Superbugs and birth

Second in an occasional series: What I’m reading while pumping breastmilk...

A recent article in the New Yorker about antibiotic-resistant infections and their prevalence in hospitals is truly frightening, and it prompted this thought: Birthing women and newborns should, wherever possible, stay the hell away from hospitals. And: C-sections, representing just the kind of surgical wound (an oft-infected one, I might add) that drug-resistant bacteria love to colonize, should be done as rarely as possible.

The tragic history of childbed fever, which proved to be a doctor- and hospital-caused epidemic, suggests good reason for worry about infection of birthing women. While discovery of the cause in the late nineteenth century—that doctors were moving between patients and from dissecting cadavers to delivering babies without washing their hands (ugh)—and introduction of antiseptic techniques dramatically reduced deaths from childbed fever, they weren’t eliminated until the introduction of antibiotics. But the bacteria that cause it were never eliminated—it's caused by the Group A and B strep bugs, among the bugs known to be developing antibiotic resistance. So the news that antibiotics are losing their effectiveness bodes badly for women birthing in hospitals.

Boston marriages revived?

I’m glad to see Broadsheet picking up on a topic I’ve discussed previously: the need to recognize other forms of partnership besides either heterosexual or gay ones. Although Carol Price’s post didn’t make the connection with the debate over gay marriage, she did pose the question, “Isn’t it time to legally recognize the bonds of friendship?” She cited others asking the question, noting articles on the subject in the Boston Globe and The New York Times.

No one in the articles or the blog post suggested the kind of systematic revision of the tax code I do, and several experts quoted seemed to miss the point altogether, dismissing the idea of giving friendships legal standing as typical American over-legislation. But Laura Rosenbury, a law professor at Washington University quoted by the Boston Globe, gets it:

"If the law decides to support some relationships, why not others that similarly involve care and support? What is it about marriage or marriage-like relationships - that is, relationships that are assumed to have sex in them?"

Jane Gross in the New York Times focuses on those who are single and childless and their need for support in old age. But this isn’t only an issue that should concern single women. It’s past due time for women to consider that most of us will spend less than half our lives married to a man (see my old article in Salon on this topic). I’ve already considered that my spouse is likely to die many years before me (sorry, sweetie) and that my friends will be the support of my old age.

Most women quit breastfeeding quickly

First the good news: Three out of four U.S. mothers are now breastfeeding their newborns, according to a recent study from Brigham Young University. I’ve heard horror stories from older women of babies being fed mixtures of Karo syrup, so let’s hear it for some enlightenment.

But now the bad news: Although the American Academy of Pediatricians recommends breastfeeding through the first year and the World Health Organization recommends breastfeeding for two years. most women have quit breastfeeding by the time their baby reaches six months.

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 incomes. Before we all leap to blaming stupid moms, surely a major cause of the drop-off is the lack of paid family leave in this country, the pathetic part-time job market, lack of flexibility in most work places, and the downright hostility of most workplaces to pumping and breastfeeding. Those women with more education are more likely to be able to take significant time off and to have higher-status jobs where pumping is a viable option (Starbucks, for example, wins kudos for supporting mothers among its managerial staff, but just try being a barista and breastfeeding).

I’m here to tell you that breastfeeding is great—no need to remember to lug any food with you! And it’s free!—but pumping sucks. Itoffers nearly all the stupidity of formula feeding—endless bottle washing—and you have to hide in a bathroom or cleaning closet and hook yourself up to a milking machine, all the while watching the clock tick and hoping nobody else is noticing that, once again, you’re not at your desk. Which stress of course tends to reduce your milk production, which in turn ups your stress. I understand why women quit breastfeeding after they return to paid work.

But here’s to my fellow Western staters and to immigrants—the populations most likely to breastfeed.

Depression increases your risk of...depression

Why is it that news about postpartum depression seems so often to fall in the no-shit-sherlock category?

