Posts by Shel Lyons
The "A-Word"
Published October 18, 2009 @ 03:51PM PT
Recently, I spoke at Perinatal: A Symposium on Birth Practices and Reproductive Rights at George Mason University. The task for the featured round table panelists was to determine legal and political strategies to advance reproductive rights in childbirth. My contribution included noting that childbirth rights advocates need to involve our work into the more mainstream causes of human rights and reproductive rights, including abortion rights.
The audience, fellow childbirth advocates, ignored my comments on abortion. Apparently, the "a-word" is not acceptance language among childbirth reformers. I discussed the abortion debate from a mother's perspective in a prior post, and understand that women who devote their lives to improving birth outcomes and lowering infant mortality rates are invested in the life of the fetus. However, my comments never took a side on the abortion debate. I merely observed an unfortunate consequence on childbirth rights from this debate.
I observed that one unexpected effect of the abortion debate was to give more importance to the choices and beliefs of third parties regarding the medical care of pregnant and laboring women than to the choices of the women themselves. Doctors and hospitals have relied upon Roe v. Wade and subsequent law to impose medical treatment on pregnant women in utter disregard of their legal rights to informed consent and informed refusal. Pregnant women's rights are ignored while the fetus receives legal representation after the 26-week gestation period. The justification has consistently been that the government's interest in the life of the fetus found in Roe overrides a woman's decision in her own healthcare and medical treatments.
One Mother’s Perspective on Reproductive Rights
Published March 25, 2009 @ 06:00AM PT
What do you think of when you think of reproductive rights? Abortion? The recent octuplet birth? Infertility treatments?
If you believe in abortion, you may believe that any restriction on abortion is illegal (e.g., against the Constitution's guarantee of privacy). If you do not believe in abortion, you may believe that any leniency of such laws are illegal (e.g., against the moral, ethical, and criminal principles of murder). With infertility treatments, the same arguments exist; believing on one side that it falls under your right to privacy, or believing on the other side that it falls under the state's right to protect life. Both sides misstate and misuse Roe v. Wade, but before beginning with the law, let us view one mother's perspective.
First, mothers are mothers because they have children, whether those children are biological or not. Even mothers who adopted their children would be saddened if they discovered that the biological mother had considered abortion. We all are deeply in love with our children and cannot imagine life without them (let alone if someone had purposefully killed them). Mothers who had previous abortions often think about their lost babies and wonder where those babies would be, especially now that they know what the bond of motherhood. Most women connect to her children before giving birth, when their babies are called "fetuses" to the scientific community. Abortion is thus a sensitive and personal topic for mothers. Childless women may not understand why it is difficult for a mother to abort one or two of eight fetuses. However, mothers can uniquely understand Nadya Suleman's decision to keep all her children once she discovered she was carrying eight fetuses. We, however, may not approve of the choices that led to that decision: Ms. Suleman's and the doctors choices to use so many fertilized eggs at one time with the risk that it would be a high multiple pregnancy.
In Roe v. Wade, the Supreme Court found that the government cannot restrict a woman's right to an abortion during the first trimester, but it can regulate it during the second trimester, and can prohibit it during the third trimester. If you disagree with the Supreme Court's finding, you may feel that abortion should be more restricted and you may feel that it should be less restricted. But, in any case, the government is found to have an interest in a woman's body during the third trimester of her pregnancy. Does that mean that the government could force a selective abortion on a woman in her third trimester to reduce the number of fetuses if she is planning a multiple birth? Selective abortion proponents argue that selective abortion is necessary to protect the lives of the remaining fetuses. Does that give a doctor the right to force medical procedures, including major abdominal surgery (a cesarean section) on mothers if the doctor finds that such a procedure will be in the best interest of the fetus? Some states have already started mandatory HIV testing for all pregnant women.
In the past month, President Obama has diplomatically avoided fueling fire in these questions related to reproductive rights. Indeed, President Obama is working on bringing both sides of the abortion issue closer together by solving the problems that leave women "choosing" abortion. These problems include: lack of access to contraception, social stigma, limited resources for pregnant and single mothers, and obstacles in adoption. I applaud him for recognizing and addressing these root problems, but it is insufficient in achieving reproductive justice, particularly outside of the abortion issue, such as regulation in infertility treatments, and court-enforced medical procedures on pregnant women.
