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.’”

White Coats White Care

As we take to the streets or our screens we have to realize that systemic racism and sexism dominates most of the larger institutions established in our country. And none other is as large as the medical industrial complex, and the emphasis on complex has truly come to fruition with the Coronavirus and the exposures with regards to the failings of public health. We have for years found a lack of funding for public enterprises, from housing, to education and lastly to health care has lent itself to major disparities of equity when it comes to the working poor. And no group composes the working poor more than faces of color.

There is some roots in this vested in racsim but it is also with regards to gender and now sexuality identity. The AIDS crisis exposed again how the system failed when it came to helping those who identified as Gay and had contracted that disease. It was labeled the “Gay disease” and much like Covid today, contributed to a genocide of those who were not part of the acceptable mainstream aka White/Male/Christian. Women’s rights so fought for in the 70’s and ultimately leading to the failure of the ERA, also plays a factor as men in leadership roles found that by having women enter the workplace they may have expectations reagarding rights and privileges that were largely the domain of men. We finally saw that come to head with #MeToo and again with Covid the rights of Trans folks shows again another marginalized group shoved aside when it comes to crime, violence, and of course health care.

Below are two articles, one about the failings of the MIC to properly treat, diagnose and care for faces brown and black and that implied if not overt bias dominates the field when it comes to finding medical care. The next is on reproductive rights and how the BLM group do not see this as an issue. Well then remind me why again I am not to support you, a woman, a face of color and with the genitalia we share, with the same reproductive rights issues and needs regardless of the shade of our skin. Of all groups most affected again by denial of access to abortion it has also led to closures of clinics that do more than provide abortion and in turn provide pre and post natal care, two issues of import that again largely affect faces of color. When you take away one right you have a domino affect that leads to a reduction of rights across the spectrum. Again, we have the right to care and because of the complext needs of Trans folks the access to proper medical care is essential. Got tits? Well welcome to breast cancer and the ability to screed for that or any other cancer is again a reproductive sexual right. Safe sex is informed sex and these clinics again provide essential information and education to eliminate the transmission of sexually transmitted diseases and the necessary vaccine to prevent cervical cancer.

So agai you say you don’t have time for this? Okay then don’t ask me for any time to spend on your issue. As clearly you have one where your sexuality is not a part of your identity and your identity is more than skin color.

Racism in care leads to health disparities, doctors and other experts say as they push for change

 

The Washington Post

By Tonya Russell
July 11, 2020 at 10:00 a.m. EDT

The protests over the deaths of black men and women at the hands of police have turned attention to other American institutions, including health care, where some members of the profession are calling for transformation of a system they say results in poorer health for black Americans because of deep-rooted racism.

“Racism is a public health emergency of global concern,” a recent editorial in the Lancet said. “It is the root cause of continued disparities in death and disease between Black and white people in the USA.”

A New England Journal of Medicine editorial puts it this way: “Slavery has produced a legacy of racism, injustice, and brutality that runs from 1619 to the present, and that legacy infects medicine as it does all social institutions.”

The novel coronavirus has provided the most recent reminder of the disparities, with black Americans falling ill and dying from covid-19 at higher rates than whites. Even so, the NEJM editorial noted, “when physicians describing its manifestations have presented images of dermatologic effects, black skin has not been included. The ‘covid toes’ have all been pink and white.”

Black Americans die younger than white Americans and they have higher rates of death from a string of diseases including heart diseases, stroke, cancer, asthma and diabetes.

By one measure, they are worse off than in the time of slavery. The black infant mortality rate (babies who die before their first birthday) is more than two times higher than for whites — 11.4 deaths per 1,000 live births for blacks compared with 4.9 for whites. Historians estimate that in 1850 it was 1.6 times higher for blacks — 340 per 1,000 vs. 217 for whites.

Medical professionals describe the effects of racism across specialties and illnesses. Tina Douroudian, an optometrist in Sterling, Va., has observed differences in the severity of her patients with diabetes, as well as their management plans.

“Black folks have higher rates of diabetes and often worse outcomes. It’s universally understood that nutrition counseling is the key factor for proper control, and this goes beyond telling patients to lose weight and cut carbs,” Douroudian says.

“I ask all of my diabetic patients if they have ever seen a registered dietitian,” she says. “The answer is an overwhelming ‘yes’ from my white patients, and an overwhelming ‘no’ from my black patients. Is there any wonder why they struggle more with their blood sugar, or why some studies cite a fourfold greater risk of visual loss from diabetes complications in black people?”

Douroudian’s patients who have never met with a dietitian in most cases have also never even heard of a dietitian, she says, and she is unsure why they don’t have this information.

Her remedy is teaching her patients how to advocate for themselves:

“I tell my diabetic patients to demand a referral from their [primary care physician] or endocrinologist. If for some reason that doctor declines, I tell them to ask to see where they documented in their medical record that the patient is struggling to control their blood sugar and the doctor is declining to provide the referral. Hint: You’ll get your referral real fast.”

