Motherhood and Mortality

I do respect those individuals who elect (at this time they still can sorta) to become Mothers. Many I think believe or feel that they can be good Mothers, whatever that means. Many Women do not certainly elect Motherhood I hope thinking it will be fine, they will fake it till they make it nonsense. I want to believe that Women are aware you cannot have it all. You cannot. You have to make a huge sacrifice the minute you decide to pursue Motherhood. That means your personal happiness, your own health, your financial security can be at risk and your own Marriage may also collapse with the weight of Parenthood. It is not for the faint of heart.

The United States has an appalling mortality rate regarding lives of both Mothers and Children. This also depends on where you live in the United States, your access to Health Care and Health Insurance. According to the March of Dimes that In the United States, about 6.9 million women have little or no access to maternal health care. And again the most single contributing factor is Race.

The CDC breaks down infant mortality and its causes to Five Factors. The NIH explains it as such here. And the current stats are not good as we enter year three of Covid.

This according to the CDC:

The number of women who died of maternal causes in the United States rose to 1,205 in 2021, according to a report from the National Center for Health Statistics, released Thursday by the US Centers for Disease Control and Prevention. That’s a sharp increase from years earlier: 658 in 2018, 754 in 2019 and 861 in 2020.

That means the US maternal death rate for 2021 – the year for which the most recent data is available – was 32.9 deaths per 100,000 live births, compared with rates of 20.1 in 2019 and 23.8 in 2020.

The new report also notes significant racial disparities in the nation’s maternal death rate. In 2021, the rate for Black women was 69.9 deaths per 100,000 live births, which is 2.6 times the rate for White women, at 26.6 per 100,000.

The number is rising and it is not good, particularly for Women of Color. But it is overall not good for any Woman.

According to the Commonwealth Fund, as well as the World Health Organization, The US has the highest maternal death rate of any developed nation. While maternal death rates have been either stable or rising across the United States, they are declining in most countries.

“A high rate of cesarean sections, inadequate prenatal care, and elevated rates of chronic illnesses like obesity, diabetes, and heart disease may be factors contributing to the high U.S. maternal mortality rate. Many maternal deaths result from missed or delayed opportunities for treatment,” researchers from the Commonwealth Fund wrote in a report last year.

The Covid-19 pandemic also may have exacerbated existing racial disparities in the maternal death rate among Black women compared with White women, said Dr. Chasity Jennings-Nuñez, a California-based site director with Ob Hospitalist Group and chair of the perinatal/gynecology department at Adventist Health-Glendale, who was not involved in the new report.

“In terms of maternal mortality, it continues to highlight those structural and systemic problems that we saw so clearly during the Covid-19 pandemic,” Jennings-Nuñez said.

“So in terms of issues of racial health inequities, of structural racism and bias, of access to health care, all of those factors that we know have played a role in terms of maternal mortality in the past continue to play a role in maternal mortality,” she said. “Until we begin to address those issues, even without a pandemic, we’re going to continue to see numbers go in the wrong direction.”

So the reality is that we have a rising tide no boats just Moby crashing his tail against the water to insure the waves drown us as we thrash along in the water. And here we are about to make it harder for Women to manage their own reproductive choices. Good idea says the White Man in the Judicial Robe.

I have been noting the deterioration of mental health particularly among children as they come of out the Pandemic. This generation born during the time it began in 2020 and those who were still in K-12 schools are the new generation and they are really fucked up. Do I think it matters if schools were open or closed? No it is larger than that. You cannot Teach and cannot learn in a world and an environment that surrounds you which is in chaos. Sorry you cannot put yourself in a bubble or Island to prevent the world that is outside waiting for you to emerge. Going to school everyday I believe did no more or less than those who remained online. You are kidding yourself if you believe otherwise.

I truly believe any Woman who CHOSE to become pregnant during Covid lockdowns was either incredibly selfish, bored or utterly oblivious. Denial perhaps but there is a type of arrogance that ignorance allows those so unaware of what was happening in hospitals and in medicine overall that I have little or no respect of. Your kids like you Lady are fucked up. Again I point to 946 as my Karen in that room. She is batshit crazy and that is contagious.