Check out this item: “Psychiatric history affects 'baby blues,' study says.
Mental health issues may increase postpartum suicide risk.” Um—it took researchers with master’s degrees to figure this out?

Then again, read deeper and you find more to undermine conventional wisdom than to reiterate common sense. Midway down the article I see this: Rates of suicide attempts by women after giving birth is much lower than in the general population.

This does make sense; most women, even depressed ones, feel an obligation to their newborns to stay alive. Still, you might think from all the publicity about postpartum depression that women were at high risk of suicide after pregnancy.

Talk about postpartum depression is a strange mixture of the deadly obvious repackaged as profound scientific insight and thoroughly bogus leaps of logic repackaged as unquestionable science. This says to me that we’re thoroughly confused about postpartum depression. And "mental illness" in general, for that matter. My favorite billboard ever, which I used to pass by daily on my way to work, is "Number one cause of suicide: Untreated depression." Can we say tautology, class?

Go, Ohio

As an article in the Dayton Daily News put it forlornly, Ohio rarely leads the nation in anything. (Not even plant closings, where it's probably edged out by Michigan.) But Ohio is poised to become the first state in the nation to require employers to give workers paid sick leave.

I don't have to tell parents how important sick leave is. The Dayton Daily News article reports that 2.2. million Ohioans have no paid sick leave and another million don't have the right to use it to care for their sick children. For low-income workers, who are least likely to have paid sick time and least likely to have the right to use it to care for sick children, one illness in the family can mean losing a job and financial ruin. This is just one element of the shadow of fear that defines the American economy. Most other rich countries have seen fit to lift that shadow by offering, among other pieces of the safety net, paid sick leave.

If voters pass this initiative this fall—and as of now 71 percent support the measure— Ohio workers will get seven paid sick days.

Here's hoping Ohio is just the first.

As the economy slides, the safety net doesn't catch women

You know times are tough when the Wall Street Journal runs stories on how hard it is to qualify for unemployment. This week the Journal reports that most of those losing their jobs in the current economic slide won’t qualify for unemployment benefits.

Only 37% of the country's unemployed received benefits in 2007, down from 55% in 1958 and 44% in 2001, according to the Labor Department. The others have exhausted their benefits, haven't applied or don't qualify.

The article goes on to note that the unemployment insurance system was set up for “traditional male breadwinners in traditional, manufacturing-type jobs," according to labor economist Lawrence F. Katz, and doesn’t fit people who work part-time, move in and out of work, or juggle multiple jobs. Which means, especially, it doesn’t fit mothers.

This is not news to me. When I went on unemployment after losing my job shortly after my first child was born because my employer was unwilling to accommodate my need for part-time work, I went through the wringer. First I had to fight to prove I qualified, in part because I’d been working part-time. I had to claim I was seeking full-time work. Then, I faced the Kafka-esque double bind that jeopardizes mothers who try to claim insurance benefits: Failure to have childcare counts as not being “ready and available for work,” and therefore disqualifies you for benefits. It’s true; how can you even look for work if you don’t have childcare, let alone accept work, what with decent childcare taking so long to locate? But how are you supposed to pay for childcare if you don’t have a job—and you can’t get unemployment? Nor of course is childcare provided as an unemployment benefit. It was maddening.

I got caught on the horns of this dilemma because I was twice required to come in to the unemployment offices to wait around and let underpaid bureaucrats peruse my paperwork. Once my partner was unavailable to watch our daughter, and although I was allowed to reschedule my mandatory appointment, this triggered the remorseless wheels of denial. Luckily, the human caseworker carefully asked me if I was unavailable—had no childcare—all the time or just that one time. I said just the once, she didn’t push further, and I was docked exactly $36 from my unemployment check. Thank goodness for real humans inside the system.

But the system must be changed, not just as the Journal suggests, to allow for people outside of long-term, full-time work, but also by providing childcare assistance as an unemployment benefit. In these hard times, change can't wait.