Black women are facing a childbirth mortality crisis. Doulas are trying to help.

Jameta Barlow, a community health psychologist at George Washington University, says that the infant mortality rate is a reflection of how black women and their pain are ignored. Brushing aside pain can mean ignoring important warning signs.

“Centering black women and their full humanity in their medical encounters should be a clinical imperative,” she says. “Instead, their humanity is often erased and replaced with stereotypes and institutionalized practices masked as medical procedure.”

Black women are more than three times as likely as white women to die of childbirth-related causes, according to the Centers for Disease Control and Prevention, (40.8 per 100,000 births vs. 12.7). Experts blame the high rate on untreated chronic conditions and lack of good health care. The CDC says that early and regular prenatal care can help prevent complications and death.

Barlow says that the high mortality rate, and many other poor health outcomes, are a result of a “failure to understand the institutionalization of racism in medicine with respect to how the medical field views patients, their needs, wants and pain thresholds. The foundation of medicine is severely cracked and it will never adequately serve black people, especially black women, until we begin to decolonize approaches and ways of doing medicine.”

Barlow’s research centers on black women’s health, and her own great-grandmother died while giving birth to her grandmother in 1924. “In the past, black women were being blamed for the maternal mortality rate, without considering the impact of living conditions due to poverty and slavery then,” she says. “The same can be said of black women today.”

Natalie DiCenzo, an OB/GYN who is set to begin her practice in New Jersey this fall, says she hopes to find ways to close the infant mortality gap. Awareness of racism is necessary for change, she says.

“I realize that fighting for health equity is often in opposition to what is valued in medicine,” she says. “As a white physician treating black patients within a racist health-care system, where only 5 percent of physicians identify as black, I recognize that I have benefited from white privilege, and I now benefit from the power inherent to the white coat. It is my responsibility to do the continuous work of dismantling both, and to check myself daily.

“That work begins with being an outspoken advocate for black patients and reproductive justice,” she says. “This means listening to black patients and centering their lived experiences — holding my patients’ expertise over their own bodies in equal or higher power to my expertise as a physician — and letting that guide my decisions and actions. This means recognizing and highlighting the strength and resilience of black birthing parents.”

DiCenzo blames the racist history of the United States for the disparities in health care. “I’m not surprised that the states with the strictest abortion laws also have the worst pregnancy-related mortality. For black LGBTQIA+ patients, all of these disparities are amplified by additional discrimination. Black, American Indian and Alaska Native women are at least two to four times more likely to die of pregnancy-related causes than white women, regardless of level of education and income,” she says.

As for covid-19, although black people are dying at a rate of 92.3 per 100,000, patients admitted to the hospital were most likely to be white, and they die at a rate of 45.2 per 100,000.

The CDC says that racial discrimination puts blacks at risk for a number of reasons, including historic practices such as redlining that segregate them in densely populated areas, where they often must travel to get food or visit a doctor.

“For many people in racial and ethnic minority groups, living conditions may contribute to underlying health conditions and make it difficult to follow steps to prevent getting sick with COVID-19 or to seek treatment if they do get sick,” the CDC says.

The CDC is urging health-care providers to follow a standard protocol with all patients, and to “[i]dentify and address implicit bias that could hinder patient-provider interactions and communication.”

In her 16 years in medicine, internist Jen Tang has provided care for mid- to upper-class Princeton residents as well as residents of inner city Trenton, N.J. She has seen privatization of medicine adversely affect people of color who may be insured by government-run programs that medical organizations refuse to accept. Some doctors complain that the fees they are paid are too low.

And that can make referrals to specialists difficult.

“Often my hands are tied,” says Tang, who now works part time at a federally qualified health center in California. “I try to give my patients the same level of care that I gave my patients in Princeton, but a lot of my patients have the free Los Angeles County insurance, so to get your patient to see a specialist is difficult. You have to work harder as a clinician, and it takes extremely long.”

Tang has also encountered what medical experts say is another effect of long-term racism: skepticism about the health-care system.

“Some patients don’t trust doctors because they haven’t had access to quality health care,” she says. “They are also extremely vulnerable.”

American history is rife with examples of how medicine has used people of color badly. In Puerto Rico, women were sterilized in the name of population control. From the 1930s to the 1970s, one-third of Puerto Rican mothers of childbearing age were sterilized.

As a result of the Family Planning Services and Population Research Act of 1970, close to 25 percent of Native American women were also sterilized. California, Virginia and North Carolina performed the most sterilizations.

The Tuskegee experiments from 1932 to 1972, which were government-sanctioned, also ruined the lives of many black families. Men recruited for the syphilis study were not given informed consent, and they were not given adequate treatment, despite the study leading to the discovery that penicillin was effective.

Though modern discrimination isn’t as apparent, it is still insidious, Barlow says, citing myths that lead to inadequate treatment, such as one that black people don’t feel pain.