I reprint this from the New York Times to understand how serious this issue is. I know I am harsh but I have that luxury and I never wanted Children so that has to be taken into account. I knew early on it was not for me. Not one regret there. But I do support Women’s Reproductive Rights and with that the choice to have a child. I support public health care, public education and tax credits for children and families as well as better wages and work environments for those who care for children, but I do not support stupidity. And those are the Women who think that it is not a massive sacrifice for at least two decades worth of life. Get over yourself you are not special. I am talking to you Karen.

Covid Worsened a Health Crisis Among Pregnant Women

In 2021, deaths of pregnant women soared by 40 percent in the United States, according to new government figures. Here’s how one family coped after the virus threatened a pregnant mother.

By Roni Caryn Rabin The New York Times March 16, 2023

KOKOMO, Ind. — Tammy Cunningham doesn’t remember the birth of her son. She was not quite seven months pregnant when she became acutely ill with Covid-19 in May 2021. By the time she was taken by helicopter to an Indianapolis hospital, she was coughing and gasping for breath.

The baby was not due for another 11 weeks, but Ms. Cunningham’s lungs were failing. The medical team, worried that neither she nor the fetus would survive so long as she was pregnant, asked her fiancé to authorize an emergency C-section.

“I asked, ‘Are they both going to make it?’” recalled Matt Cunningham. “And they said they couldn’t answer that.”

New government data suggest that scenes like this played out with shocking frequency in 2021, the second year of the pandemic.

The National Center for Health Statistics reported on Thursday that 1,205 pregnant women died in 2021, representing a 40 percent increase in maternal deaths compared with 2020, when there were 861 deaths, and a 60 percent increase compared with 2019, when there were 754.

The count includes deaths of women who were pregnant or had been pregnant within the last 42 days, from any cause related to or aggravated by the pregnancy. A separate report by the Government Accountability Office has cited Covid as a contributing factor in at least 400 maternal deaths in 2021, accounting for much of the increase.

Even before the pandemic, the United States had the highest maternal mortality rate of any industrialized nation. The coronavirus worsened an already dire situation, pushing the rate to 32.9 per 100,000 births in 2021 from 20.1 per 100,000 live births in 2019.

The racial disparities have been particularly acute. The maternal mortality rate among Black women rose to 69.9 deaths per 100,000 live births in 2021, 2.6 times the rate among white women. From 2020 to 2021, mortality rates doubled among Native American and Alaska Native women who were pregnant or had given birth within the previous year, according to a study published on Thursday in Obstetrics & Gynecology.

The deaths tell only part of the story. For each woman who died of a pregnancy-related complication, there were many others, like Ms. Cunningham, who experienced the kind of severe illness that leads to premature birth and can compromise the long-term health of both mother and child. Lost wages, medical bills and psychological trauma add to the strain.

Pregnancy leaves women uniquely vulnerable to infectious diseases like Covid. The heart, lungs and kidneys are all working harder during pregnancy. The immune system, while not exactly depressed, is retuned to accommodate the fetus.

Abdominal pressure reduces excess lung capacity. Blood clots more easily, a tendency amplified by Covid, raising the risk of dangerous blockages. The infection also appears to damage the placenta, which delivers oxygen and nutrients to the fetus, and may increase the risk of a dangerous complication of pregnancy called pre-eclampsia.

Pregnant women with Covid face a sevenfold risk of dying compared with uninfected pregnant women, according to one large meta-analysis tracking unvaccinated people. The infection also makes it more likely that a woman will give birth prematurely and that the baby will require neonatal intensive care.

Fortunately, the current Omicron variant appears to be less virulent than the Delta variant, which surfaced in the summer of 2021, and more people have acquired immunity to the coronavirus by now. Preliminary figures suggest maternal deaths dropped to roughly prepandemic levels in 2022.