A Review of the 2009 Mother-Friendly Forum
Published March 23, 2009 @ 06:00AM PT
On March 5-7, the Coalition for Improving Maternity Services (CIMS) held its annual meeting in San Diego, California. Its long list of presenters, included the following: Henci Goer, the author of The Thinking Woman's Guide to a Better Birth; Maureen Corry, the Executive Director of the Childbirth Connection, and Debra Pascali-Bonaro, the filmmaker for the award-winning Orgasmic Birth.
The entire conference was energizing and illuminating, and I believe that the participants were at least as wonderful to meet, as the speakers were to hear. However, I would like to highlight three plenary session speakers. First, Dr. Michael Lu, UCLA Professor of Obstetrics & Gynecology, spoke about racial and ethical disparities in birth outcomes. Even in a room filled with experts on birth, Dr. Lu broke down stereotypes about causes of premature birth, showing that the major cause in the African-American community is not smoking, education, or nutrition, but stress. Second, Dr. Laurence M. Grummer-Strawn, Chief of the Nutrition Branch at the Center for Disease Control (CDC), shared the results from a first-ever comprehensive, nationwide survey of hospitals and birth centers on breastfeeding trends. Although the facility-level results are not public, Dr. Grummer-Strawn, hopes that the information will help each facility improve its own outcomes. Third, Mayri Sagady Leslie, Georgetown Faculty in its School of Nursing & Health Studies, led an open forum where everyone in the audience had individual remotes to respond to her polling questions. The audience-response system generated significant buzz during and after her session; it both allowed audience members to better understand our colleagues' experiences, and it allowed CIMS to gather important data for future conferences.
Last but not least, I would like to share a small portion of the presentation I gave with two of my colleagues in the Opening Ceremony of the Forum. The absolute best part of the 2009 CIMS Forum was co-presenting my work with The Birth Survey, a national online, ongoing survey of new moms about their specific prenatal providers and birth settings. Since it's recent nationwide launch, The Birth Survey already has 15,000 surveys started by new moms! Although this sample may not be representative of the 4 million births in the United States yet, The Birth Survey expects the number of surveys to increase exponentially once The Birth Survey reaches a tipping point. For now, however, from the moms who have submitted a survey, The Birth Survey was able to share some preliminary results that were not yet public! It received an extraordinarily positive response from CIMS Forum participants, who are anxious to hear more from The Birth Survey at next year's Forum in Austin, Texas. To participate in The Birth Survey or to view the results from the Survey, please visit http://www.thebirthsurvey.com.
This sampling just barely etches the surface of the buzz around reproductive rights in birth. Larger organizations, including the National Partnership for Women and Families (NPWF) and the National Women's Law Center (NWLC), as well as the National Advocates for Pregnant Women (NAPW) have started to expand their work into this area, as reproductive justice advocates become more concerned with the treatment of pregnant, laboring, and breastfeeding mothers.
Moms Changing Society: Breastfeeding in Public & On Facebook
Published February 12, 2009 @ 12:06PM PT
Breastfeeding in public is not illegal in any state. Moreover, there are 40 states, the District of Columbia, and the Virgina Islands which all have laws specifically protecting a woman’s right to breastfeed in any public and private location. Furthermore, there are thousands of benefits of breastfeeding, including reducing risk of cancers, diabetes, and other life-threatening diseases. There are no risks of breastfeeding except in very unusual circumstances (for instance, when the mothers has AIDS). Finally, through laws and education, breastfeeding is no longer shocking to most of society.
In November, actor Brad Pitt took photographs of his current partner Angelina Jolie breastfeeding for the cover of W Magazine. Just today, Time Magazine reported that Salma Hayek nursed a starving baby (not her own) in Western Africa while being filmed by ABC News.
Nonetheless, the social networking site, Facebook, has been intertwined in a controversy that has lasted for over a year by banning photographs of women breastfeeding. On December 27, 2008, there was a “virtual protest” when 11,000 Facebook users changed their profile photograph to a breastfeeding photograph and changed their status updates to “Hey, Facebook, Breastfeeding is Not Obscene.” Simultaneously, one woman led a 3-hour march in front of the Facebook headquarters in California.