“We must decolonize science,” Barlow says, by which she means examining practices that developed out of bias but are accepted because they have always been done that way. “For example, race is a social construct and not clinically useful in knowing a patient, understanding a patient’s disease, or creating a treatment plan,” she says, but it still informs patient treatment.

She calls upon fellow researchers to question research, data collection, methodologies and interpretations.

Like Douroudian, she recommends self-advocacy for patients. This can mean asking as many questions as needed to get clarification, and if feasible, getting a second opinion. Bring a friend along to the doctor, and record conversations with your doctor for later reflection.

“I tell every woman this when doctors recommend a drug or procedure that you have reservations about: ‘Is this drug or procedure medically necessary?’ If they answer yes, then have them put it in your medical chart,” Barlow says. “If they say it is not necessary to do that, then be sure to get another doctor’s opinion on the recommendation. Black women have always had to look out for themselves, even in the most vulnerable medical situations such as giving birth.”

Medicine’s relationship with black people has advanced beyond keeping slaves healthy enough to perform their tasks. Barlow says, however, that more work needs to be done to regain trust, and uproot the bias that runs over 400 years deep.

“This medical industrial complex will only improve,” she says, “when it is dismantled and reimagined.”

Can’t Focus on Abortion Access if My People Are Dying’

Some Gen Z and millennial women said they viewed abortion rights as important but less urgent than other social justice causes. Others said racial disparities in reproductive health must be a focus.

Emma Goldman|| The New York Times

Like many young Americans, Brea Baker experienced her first moment of political outrage after the killing of a Black man. She was 18 when Trayvon Martin was shot. When she saw his photo on the news, she thought of her younger brother, and the boundary between her politics and her sense of survival collapsed.

In college she volunteered for the N.A.A.C.P. and as a national organizer for the Women’s March. But when conversations among campus activists turned to abortion access, she didn’t feel the same sense of personal rage.

“A lot of the language I heard was about protecting Roe v. Wade,” Ms. Baker, 26, said. “It felt grounded in the ’70s feminist movement. And it felt like, I can’t focus on abortion access if my people are dying. The narrative around abortion access wasn’t made for people from the hood.”

Ms. Baker has attended protests against police brutality in Atlanta in recent weeks, but the looming Supreme Court decision on reproductive health, June Medical Services v. Russo, felt more distant. As she learned more about the case and other legal threats to abortion access, she wished that advocates would talk about the issue in a way that felt urgent to members of Generation Z and young millennials like her.

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“It’s not that young people don’t care about abortion, it’s that they don’t think it applies to them,” she said. Language about “protecting Roe” feels “antiquated,” she added. “If I’m a high school student who got activated by March for Our Lives, I’m not hip to Supreme Court cases that happened before my time.”

Her question, as she kept her eyes on the court, was: “How can we reframe it so it feels like a young woman’s fight?”

On Monday the Supreme Court ruled on the case, striking down a Louisiana law that required abortion clinics to have admitting privileges at local hospitals, four years after deciding that an effectively identical Texas requirement was unconstitutional because it placed an “undue burden” on safe abortion access. The Guttmacher Institute had estimated that 15 states could potentially put similarly restrictive laws on the books if the Supreme Court upheld the Louisiana law.

The leaders of reproductive rights organizations celebrated their victory with caution. At least 16 cases that would restrict access to legal abortion remain in lower courts, and 25 abortion bans have been enacted in more than a dozen states in the last year.

“The fight is far from over,” said Alexis McGill Johnson, the president of Planned Parenthood. “Our vigilance continues, knowing the makeup of the court as well as the federal judiciary is not in our favor.

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Interviews with more than a dozen young women who have taken to the streets for racial justice in recent weeks, though, reflected some ambivalence about their role in the movement for reproductive rights.

These young women recognized that while some American women can now gain easy access to abortion, millions more cannot; at least five states have only one abortion clinic.

But some, raised in a post-Roe world, do not feel the same urgency toward abortion as they do for other social justice causes; others want to ensure that the fight is broadly defined, with an emphasis on racial disparities in reproductive health.

Members of Gen Z and millennials are more progressive than older generations; they’ve also been politically active, whether organizing a global climate strike or mass marches against gun violence in schools.

While Gen Z women ranked abortion as very important to them in a 2019 survey from Ignite, a nonpartisan group focused on young women’s political education, mass shootings, climate change, education and racial inequality all edged it out. On the right, meanwhile, researchers say that opposition to abortion has become more central to young people’s political beliefs.

Melissa Deckman, a professor of political science at Washington College who studies young women’s political beliefs, said that Gen Z women predominantly believe in reproductive freedom but that some believe it is less pressing because they see it as a “given,” having grown up in a world of legalized abortion.

“Myself and other activists in my community are focused on issues that feel like immediate life or death, like the environment,” said Kaitlin Ahern, 19, who was raised in Scranton, Pa., in a community where air quality was low because of proximity to a landfill. “It’s easier to disassociate from abortion rights.”