But pregnancy continues to be a factor that makes even young women uniquely vulnerable to severe illness. Ms. Cunningham, now 39, who was slightly overweight when she became pregnant, had just been diagnosed with gestational diabetes when she got sick.

“It’s something I talk to all my patients about,” said Dr. Torri Metz, a maternal fetal medicine specialist at the University of Utah. “If they have some of these underlying medical conditions and they’re pregnant, both of which are high-risk categories, they have to be especially careful about putting themselves at risk of exposure to any kind of respiratory virus, because we know that pregnant people get sicker from those viruses.”

Lagging Vaccination

In the summer of 2021, scientists were somewhat unsure of the safety of mRNA vaccines during pregnancy; pregnant women had been excluded from the clinical trials, as they often are. It was not until August 2021 that the Centers for Disease Control and Prevention came out with unambiguous guidance supporting vaccination for pregnant women.

Most of the pregnant women who died of Covid had not been vaccinated. These days, more than 70 percent of pregnant women have gotten Covid vaccines, but only about 20 percent have received the bivalent boosters.

“We know definitively that vaccination prevents severe disease and hospitalization and prevents poor maternal and infant outcomes,” said Dr. Dana Meaney-Delman, chief of the C.D.C.’s infant outcomes monitoring, research and prevention branch. “We have to keep emphasizing that point.”

Ms. Cunningham’s obstetrician had encouraged her to get the shots, but she vacillated. She was “almost there” when she suddenly started having unusually heavy nosebleeds that produced blood clots “the size of golf balls,” she said.

Ms. Cunningham was also feeling short of breath, but she ascribed that to the advancing pregnancy. (Many Covid symptoms can be missed because they resemble those normally occurring in pregnancy.)

A Covid test came back negative, and Ms. Cunningham was happy to return to her job. She had already lost wages after earlier pandemic furloughs at the auto parts plant where she worked. On May 3, 2021, shortly after clocking in, she turned to a friend at the plant and said, “I can’t breathe.”

By the time she arrived at IU Health Methodist Hospital in Indianapolis, she was in acute respiratory distress. Doctors diagnosed pneumonia and found patchy shadows in her lungs.

Her oxygen levels continued falling even after she was put on undiluted oxygen, and even after the baby was delivered.

“It was clear her lungs were extremely damaged and unable to work on their own,” said Dr. Omar Rahman, a critical care physician who treated Ms. Cunningham. Already on a ventilator, Ms. Cunningham was connected to a specialized heart-lung bypass machine.

Jennifer McGregor, a friend who visited Ms. Cunningham in the hospital, was shocked at how quickly her condition had deteriorated. “I can’t tell you how many bags were hanging there, and how many tubes were going into her body,” she said.

But over the next 10 days, Ms. Cunningham started to recover. Once she was weaned off the heart-lung machine, she discovered she had missed a major life event while under sedation: She had a son.

He was born 29 weeks and two days into the pregnancy, weighing three pounds.

Premature births declined slightly during the first year of the pandemic. But they rose sharply in 2021, the year of the Delta surge, reaching the highest rate since 2007.

Some 10.5 percent of all births were preterm that year, up from 10.1 percent in 2020, and from 10.2 percent in 2019, the year before the pandemic.

Though the Cunninghams’ baby, Calum, never tested positive for Covid, he was hospitalized in the neonatal intensive care unit at Riley Hospital for Children in Indianapolis. He was on a breathing tube, and occasionally stopped breathing for seconds at a time.

Doctors worried that he was not gaining weight quickly enough — “failure to thrive,” they wrote in his chart. They worried about possible vision and hearing loss.

But after 66 days in the NICU, the Cunninghams were able to take Calum home. They learned how to use his feeding tube by practicing on a mannequin, and they prepared for the worst.

“From everything they told us, he was going to have developmental delays and be really behind,” Mr. Cunningham said.

After her discharge from the hospital, Ms. Cunningham was under strict orders to have a caretaker with her at all times and to rest. She didn’t return to work for seven months, after she finally secured her doctors’ approval.