Last month, breastfeeding moms had a big triumph when Facebook changed their policy. Facebook’s new official policy is to remove photographs that show “a fully exposed breast,” which it then defines as showing any part of the areola or nipple. The result is that photos where women are wearing nothing but pasties are allowed, but photos where women are breastfeeding and exposing a tiny part of the areola are banned. Thus, while this change is positive (before women, like Karen Speed, had their entire profile removed for photographs that showed no skin), it is insufficient.
A woman’s right to breastfeed in a private place such as a shopping mall is protected in all 50 states. Furthermore, her right to show a picture of her breastfeeding at that same private shopping mall is also protected. In 1980, the United States Supreme Court acknowledged that shopping malls had become equivalent to public squares of years ago.
Today, Facebook and other social websites are fulfilling that same role of shopping malls. While they are privately owned and privately run, they are considered “public squares.” To ban a women’s breastfeeding photographs from being uploaded because they show a tiny bit of her areola or nipple is as outrageous as banning a women from showing the same amount of skin breastfeeding in public.
Above is an example of an image banned by Facebook (banned January 10, 2009). It shows detail from "Virgin and Child Surrounded by Angels" (ca. 1450) by Jean Fouquet. The painting is in a museum in Belgium. Below is a drawing from a Facebook user; it was also banned last month.
The Newest Mommy War: Co-Sleeping & SIDS
Published January 28, 2009 @ 01:28PM PT
When "Mommy Wars" originated, it related to the disputes between work at home mothers and stay at home mothers. Then came the Mommy Wars on breastfeeding, which was just fueled again by The Washington Post on Monday, finding that moms who don't breastfeed are more likely to neglect their children.
One of the main weapons of the "war" is the use of misinformation and misleading statistics. Most women agree that a mom's choice to either work or not work often has more to do with the financial situation of the household (either they can't afford to stay at home, or they can't afford childcare) and less to do with personal choice. Even when it is a personal choice, however, mothers' have earned a right to make that decision to go to work (as men have done for centuries) or stay at home. A young infant (under one year) has some attachment difficulties if they are in daycare for longer than 20 hours per week, but there are many options for that first year, including a nanny, a relative, or the father. Similarly, moms are starting to understand that while breastfeeding is better, some mothers cannot handle the emotional, mental, and physical effort exclusive breastfeeding requires, and are more caring moms because they recognized their limits - a reality that is often misunderstood.
Lately, it looks like a new war is brewing about co-sleeping. Despite the fact that co-sleeping has been successful for centuries throughout Asia, Africa, and South America, as well as many parts of Europe and North America, suddenly moms are being are warned that it is causing infant deaths.
This of course begs the question: are co-sleeping moms (myself included) presenting daily dangers to their infants?
The Washington Post reported in an article titled More Accidental Infant Deaths Blamed on Suffocation in Bed in the first line, "Even while the rate of sudden infant death syndrome (SIDS) in the United States has declined, the rate of infant deaths from accidental suffocation in bed has quadrupled, a new study reports." The author of the study is then quoted: "‘The safest sleep environment for an infant is one that's close to the parent on a separate sleep surface,' said study author Carrie K. Shapiro-Mendoza, an epidemiologist in the division of reproductive health at the U.S. Centers for Disease Control and Prevention. However, on page two of the article, there is more information: "It seems that medical examiners or coroners seem to be moving away from SIDS as a diagnosis and more likely to report suffocation as the cause of death,' said Shapiro-Mendoza."
The article should have been titled Reclassification of SIDS Gives False Alarm on Co-Sleeping. The truth is that worldwide research has shown the safety of co-sleeping, such as significantly reducing the risk of SIDS. Besides the risks by not co-sleeping, co-sleeping has many benefits, such as fulfilling the emotional needs of their babies.
The truth is that mothers are working hard to get past constant misinformation. Even when mothers make decisions to stay-at-home despite their Harvard Law School degrees (a la First Lady/Mom-in-Chief Michelle Obama) or breastfed despite scientific advancements in infant formula, or co-sleep despite these campaigns (paid for and supported by crib manufacturers), let's respect them and end the mommy wars.