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Fatimata Cham, 19, an ambassador for the anti-gun violence advocacy group Youth Over Guns, agreed that the fight for reproductive rights felt less personal. “For many activists, we have a calling, a realm of work we want to pursue because of our own personal experiences,” Ms. Cham said. “Growing up, abortion never came to mind as an issue I needed to work on.”

Some young women said that they considered reproductive rights an important factor in determining how they vote, but they struggled to see how their activism on the issue could have an effect.

When Ms. Baker helped coordinate local walkouts against gun violence, she sensed that young people no longer needed to wait for “permission” to demand change. With abortion advocacy, she said, organizers seem focused on waiting for decisions from the highest courts.

And even as those decisions move through the courts, the possibility of a future without legal abortion can feel implausible. “I know we have a lot to lose, but it’s hard to imagine us going backward,” said Alliyah Logan, 18, a recent high school graduate from the Bronx. “Is it possible to go that far back?”

Then she added: “Of course in this administration, anything is possible.”

For many women in the 1970s and ’80s, fighting for legal abortion was an essential aspect of being a feminist activist. A 1989 march for reproductive rights drew crowds larger than most protests since the Vietnam War, with more than half a million women rallying in Washington, D.C.

Today, young women who define themselves as progressive and politically active do not always consider the issue central to their identities, said Johanna Schoen, a professor of history at Rutgers and the author of “Abortion After Roe.”

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“Women in the ’70s understood very clearly that having control over reproduction is central to women’s ability to determine their own futures, to get the education they want, to have careers,” Dr. Schoen said. “As people got used to having access to abortion — and there’s a false sense that we’ve achieved a measure of equality — that radicalism women had in the early years got lost.”

Some millennial women who can easily and safely get abortions do not connect the experience to their political activism. Cynthia Gutierrez, 30, a community organizer in California, got a medication abortion in 2013. Because she did not struggle with medical access or insurance, the experience did not immediately propel her toward advocacy.

“I had no idea about the political landscape around it,” she said. “I had no idea that other people had challenges with access or finding a clinic or being able to afford an abortion.”

Around that time, Ms. Gutierrez began working at a criminal justice reform organization. “I wasn’t thinking, let me go to the next pro-choice rally,” she said. “The racial justice and criminal justice work I did felt more relevant because I had people in my life who had gone through the prison industrial complex, and I experienced discrimination.”

Other young women said they felt less drawn to reproductive rights messaging that is focused strictly on legal abortion access, and more drawn to messaging about racial and socioeconomic disparities in access to abortion, widely referred to as reproductive justice.

Deja Foxx, 20, a college student from Tucson, Ariz., became involved in reproductive justice advocacy when she confronted former Senator Jeff Flake, Republican of Arizona, at a town hall event over his push to defund Planned Parenthood.

But abortion access is not what initially drew her to the movement. She wanted to fight for coverage of contraceptives, as someone who was then homeless and uninsured, and for comprehensive sex education, since her high school’s curriculum did not mention the word consent.

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“There’s a need to protect the wins of the generation before us,” Ms. Foxx said. But she believes the conversations that engage members of her generation look different. “My story is about birth control access as a young person who didn’t have access to insurance,” she said.

The generational shift is evident at national gatherings for abortion providers. Ms. Schoen has attended the National Abortion Federation’s annual conference each year from 2003 to 2019. In recent years, she said, its attendees have grown more racially diverse and the agenda has shifted, from calls to keep abortion “safe, legal and rare” to an emphasis on racial equity in abortion access.

“The political questions and demands that the younger generation raises are very different,” she said. “There’s more of a focus on health inequalities and lack of access that Black and brown women have to abortion.”

Amid the coronavirus outbreak, even the most fundamental legal access to abortion seemed in question in some states. At least nine states took steps to temporarily ban abortions, deeming them elective or not medically necessary, although all the bans were challenged in court.

Research from the Kaiser Family Foundation found that the pandemic led to various new legal and logistical hurdles. In South Dakota, abortion providers have been unable to travel to their clinics from out of state. In Arkansas, women could receive abortions only with a negative Covid-19 swab within 72 hours of the procedure, and some have struggled to get tested.

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Alliyah Logan, a recent high school graduate, near her home in the Bronx. “I know we have a lot to lose, but it’s hard to imagine us going backward,” she said.Credit…Hiroko Masuike/The New York Times

But in spite of the threats, for some young women the calls to action feel sharpest when they go beyond defending rights they were raised with.

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“Right now, in a lot of social justice movements we’re seeing language about the future,” said Molly Brodsky, 25. “I hear ‘protect Roe v. Wade,’ and it feels like there needs to be another clause about the future we’re going to build. What other changes do we need? We can’t be complacent with past wins.”