Ms. Cunningham has three teenage daughters, and Mr. Cunningham has another daughter from a previous relationship. Money was tight. Friends dropped off groceries, and the landlord accepted late payments. But the Cunninghams received no government aid: They were even turned down for food stamps.

“We had never asked for assistance in our lives,” Ms. Cunningham said. “We were workers. We used to work seven days a week, eight-hour days, sometimes 12. But when the whole world shut down in 2020, we used up a lot of our savings, and then I got sick. We never got caught up.”

Though she is back to work at the plant, Ms. Cunningham has lingering symptoms, including migraines and short-term memory problems. She forgets doctor’s appointments and what she went to the store for. Recently she left her card in an A.T.M.

Many patients are so traumatized by their stays in intensive care units that they develop so-called post-intensive care syndrome. Ms. Cunningham has flashbacks and nightmares about being back in the hospital.

“I wake up feeling like I’m being smothered at the hospital, or that they’re killing my whole family,” she said. Recently she was diagnosed with post-traumatic stress disorder.

Calum, however, has surprised everyone. Within months of coming home from the hospital, he was reaching developmental milestones on time. He started walking soon after his first birthday, and likes to chime in with “What’s up?” and “Uh-oh!”

He has been back to the hospital for viral infections, but his vocabulary and comprehension are superb, his father said. “If you ask if he wants a bath, he’ll take off all his clothes and meet you at the bath,” he said.

Louann Gross, who owns the day care that Calum attends, said he has a hearty appetite — often asking for “thirds” — and more than keeps up with his peers. She added, “I nicknamed him our ‘Superbaby.’”

Nothing left to see…

So now move along its all over folks. You know the drill, the train wreck happens and we all stop and crane our necks, pivot and watch the disaster unfold. We do our best to act shocked and horrified but it is more about that Instagram moment where you can whip out your phone, document and tell everyone “It could have been me!” Yes that is the battle cry of Americans every time a disaster strikes. We are such a ME culture it should explain the endless divisiveness and rage that permeates society, from mask wearing to Covid vaccine.

Marco Rubio immediately after being vaccinated decided to emulate his cult leader and tweet about Fauci and Covid and of course this being a time when all the world is addicted to social media (getting Opioids in Covid time is challenging) so this is the way to be heard and it beats getting a megaphone and standing in a public park or square. And from this new mode of communication you can reach thousands/millions who will affirm your insanity or dogpile you to later amend, defend, deny or remove said offense. This is social media – lather, rinse, repeat. Every day when I log on I see the trending subjects and wonder why in the fuck do you care about Geraldo Riveria or Hillaire Baldwin? Do you know them? Did they do something to you personally? Are they dead of Covid? When you give someone so much attention it shows you do care. It is why when someone responds to a post on a message board, Facebook, a newspage comment page or other forum with a nasty usually ad hominem attack (it is never about logic, thought or an analytic rational response just knee jerk emotions) it makes them feel better that they “got them.” No, what it does tell me is that you have no life, you play target games online and you then walk away with nothing gained or ventured. Wow just wow. This is cancel culture.

Yesterday I read of a sad young man’s struggle with race in his high school and with issues that were about bullying (which I wrote about) and how that accompanies often racist tropes among them. So over three years he retained a video of a classmate he did not know well, socialize with but she was the archetype/prototype of a popular girl. Blonde, blue eyed and a cheerleader. Then as graduation day came he released this video to damage her reputation, to call out the culture of the school and to quote him: “I’m going to remind myself, you started something,” he said with satisfaction. “You taught someone a lesson.”

