown that women who are given free samples of formula are less likely to continue breastfeeding as long as recommended (2 years by the World Health Organization, and at least one year and longer by the American Academy of Pediatrics). Women use formula feed their babies spend on average $2,000 on formula in the first year, whereas breastfeeding is free. Obviously the formula companies have a financial incentive to get as many mothers as possible to breastfeed, and through hospital giving out free samples, "mothers will assume that the brand [of formula] is sanctioned by the health care provider and safe to use."

The sour note to the article was learning about the history of the Ban the Bags bill from the Massachusetts state legislature. It appears that former presidential candidate Mitt Romney gave into the temptation of letting special interests and money get in the way of promoting what is healthy for infants and mothers.

He then defended his actions by saying that not giving women formula when they left the hospital with their new babies interferes with a woman's "choice" to feed their baby in whatever way they view as appropriate. What an awful argument! A woman has the choice to go to the store and buy formula if she chooses to formula feed her baby. Nothing is stopping her! She's going to have to feed her baby, so if she's not using the milk produced by her breasts, then she needs to go to the store. Simple enough solution to protecting a woman's choice.

If Romney wants to argue that hospitals are not offering equal time to the various methods of infant feeding, then we can say that hospitals need to become objective when it comes to issues relating to infant feeding. If this were to happen, hospitals would not be allowed to advocate or assist mothers in establishing the breastfeeding relationship. Hospitals would either need to remain mum on the topic or provide information (but information, only!) on the benefits, disadvantages and risks of both breastfeeding and infant formula. In this way, mothers would be given knowledge and then the opportunity to make the choice for themselves.

Unfortunately (rather, fortunately), the public health arena realizes the risks to the overall health of our society that comes from not advocating breastfeeding. Research has shown that breastfeeding is the optimal way to feed infants, so much so that hospitals across the country are employing specially trained professionals known as Lactation Consultants who counsel women and often provide around the clock assistance to women who have questions and concerns with breastfeeding. Women, of course, have the freedom to choose to employ the LC's assistance or to go to formula. Not providing bags of formula doesn't interfere with choice: just with the finanical incentives of hospitals, formula manufactures and now we see, politician who are courting the big business constituency.