Mother’s Day

As we acknowledge or celebrate Mother’s Day we have to remember that not all of us commemorate or even recognize the woman who was our Mother for many they lost her early in life, she chose to give you to another family and offer that celebration to another and those whose mother was not present even when they were in the same room, this day has many meanings.  But perhaps this story illustrates the reality of neglect and abuse by the Medical Industrial Complex who has proven during this pandemic to be ill prepared let alone well equipped to handle the onslaught of patients and the demands upon a system that is about access and availability. And for many they have neither. This is one Mother’s Day story about just that.

New York mother dies after raising alarm on hospital neglect

Amber Rose Isaac died less than four days after tweeting that she should write an exposé on ‘dealing with incompetent doctors’

Alexandra Villarreal in New York
The Guardian
Sat 2 May 2020 12.39 EDT

Amber Rose Isaac tweeted on 17 April about how she would write an exposé on “dealing with incompetent doctors” in the Bronx while pregnant with her first child.

Less than four days later, she was pronounced dead after a caesarean section went wrong. She died alone as New York City battled with coronavirus.

“All of this was 100% preventable. All of it,” said Bruce McIntyre III, Isaac’s partner. “I feel like she would have got more attentive care if she was a white mother, to be completely honest with you.”

In an interview with the Guardian, he described a pregnancy riddled with neglect by rude and unprofessional staff at the Montefiore Medical Center, who he said ignored Isaac – a 26-year-old black, Puerto Rican New Yorker – even as she reached out to them during her final weeks.

“We know she did all that she was supposed to do, right?” said Dr Joia Crear-Perry, founder and president of the National Birth Equity Collaborative. “And she’s not the only one. That’s the story of the black maternal mortality issue across the United States.”

The City, an independent, nonprofit newsroom, first reported Isaac’s death. Spokespeople from Montefiore did not return the Guardian’s request for comment.

In New York City, black women are nearly eight times more likely to die from pregnancy-related causes than white women. Latinas in the metropolis – especially Puerto Ricans – also face higher risks of life-threatening complications during childbirth.

“Unfortunately, what I see when I look at Amber Rose’s case is a beautiful young woman who fell through our big, gaping hole of a healthcare system,” Crear-Perry said.

Maternal care has continually failed all women in recent years, with maternal mortality rates devastatingly high compared to similarly well-off countries. But the crisis has disproportionately burdened black mothers, who are exponentially more likely to die from conditions related to or aggravated by pregnancy than their white and Hispanic counterparts nationwide. And, as Covid-19 overburdens already under-resourced hospitals and complicates how women give birth, experts fear pre-existing problems may get worse.

Isaac died in the same hospital where her mother has worked for 25 years, after switching Montefiore facilities because she felt so mistreated at her original branch, under the care of a doctor she had known since she was a teenager.

“Implicit bias, racism, being very dismissive of people that look like Amber, making assumptions,” said Angela D Aina, interim executive director of the Black Mamas Matter Alliance. “This is the result.”

Isaac developed HELLP syndrome, a pregnancy-related condition that only proves fatal for “a small number of women” – if they go without treatment, according to March of Dimes, a nonprofit focused on mothers and babies.

“It’s definitely not something that people in the United States generally die from,” Crear-Perry said. “If you are a person who has been receiving prenatal care and people are aware that you have something going on, it’s not a surprise, you’re able to manage it with treatment.”

Around 60% of pregnancy-related deaths are preventable, according to the Centers for Disease Control and Prevention.

As early as February, Isaac knew her platelet levels – which help blood clot – had started to drop. But because of the pandemic, her routine doctor’s visits turned into conference calls over Zoom, where she answered a few screening questions and checked her blood pressure.

Isaac got updated bloodwork because she decided she wanted to hire a doula or midwife for an at-home delivery during the pandemic, partially because she felt so neglected by the system, McIntyre said. But she was labeled too high-risk and needed a surgeon after she discovered her platelet counts were still falling.

Isaac tried to raise the alarm and figure out what was happening, but her medical team at first ignored her calls. When she finally had blood work done and was later admitted to the hospital, she entered scared and alone – neither her mother nor McIntyre was initially allowed to join her.

She died on 21 April, after being induced more than a month early, then rushed into an emergency C-section. The surgeon she had been assigned wasn’t present.

Aina said there has been an uptick in C-sections during the pandemic, after years of advocacy campaigns against the invasive surgery’s rising rates.

Now, Isaac’s newborn Elias will live in an apartment that was meticulously planned for him by a mother who will never get to be a part of it.

“It’s very hard being in this home and imagining her here with us,” McIntyre said. “She never got to even meet him. She never got to see him. And she was just so thrilled about having hi

Aging Badly

The cover of the Styles section of The New York Times had an article in print called, Too Old? You Mean Fabulous.  Funny how they re-titled the same article for online called The Glamorous Grandmas of  Instagram.  Really?  If you read the article some of the women identify as a Grandmother but they don’t consider themselves traditionally Grandmotherly, which was the point of the article that I read.  Even the subtitle changed from Women Over 60 with sass and riveting style are Instagram stars.  Funny now it is apparently “subversive” to not ‘traditionally’ age.  And then promptly explains that our image and concept of aging is outdated and is changing as we change and transition into age.