Okay lesson learned that you hold onto anger you don’t communicate with the one directly involved that caused the anger, nor even to the person who forwarded a private conversation to you who should also be questioned as to the intent, and wait three years to do harm, to bring attention to what is important but in a manner that is less about the issue itself and more about the person and what they did. Well, we all do stupid shit and we should be able to correct our behavior and apologize. I also wrote about Social Emotional Learning and part of that curriculum is the concept of Restorative Justice. He may of missed that class. As a saying I like to use here – Two Wrongs Don’t Make it Right. There are two people wrong and wronged here. The young lady using the word “Nigger” to address a friend is idiotic but then again have you heard Rap lyrics. The missed messaging the contradiction there is using a slur to embody a culture that white kids emulate. It is up there with the GOP eschewing Covid protocols while actually following them and lining up for vaccines when offered. It sends a note that says, do as I do and say but don’t do as I say and do if you are smart enough to know this is all bullshit. So to young rappers who cavalierly throw about the word, have you read Huckleberry Finn or other works that use that term and what are your thoughts there? Or no you can’t read that book as it uses the word. See the contradiction.

Then we have another musical medium, Country. Again here is where mixed messaging expounds in ways that again left another Musician, a black one no less, a rarity in Country dead. This is the Herman Cain of Donald Trump, damned if I do, damned if I don’t ethos.

This editorial in the Washington Post discusses that conundrum about how the CMA Awards went ahead with the show, with some protocols in place but sent a man to his death. Traveling exposes you to many people in the process. I suspect that again this virus is a 72 hour window one, where you get somewhere wait three days, test, wait the three days for results and go from there. So in other words the actual current standard of a seven day quarantine. There are immediate ones and they are only great if you have a high viral load so this can miss the again, infectious period. We are already off an running with the new strain that is still no measles but is infectious longer clearly. Again, what that means is understanding how this transmits. and so far we are guessing but it seems to be very flu like and just wider in spread. Again if this was airborne like measles and highly contagious like smallpox, we would all be dead.

So Charlie Pride is another casualty of what I call So Nashville. An unprecedented arrogance and idiocy that defies logic. From the suicide bomber to the endless headlines of how much money the city got in PPP funds, will get in the current stimulus, while talking about the price of real estate and sales of land as they rank number one in Covid positive again only proves my point. They have no priorities other than money and the collateral damage in the wake is just another way to make money. Mark my words all those small businesses damaged in the bomb will be out of business, the property sold for millions and some massive condo or hotel up in their place with flashing dollar signs to let people know they are rich, bitch! It’s So Nashville.

And that is where we are with Covid, the real issue is money and the endless shutdowns, curfews and restrictions have further confused and infuriated people to ignore warnings, that with every day do become more dire. The endless contradictory models used by varying medical facilities that have us coming into contact with a death racing comet or well crashing into black hole are also confusing as who the fuck knows science here in America? And this essay in the Washington Post sums it up nicely calling it the Covid Gotcha Game.

This I can’t stress enough which the author states:

There’s hope in the vaccines and in the change of president. But the next administration should refrain from pinning too much hope on us. President-elect Joe Biden has said that the moment he takes office, he will ask people to wear a mask for 100 days. Sure, ask. But also, please, mandate masks in public indoor spaces and enforce that mandate. Close the places where we gather indoors against our (or our families’) better judgment. Compensate the businesses that have to close. Pay workers to stay home if they have covid symptoms. Make testing easy, fast and free. Restrict gatherings and travel and enforce those restrictions.

In other words, make us behave as though we are still in the midst of a massive public health crisis in which thousands of Americans are dying every day.

And leaving it to us to regulate and control ourselves is not working and the idea that you can be the mask police and confront someone over their not wearing one is a bad idea. This is from the Post’s Miss Manners column.

Dear Miss Manners: How can I make people aware of the need for safety precautions? I see people on the street who are not social distancing and not wearing masks. I just want to yell at them that they’re being stupid and endangering themselves and others. But I suppose you would say that’s impolite.

Yes, and it is also counterproductive and, unfortunately, provocative.

You may be sure that there is not a soul left who is unaware of the recommended safety guidelines. Those who disobey the rules have chosen to do so, for whatever reason — they don’t believe the science, they consider it a nuisance, or they are indifferent to endangering others.

Compliance, as with etiquette rules in general, is voluntary. That is why it is the law’s responsibility to protect us from threats to life, limb and property. Attempts by citizens to do so do not end well.

