Strange choices bring octuplets

I’ve been spending a lot of time in the last few weeks talking to mothers who can’t get the most basic health care for their children—because they have no health insurance—so the story of the octuplets born this week stuck in my craw. Even as mothers can’t get their daughters the asthma medications they need, can’t get their children to the dentist, can’t get their son’s broken shoulder set properly, get taken to collections for the bill from treating a child’s ear infection, 46 doctors and untold millions of dollars have been devoted to this freak of un-nature.

And it is certainly not natural. The newspapers are being coy about the question how the mother came to bear so many babies at once. But they do note that there’s virtually no chance this happened naturally; it’s a near certainty the parents used fertility treatments, most likely IVF, and that the parents refused what’s delicately termed a “reduction.” Yet as AP notes, “Multiple births can be dangerous for babies and their mother, and in some cases, may result in lasting health problems.” That’s an understatement. One of the doctors in the case noted that the human uterus is designed to hold at most two babies. Putting more in there puts a mother’s life at risk and is likely to cause terrible health complications and suffering for the babies (including long-term physical and cognitive problems).

Make no mistake, therefore, octuplets are the result of choices, some very strange choices at that, most likely based on strange and incoherent ideas about God’s will. The parents and their caregivers chose to have multiple embryos implanted and they chose not to reduce the number of fetuses in the interests of the health of mother or babies.

This case is also the result of choices we as a society have made, to devote resources to enable these strange choices, at the expense of basic health care for all children. The AP article on the case quotes a doctor saying that doctors can’t force women to have reductions, but in most European countries there are limits on the number of embryos doctors are allowed to implant or the number of cycles of IVF covered by national insurance (and there is evidence that increasing the number of embryos doesn't increase the odds of success).

All of us bear the cost of extraordinary medicine like this, through our insurance premiums and our tax dollars, in the form of the state and federal funds that go to hospitals, doctors, and medical schools. As I have listened to Vicky worry about her daughter’s next asthma attack, Paula anguish over missed check-ups and dunning letters from collections, and Traci worry about the pain in her son’s teeth, I am disgusted by my society’s choices. The octuplets are no miracle.

The change cometh

What more can I add to all that’s been said about this beautiful week? Not much. Just when I was coming off my inauguration high, Obama’s first executive orders came down. Oh, yes, it’s real. Closing Guantanamo, ending torture, opening government, protecting public lands from oil drilling, lifting the global gag order—sweet rain in the desert.

And then there was the news that Michelle Obama does not plan to spend all her time on selecting ball gowns and redecorating the White House. She has just appointed the general counsel of the National Partnership for Women and Families to be her policy director. The Wall Street Journal describes Jocelyn Frye as “one of Washington’s most visible advocates of expanding family leave and ending pregnancy discrimination” and reads the appointment as a signal that Michelle Obama is “preparing to take an activist stance on such policy issues as family leave and flexible scheduling.”

Looks like Michelle too may have the Obama touch, the ability to make hot button issues safe for prime time, She’s jujitsuing the requirement for the First Lady to focus on family into a feminist agenda.

Online sex predators a rare breed

My favorite “Dog Doesn’t Bite Man” news of the week: “Threat overblown of online sexual predators.” A task force of state attorneys general has found that sexual solicitation of children online is not a significant problem.

People seem to love to get hysterical about this supposed problem, perhaps because it is an excuse to a) violate civil liberties, including free speech, and b) avoid addressing the real sexual threats to children, namely people known to them. It’s so much nicer to pretend the problem is scary faceless Others, not the people close to us. If we admitted that the problem is close to home, we’d have to accept its causes in our culture and, for many, complicity in it. Children are most often abused by someone they know, and what may be worse, they often aren’t protected or supported by the people closest to them. In my experience as a teacher, I’ve heard quite a few stories of abuse and it seemed that worse than the abuse itself was the experience of not being supported, protected, or believed by those they most trusted and loved.

Here’s to the attorneys general for the reality check.