“Age no longer dictates the way we live. Physical capacity, financial circumstances and mind-set arguably have far greater influence.”

A woman in her 50s, then, “might be a grandmother or a new mother,” the study goes on to say. “She might be an entrepreneur, a wild motorcyclist or a multi-marathon runner. Her lifestyle is not governed by her age but by her values and the things she cares about.” Some of these women and their counterparts abroad are still subscribing to the counterculture values and maverick stance they adopted in the 1960s and ’70s.

So why the title change?  Why classify women over 60 as Grandmothers or are choosing to be chic in their senior years, search out and employ methods to belong via social media and in turn are embracing age in ways that are less in the shadows and more in the forefront.

Also overlooked is their social media savvy. Eschewing stereotypes, 73 percent of participants “hate the way their generation is patronized when it comes to technology,” the report says. Six out of 10 say they find tech “fascinating,” according to the report, and many of those may actually be more competent using tech than their younger counterparts.

 Well Boomers are aging and they dying off and now the Millennials are the du jour cohort to embrace as they are the largest sector of population and will be entirely responsible for the economy in the decades to come thanks to declining birth rates.  So to that I say knock yourself up MeMe’s and make sure I get that Social Security check and Medicare I so need and want.  I cannot for the life of me understand why I can get Social Security at 62 but must wait three more years to get the Medicare?  If I am retired and not working I should be covered right?  Wrong and so I will work until I die just in the parameters of SS in order to retain the benefit.  I loathe working full time but I always did so now I have to go to part time and it cannot come soon enough – four years and counting! 

The other day I was at Dilliards talking to the salesperson as I was buying just ordinary underwear, neither granny nor sex kitten just underwear and in the exchange the clerk said:  “I see myself in the future talking to you.”  And I warned her that it is wonderfully freeing to be independent, secure, confident and without obligations, it also costs a great deal in ways that I had not anticipated 30 years ago.   If I had not married well and divorced even moreso I would be a clerk or a Teacher living hand to mouth but I am pretty sure the person I am, loud, abrasively honest and just me.  I may not have been nearly killed by a younger man six years ago, I may have married and still be so, I don’t think I would have ever capitulated on the bearing kids thing but hey you never know.. but no. To this day this is something I am relieved and grateful I did not.  But I wish I was better at intimacy and securing a long term relationship with a man in my peer group.  I told this same young woman that I see the point of men and in turn it is the point you make and in turn the one you want which you will have to sacrifice in order to have one in your life.  Men do not do well with women who have their own mind. 

And the same paper again last week had a massive article on how women give up their professional careers, wages and job growth when they are pregnant regardless of the employer, be it Walmart or Wall Street.  Once a woman chooses to have a baby she is labeled and marginalized by her employer and in turn her work life becomes one direction, down.  Everyone loves a mother, at home, not work.  Another story I heard on BBC this last week was about social personal boundaries regarding work and home life. This story in The Atlantic in 2016 confirms the same.  And regardless of income again women do the most amount of house keeping and child care even when in a two partner relationship. What was more shocking was that the more money the woman earned the more responsibility she takes on in the home as a way of over compensating to maintain order and the relationship. So there you go – be dumber and poorer and keep a good house.  Making America Great Again… via Betty Crocker, Good Housekeeping and Better Home and Gardens.  1950 is back people!

A few months ago I read an article in the same paper about adult orphans and the problems they face (as that would also be me) in living alone, long term planning for care and other social emotional issues faced by those aging and alone.  And that is another issue that I face myself, alone again naturally.   Women are not dynamos or thought of as interesting, chic or fashionable unless they live in New York City.  I live in Nashville and this is where aging is done in a church pew, over a stove making biscuits or egg dishes and in turn wearing utterly unattractive attire regardless of age, however, as this is surreal to see how they seem to think maxi dresses and chunky shoes are the new cover on WWD.  If you think wearing what you like and feel comfortable in includes athlesisure wear which I live in think again.  Not once but twice at Barre3 classes this last week I was “complimented” on my flare yoga pants. The two women said they loved them and wished they would come back in fashion so they can wear them. I said, “I don’t care about what is in or out in regards to exercise, as I approach 60 this is the last place I care about what I look like.  And by the way I bought these online about a month ago at Prana.”  One laughed the other goes I will go there right away.   For fuck’s sake this is a Barre3 class not Project Runway.  It’s like skinny jeans, if you are not skinny don’t wear them.  

I again as I said in the last blog post about Pride and why I chose not to participate was largely due to the lack of courtesy extended to me on the occasions that I went to the local bars of which I am truly a local and was ignored and duly bored.  One does not go to a bar to sit alone and drink and I can do that at home thankyouverymuch.   This community does not want strangers in their midst unless there is a check involved.   Hence the invites to Church, less about salvation but more about restitution.  In the Churches I visited that was clear and I did drop my $5 bucks in the kitty as I would in a Honky Tonk, the singers are always entertaining in that same way a Pastor and Choir are.  The songs and words however are forgotten once you vacate the premise.  The reality is that for this Christian place and the whole bullshit of Nashville nice and Southern Hospitality is just that bullshit.  This idea that a bunch of aging granny’s are hot, fun and chic are just that on paper.  In real life who are their friends, what is their life like and what do they do to feel wanted, important and active other than posting on social media.  Again that is just another way of aging badly. 