Going around yelling at scofflaws is itself a danger. Those who are challenged like that do not apologize and reform; they fight back. Being challenged arouses defenses, which tend to be highly emotional and have occasionally been lethal.

Even milder approaches, such as offering a stranger a mask, are likely to be rebuffed, and probably not pleasantly.

No one would like to see everyone behaving properly and responsibly more than Miss Manners. You would then find her on her front porch, with a book and a glass of prosecco, satisfied that she had accomplished her life’s work.

But she could not accomplish this by running around scolding strangers. When people come to her, it is because they have behavior problems — their own or, more likely, someone else’s. She endeavors to convince them that considerate behavior is in everyone’s interest; even those who are proudly rude hate being treated rudely. And she helps people refuse to be victimized by others’ rudeness.

But when it comes to physical threats, whether from weapons or disease, she cannot recommend direct confrontation. The practical thing to do is to get out of range.

And this brings me to my last incident of the day that is about the endless need to confront, scold, reprimand or simply demean another you feel is wrong and you need to be right. I have of late experienced and also felt compelled to do so as a matter of respect. I get it, I really do but there comes a time to do the dance, the Walk-Away. Your dignity and self respect matters more.

This is from New York Magazine about a neighborhood Karen. It was perceived as a racial issue but that is again from the narrator whose prism he sees the worlds as a man of color. He did not see that his neighbor who yes was white, but also a woman and lesbian which puts her in the same classification as he, a marginalized minority in America. But in the initial stages of their encounter it is understandable but what happened does not make it right. Even the Bird Watcher in Central Park refused to continue on with the level of persecution faced by the idiot woman, who again should have been mandated to sit with him an do some restorative justice as a way of seeing how her actions can lead to serious reactions and in turn serious problems. Going back to the teenagers who could have had that teachable moment that might have also reverberated through the school and its culture. But alas no that requires work. We don’t like to do work, we can however rubberneck quite well.

The article ended on this note:

“It shouldn’t have started any conversation,” Norrinda replied. The Hayats spent most of the summer hoping the conversation would die out, if she was being honest. In the end, they didn’t write back to the people vowing to curse Schulz on their behalf; they didn’t take that discount at the restaurant. They chose not to cooperate with the prosecutor. “Personally, I think if [Schulz] had been prosecuted and found guilty in any way, even just paid a $500 fine, I think this would have gone away for her a lot faster,” suggested a Montclair resident who had tracked the situation.

“I find it embarrassing, the entire ordeal,” Norrinda emailed me one night. “Didn’t Toni Morrison say, ‘The function, the very serious function of racism is distraction. It keeps you from doing your work. It keeps you explaining, over and over again, your reason for being.’ I should be grading papers right now, but I am writing you.” That was the rub. “What is Susan doing right now? Not this. Not explaining herself six months later. We didn’t press charges because then we become the wrongdoer. We don’t believe in the criminal legal system. We believe in restorative practice. I would be happy if she moved. It would not make me happy if she was in jail.”

Fareed posed a question in one of our talks: “White supremacy that’s alive and well and a part of all of us,” he said, “and the question is, How much of it are we going to reject? And how much are we willing to sacrifice ourselves in order to continue to move forward?” He asked it from an intellectual distance, as if he were delivering closing arguments or posing a question to his class. But at close range, the question simply is, Would my neighbors step up to defend me again? And will they continue to want to have this conversation about race now that the immediate drama is over?

To that I have no answer. If history repeats itself, which for the record it is right now we are now moving into the 70s, the 80s sucked then and now so yeah, back to Disco! That said, we are not resolving anyting but turning up more shit to stir the pot and for many who will elect to continue and do the work, yeah that, work. The heavy lifting we may see an opporturnity to grow. If Christidakis is correct and we are following this pandemic with the Golden Age of the 1920’s then we have a two fold problem but irony it was from that we had a move out of darkness into light when it came to issues around sex, gender and race. We are smarter now and we have more so what do we do with more? Well we could just pivot and walk away or we could stay and clean up the wreck we made. Restorative justice.