Mom's fault, as usual, or, yet another installment of crummy science reporting

Get a load of how the media played today’s story on new evidence of the risks of early C-section. Here’s the LA Times lead: “Thousands of women put their babies at needless risk of respiratory problems, hypoglycemia and other medical ailments by scheduling cesarean deliveries too early.” It’s women who put babies at needless risk. Not doctors or hospital policies. As usual, it’s mom’s fault.

Why would silly moms do this? NPR concluded its spot on the same research by noting that women may be scheduling C-sections early to insure that their “personal physicians” (idiotic term) were available to deliver their babies. To protect their babies, women may just have to let go of that choice, intoned the reporter.

The research looked at “elective” C-sections, that is C-sections for which there is no medical reason. Why would anyone have such a thing? The Times opined that it was women who are “too posh to push.” Again, those irresponsible moms.

Nowhere in the stories was there any mention of whether medical practice and policy might have anything to do with this problem. Nowhere in the stories was there any attention paid to the strange fact that doctors perform such a thing as a C-section for which there is no medical reason, or the disturbing fact that researchers could find 13,000 elective C-sections to study.

In further scolding of women, the LA Times mentioned that the American College of Obstetrics and Gynecology has counseled that women wait until 39 weeks before having an elective C-section. But missing from the stories was the information that ACOG and the American Medical Association have ruled elective C-sections to be ethically neutral, despite the health risks C-sections pose to women and babies (especially repeat C-sections) or that when researchers have looked for women who chose C-sections for the heck of it, they haven’t found any.

The Listening to Mothers survey, the biggest and best look at the subject, managed to find one woman among the 1600 surveyed who chose a C-section of her own volition. A full quarter of those who’d had C-sections described themselves as “pressured” by medical caregivers to have the operations—information that doesn’t appear in medical records that term the C-section “elective.” And, thanks to another directive from ACOG, fewer and fewer hospitals will allow women to even attempt vaginal birth after C-section. Women’s childbirth choices certainly play a role in this issue, but their choices aren’t made in a vacuum.

Nor did the stories mention the inherent risks of C-section, regardless of when they’re scheduled. The LA Times story did contain a hint in that direction: “The initiation of labor is a baby's way of signaling that it is ready to live outside the womb,’ [Dr. John Thorp, a professor of obstetrics and gynecology at the University of North Carolina at Chapel Hill and coauthor of the study] said. When doctors schedule elective C-sections, ‘we're saying we're smarter than that signal,’ he said. ‘There are some babies who aren't ready to make that transition and are forced to do so.’ ”

Bread (and roses), not circuses

Amazing fact: Forbes calculates profits of the big four sports (I guess that’s baseball, football, basketball, and tiddlywinks?) at $1.6 billion, but these industries receive taxpayer subsidies totaling more than $2 billion a year. That is, taxpayers provide the entire profits of sports. Explains a lot, doesn’t it?

I’ve always had a deep resentment of sports analogies, the continued job security of sports writers even as investigative reporters become an endangered species, and sports films with “universal appeal,” not to mention taxpayer-funded stadiums. Why am I supposed to take overgrown boys’ games any more seriously than I would expect anyone to take pedicures, eye-brow-plucking technique, or the collection of Beanie Babies?

Now I know what I've always suspected: the whole sports business really is parasitism, pure and simple.

The above revelation comes from a terrific article in the current issue of Mother Jones laying out how we can get the economy back on track. Check it out.

Another fact to ponder in a different article in the same issue of MoJo: Tax cuts and credits for corporations and wealthy individuals have a negative return on investment—less than 37 cents on the dollar—while every dollar spent on food stamp benefits returns $1.73 to the economy. I’d like to see what the return on investment in childcare or paid family leave might be. Something tells me it’d be better than sports stadiums.

Notes on Christmas

Thoughts on Christmas, now we’ve survived it.