Knocked Up, Locked Up

The war on women is moving on up the stream at a rapid clip. The issue of women testing positive for drugs and/or/both alcohol when pregnant is the latest and greatest way to ensure that we are kept home knocked up and locked up behind the stove or behind bars, whichever.

The irony is that while the laws discussed in the below editorial and this article in Rolling Stone about this new war (move on past the rape one as we all need to) discusses how these laws are largely directed to the poor who are also the more highly prescribed people when it comes to opiates during pregnancy. Irony or is that a conflict of interest? So the Doctor gives you Percocet for the pain and in turn you become addicted, test positive and the OB/GYN calls the cops. I see this very Lion King and circle of life.

And add to that the many women are still shackled during labor and in turn during birth. Nothing says this bitch might escape during labor. Further indignities and shame is what our prison system is all about. Well mostly it is about profit the rest is a bonus!

How Not to Protect Pregnant Women

By DEBORAH TUERKHEIMER
APRIL 13, 2015
The New York Times
Opinion

CHICAGO — IN the wake of a savage attack on a pregnant woman and the removal of her fetus, Colorado lawmakers are planning to introduce a bill that would criminalize fetal homicide. If the bill passes, the state would join nearly 40 others that make fetuses a distinct class of victims. (The federal Unborn Victims of Violence Act of 2004 similarly makes it a crime to kill or injure a fetus in certain circumstances.)

This would not be the first time that lawmakers exploited an extraordinary incident of violence against a pregnant woman to promote the rights of fetal victims. In 2009, Indiana, for example, passed a draconian fetal homicide law after a horrific shooting of a bank teller who was pregnant with twins.

This type of legislation, however, is not about protecting the rights and well-being of the pregnant woman. Rather the reverse: The risk is that, without statutory reform, the pregnant woman as a category of victim will remain overlooked, while the fetus gets special protection.

Opposition to the creation of fetal victimhood has focused largely on the threat to abortion rights. This is a legitimate concern, but affording victim status to a fetus has implications beyond the erosion of abortion rights. Legally severing a fetus from the pregnant woman has the effect of pitting her interests against the fetus’s.

Over time, this move has increased the state’s power to interfere in the lives of pregnant women. Hence the experience of Alicia Beltran, who, in Wisconsin in 2013, during the second trimester of her pregnancy, was arrested and forced to enter inpatient drug treatment for a past pill addiction.

Granting personhood to fetuses makes women criminally responsible, not only for the life of the fetus, but also for its well-being. This is a particularly high burden. Pregnancy in our society tends to be idealized and women counted on to provide a perfect uterine environment.

Fetal rights can be employed to justify punishing any deviation from this standard. This is not hypothetical: Pregnant women have already been prosecuted for using drugs, refusing a cesarean section, having sex against a doctor’s recommendation and attempting suicide.

Prosecutors could, in theory, use the notion of “prenatal abuse” to pursue pregnant women who consumed too little folic acid; neglected exercise; gained too much or too little weight; continued on a course of anti-depressants; or had a stressful job. Under the mantle of fetal protection, pregnancy could become subject not only to criminal sanction but to pervasive state regulation.

In reality, those who are targeted by government intervention on behalf of the unborn tend to be the vulnerable and marginalized. In recent decades, hundreds of women, disproportionately low-income and African-American, have been prosecuted or subjected to court orders over behaviors like drug use that are considered a risk to developing fetuses. Often, these women are themselves victims of violence during pregnancy.

Of course, the impulse to punish violence against pregnant women differently is widely shared and understandable. In the case of the Colorado stabbing, the victim, Michelle Wilkins, suffered an injury that was entirely entwined with her pregnancy, an injury not specified in the statutes covering assault and attempted murder that already carry lengthy prison sentences.

Granting fetuses victim status, however, does not address the core harm. When violence is done to a pregnant woman, her reproductive freedom is trampled.

A woman who is assaulted while pregnant reasonably fears the consequences for a pregnancy that she has chosen to carry to term. Abuse during pregnancy can cause miscarriage and stillbirth, as well as maternal substance use, delayed entry into prenatal care and low birth weight. The victim’s interest in her developing fetus is thus violated.

The law should provide a remedy. Reform matters because abuse of pregnant women is so common. The Centers for Disease Control and Prevention estimate that more than 300,000 pregnant women a year are victims of domestic violence. Unlike headline-grabbing cases like the Colorado attack, violence against pregnant women is usually inflicted not by strangers, but by current or former partners.