Back Alley Births
Published January 14, 2009 @ 05:58PM PT
Research Supports Birth Choices as Insurance and Hospitals Limit Them
Most women's rights advocates know the phrase "back alley abortions."This phrase was popular before the passage of Roe v. Wade, when anti-abortion laws were not effectively reducing the number of abortions. Instead, the restrictions were, in effect, putting women's lives at risk by increasing unsafe abortions in "back alleys" or other unsanitary locations with no assistance from medical professionals.
Today, abortion is legal in every state. But today, a new problem has arisen as now birth is being highly restricted.
Birth advocates are trying to garner media attention regarding the rise of "back alley births." For a long time, insurance companies have deemed pregnancy a "pre-existing condition." For women who switch insurance mid-pregnancy, this switch can leave the pregnant women without the ability to pay for needed medical assistance during her labor. In June 2008, the New York Times reported that insurance companies are refusing to cover women with prior c-sections whether they are pregnant or not, leaving those women uninsured unless they submit to a hysterectomy surgery to remove their uterus. See also the ICAN press release.
Even when pregnant women are able to obtain insurance, the insurance companies may limit the care they receive. For example, Kaiser refuses to compensate home births despite the fact that home births average costs less than $2000 and the typical cost for a cesarean birth (c-section) without complications can range between $14,000 and $25,000 or more! Just last fall, Aetna insurance announced that they also will not cover home births, and in addition, that they will not cover birth center births unless the birth center is attached to a hospital. Recently, Blue Cross Blue Shield made the only birth center in the Northern Virginia area an "out-of-network" provider, which will increase the costs to patients who choose to birth at home. These insurance companies are essentially limiting the women's right to choose to birth at home.
The problem, of course, lies in the fact that many women do not discover the restrictions by their health insurance company until it's too late. But, even for informed pregnant women who use a mother-friendly health insurance company, they may not be able to find a doctor to support them in their birth choices. In 2004, The International Cesarean Awareness Network (ICAN) exposed that over 300 hospitals in the United States completely ban Vaginal Birth After C-section (VBAC) even though VBACs are safer for most women than a repeat c-section. And, the entire state of Oklahoma has basically stopped giving pregnant women the option for a VBAC due to the medical malpractice insurance company , which will not cover doctors who offer VBACs to their patients.
With these multiple, severe restrictions on pregnant patients' established right to informed refusal, there is a clear violation of women's rights that we need to fight. But, in these cases, the injury goes significantly further than just the theoretical right. C-sections, while a life-saving surgery sometimes, are to blame for higher maternal and infant mortality rates, as well as long-term harm, like increased risk of infection and decreased breastfeeding rates besides countless other more minor dangers. Women who do not want to be subject to these restrictions - either because they underwent a painful c-section birth with their first child or were informed before their first birth - are often forced to seek a "back-alley birth." This means that they either have no assistance ("free birth") or they use an unlicensed midwife or a midwife practicing outside the scope of her license. These choices are more dangerous for high-risk women with previous c-sections than attempting a VBAC in a hospital setting. For women who cannot find a provider who supports VBACs, however, this is their only choice.
Just last week, the Wall Street Journal reported that a study in the New England Journal of Medicine shows that one-third of c-sections are done too early, putting the mother and infant at increased risk. With more and more studies showing that hospital interventions are dangerous, while more insurance companies limit coverage of out-of-hospital births, more and more women will be left to do "back-alley births."
Will Stronger Equal Pay Laws Backfire on Moms?
Published January 13, 2009 @ 11:12AM PT
Last month, Jen blogged about pay gap between women and men. She shared the campaign "Out of the Way of Fair Pay" by the Center For American Progress, which argued that there needs to be more laws to protect equal pay for equal work, and blamed the wage gap on discrimination of women by employers. In doing so, this followed the century-old rhetoric from women's rights advocates, starting before the 1960s. Equal pay has become a timely topic again as many political pundits think that it will be the top of President-Elect Barak Obama's agenda when he takes office next week. In fact, during the campaign, CNNMoney.com reported "It's baaaack!!" in reference to the "wage gap" debate.