1. I Heart Doctor Seuss: On Christmas eve, my (Jewish) partner and I found ourselves reading “How the Grinch Stole Christmas.” I was newly aware that what makes this story so great is its moral complexity. Unlike George “you’re either with us or against us” Bush, Dr. Seuss presents his central character as both villain and hero. Dr. Seuss may be laughing at his grinch, but he also seems to identify with him; who hasn’t sometimes felt their stomach turn and their heart shrink when witnessing this saccharine celebration of purchasing piles of cheaply made crap? The over-indulgence in tinsel, toys, and gorging that grosses out the Grinch is repugnant. His theft of all the ticky tack in Whoville is mean, but it is also a gift, clearing out room for the Whos to remember the real spirit of Christmas.

2. Down with White Christmas, Up with Herald Angels and Satan’s Grasp: When I listen to the Bing-era Christmas songs, I hear the jingle of cash registers. I can’t separate these modern secular songs from malls and mobs of bargain hunters. On the other hand, I’m no Christian, but I get choked up when I hear “Joy to the World,” “Hark the Herald Angels,” “We Three Kings, and “Holy Night” (way, way better than the sentimental pap of “Silent Night”). These songs are serious and sometimes dark. (Note the minor key of “God Rest Ye Merry Gentlemen” and the reference to freeing us from “Satan’s grasp when we had gone astray.” Not for nothing is this song, and that very line, the background of the ominous last scene in “Three Days of the Condor.”) The joy is therefore earned and real. What they celebrate is the possibility of the redemption of the world through the birth of a child. This is the miracle we all participate in with every birth.

Bah humbug and happy Boxing Day (don't forget the presents for the servants). On to Three Kings Day.

Build windmills and wipe babies' bottoms

A number of critics have begun to note the macho slant of Obama’s job plan, as it’s being outlined so far. Katha Pollitt, for one, has done so, but then she would, wouldn’t she? (I mean that very much as compliment.) More noteworthy are columns in The New York Times, the Boston Globe, and, believe it or not, Forbes.

The economist Randy Albelda writes in the Boston Globe that although we certainly need bridges, roads, windmills, and efficient cars and the jobs that go with them, those jobs will overwhelmingly go to men. Albelda notes that “almost one-quarter of families with children under the age of 18 are headed and supported by women as are the majority of single-adult households without children.” You wouldn’t think that you’d have to point out that leaving out women leaves out most of the country, and the majority of its breadwinners, but you do.

Writes Linda Hirshman in the New York Times, “Mr. Obama compared his infrastructure plan to the Eisenhower-era construction of the Interstate System of highways. It brings back the Eisenhower era in a less appealing way as well: there are almost no women on this road to recovery.” This column is almost enough to make me forgive her for her earlier polemics.

Neither Albelda nor Hirshman include in their criticism the demand that Obama’s jobs plan should include aggressive affirmative action and efforts to pull women into apprenticeship programs in the construction trades. In Forbes, Ruthie Ackerman makes this point. “The answer is not, as Hirshman suggests, to create more low-paying jobs "in fields like social work and teaching, where large numbers of women work." The solution is redefine what we consider women's work.”

I can’t help feeling that Hirshman and Ackerman both have it half wrong, and both carry some misogyny around, Hirshman in assuming that women will always do “women’s work” in social work and teaching, and Ackerman in rejecting that work as unimportant. Ackerman would do well to read her fellow Forbes columnist Thomas Cooley arguing for investment in education as part of the stimulus package, not because it helps women, but because it will have the biggest long-term payoff.

Ackerman describes the trades as unsexy. Not to me. A person who knows how to build something—that’s pretty sexy. When my sweetie puts on a pair of Carharts, I go a little mushy. That kind of apparel puts me in mind of the men who worked as part of the original stimulus plan, in the Civilian Conservation Corps, building the trails, bridges, picnic tables, and other amenities I enjoyed throughout my childhood and that my children still enjoy. My daughters ought to get a chance to build such things and say proudly to their daughters, “I built that.”

If I had sons, I would want them to be proud of jobs they'd had caring for children, to point to flourishing people and tell their sons, "I helped raise that." If such work were better paid, such a thing would be far more likely.

How about both and? Get people (including women) building trails, daycare centers, and windmills, and give people (including men) well-paid jobs caring for our elders and children. I want it all. We can do it.