Obama campaigned as a stout advocate of equal pay for women: He argued that women "women still make only 77 cents for every dollar a man makes." He pointed out that he supported the Fair Pay Restoration Act and promised to "close the wage gap between men and women." He blasted Senator John McCain's infamous remark that women need more "education and training" to close the pay gap.
Mothers in particular are affected by the pay gap. As MomsRising.org states: "Non-mothers earn 10 percent less than their male counterparts; mothers earn 27 percent less; and single mothers earn between 34 percent and 44 percent less." In other words, mothers are affected four times more than non-mothers.
Despite these alarming facts, more equal pay legislation is not the solution for the pay gap. First, there already exist many laws to guarantee equal pay for equal work, including the Equal Pay Act of 1963, Title VII of the Civil Rights Act of 1964, the Age Discrimination in Employment Act of 1967, and Title I of the Americans with Disabilities Act of 1990. Second, the U.S. Department of Labor, and many other economic experts, has already shown that the pay gap is not based on equal work at all, but instead due to so-called "fair" factors.
In fact, the "pay gap" is not a comparison of one woman and one man doing the same job, but just an average of all women and all men who work full-time doing unequal, very different jobs. For instance, in education, men often choose higher-paid majors than women choose. Eighty percent (80%) of engineering majors are men. Men also receive more-marketing training and experience for future promotions, as well. Men then take higher-paid jobs in the private sector where many women choose to become teachers in the public sector. In addition, men are also in the workforce longer and more constantly. Women tend to leave the workforce for a certain number of years to focus on child rearing. Men are also willing to take jobs that require longer-hour days. While many women choose "full-time" jobs that require 30-40 hours per week, men mostly fill the jobs that require 60 hours and more per week. Therefore, the "77 cents on the man's dollar" myth (which is now statistically 79 cents on the dollar) has been debunked. Blogger Glenn Sacks pointed out "When men and women of matched qualifications are working in matched jobs, women earn as much as men do." The Bureau of Labor Statistics (BLS) of the U.S. Department of Labor publishes the statistics on women's earnings every year.
However, that does not mean that the pay gap is not a major problem for mothers' and women's rights. Indeed, the pay gap is even more alarming because it cannot be solved by simple anti-discrimination laws. A truth that may disturb some Obama fans is that Senator McCain's solution, while incomplete, is a better answer. In fact, unnecessary equal pay legislation may just create a bias against hiring women in the first place, or to increased unsuccessful litigation. If the pay gap is not due to discrimination, anti-discrimination laws will not lead to any actual increased pay for women. These unintended consequences have already been seen in the UK and in Germany and were reported by the Washington Post last October.
Instead, there needs to be a new way of solving the pay gap through a combination of the methods below. First, during elementary school, there needs to be more math programs for girls to help them learn and gain interest in the higher-paid science-based vocations as compared to the lower-paid arts-based vocations. Second, at the high school level, women need to receive the salary data for various careers to make informed decisions on their college major or technical training.
Most importantly, there needs to be better protection for all workers so that there is less of a gap between all workers - men or women. By better protection, I mean that there needs to be: 1) higher minimum wages; 2) paid sick leave; and 3) stated maximum hours in a work day for overtime purposes without exceptions. By doing so, we will increase the benefits for the employees with the lowest paying jobs with no benefits - namely, moms - and make the choice to higher men who can work longer hours less seductive for employers since overtime pay will include all workers, including salaried workers.
Finally, although slightly less important, we need more funding for school loans so that women can afford the "education and training" that Senator McCain correctly pointed out that women need, and a universal childcare system. Without subsidized childcare, in the same manner that states subsidize state university systems, women are sometimes forced to leave the workforce to rear children since they cannot afford the childcare.
In other words, lets stop treating the symptoms (wage gap) and start treating the root cause (worse, lower-paid jobs for woman who cannot work as many hours as men or who do not have the training to take higher-paid jobs). This solution does not mean that men and women would have equal pay - and it shouldn't. It just means that the "wage gap" would be due to educated choices that women, or men, may make to take lower paid jobs for the simple reason that those jobs interest them more.