Yet the criminal law largely fails to account for how the fact of pregnancy defines the harm experienced by these women. Instead, Congress and most states have passed feticide laws. (A few states simply apply tougher penalties for existing offenses if the death or injury of a pregnant victim is involved.)

Only a few jurisdictions criminalize acts that cause a pregnant woman to lose her pregnancy. In 2013, Colorado enacted a crime of “unlawful termination of pregnancy” that expressly recognizes the pregnant woman as the victim of violence. Other states should follow suit and reject the wrongheaded logic of maternal-fetal conflict behind the new Colorado proposal.

That would be a start, but not sufficient. Cases of violence against pregnant women that don’t involve loss of pregnancy still lie largely beyond the reach of the law. A separate crime of assault on a pregnant woman would establish that a woman has a stake in her pregnancy, an interest worth protecting.

Hysteria, The New Disease

Or old one. Everything old is new again.

I read this front page article in the New York Times and my head imploded. I have no children, never had any, never had an abortion. Wow that is was in the day when birth control, insurance and medical care was still affordable. WOW those good old days.

The ever increasing hysteria about preventing women from having an abortion need to read this article. I think that was the passive aggressive purpose of it or the other was to push drugs. Pick one. Apparently being a mother means you will either be mentally ill or a murderer.

I was born in a time when my mother worked and my father worked. You know the mystical legendary two parent family. My Nana lived close and well we also had a Nanny and Cleaner. My family was Middle Class. I had more people in my house than a Department Store. I have no idea why my family was so social and in turn we lived in a neighborhood where I knew my neighbors, went to their houses and visited. Funny I spent most of my childhood years with Adults it explains a lot.

But I had them. Again a ton of them. Old, black, single mothers, gays, religious people (I have a thing for all religion) men, women and some kids. I have never really liked my peers. Again, it explains a lot.

But my mother worked and she was 45 when she had me, a definite unplanned pregnancy. But I am alive. I chose not to have children as her sex education consisted of showing me a Phil Donahue show where a woman gave birth on television. That was enough for me to go “I will not be doing that!” I meant having a baby, the sex part came way later as well when I was in College old enough to go to a Doctor with my future sexual partner and force him to listen to the whole birth control speech. Yes I did that. He was a hell of a dude. I will always have some love for him.

So I cannot clearly comment on the entire I want to kill my baby shit that is mentioned in this article. I have had friends who have discussed their roller coaster emotions about birth and all that comes from that time in life. But when you read this you think “wow how did this species survive until the advent of big pharma?”

The studies are of course vague on whom they studied, where and the time frame it occurred. I would love to know the education, income, family and health history and where were these studies held. Only one woman provided a family history and of course it was laden with drama and mental health issues.

This article explains why now I am seeing this rotation of advertising for ‘bi polar depression’ as apparently post partum causes that along with many many other mental disorders. Wow and all treatable thanks to Partumless, the new drug from XYZ company that takes the baby blues out of mom and onto the walls.

We have a serious problem in well getting proper mental health diagnosis let alone treatment. These bullshit MSW, Master of Social Work and Ph.D’s in Psychology that have copies of the bullshit D.S.M on the shelf which is what they use to diagnose and then ladle out the spiel that is utterly useless and unhelpful at best, destructive at worst, until finally the patient gets a Doctor to write a scrip and in turn the patient suddenly feels better over time. And time and drugs allow all wounds to heal. But often the help you actually need versus the help you get are not equitable and appropriate. I am not sure trading frustration and fear for addiction and negative labels is all that helpful. As they used to threaten us in school, “do you want that on your permanent record?”

How about in home care and child minding. Opportunity for mother and baby to disconnect and in turn someone to take on the family responsibilities and allow a break? Wow there is something that might actually be cheaper and better in the long run then drugs. And proper counseling and therapy so women who have had serious mental health “breaks” to find the resources they need to ensure that unwanted pregnancies and in turn post natal issues are addressed for the long term versus the short term.

To diagnose and in turn label a pregnant woman or post partum woman, “mentally ill” what does that mean for the woman, the child and her family in the long run? We already have Tennessee taking children away from mothers who test positive for opioid. Funny that is a major ingredient in many anti anxiety/depression drugs that are prescribed. And what is interesting is that in another ‘study’ they found that most women prescribed said drugs were often low income and more often Medicaid patients. Better stoned that well demanding.

Not to say that it is not serious but once again I wonder the point of this article and in turn what is its intent?

Thinking of Ways to Harm Her’
New Findings on Timing and Range of Maternal Mental Illness
By PAM BELLUCK
JUNE 15, 2014

When her second son was born, six weeks premature, Emily Guillermo recalled thinking, “You’re not supposed to be mine. You were not supposed to be made.”

Postpartum depression isn’t always postpartum. It isn’t even always depression. A fast-growing body of research is changing the very definition of maternal mental illness, showing that it is more common and varied than previously thought.

Scientists say new findings contradict the longstanding view that symptoms begin only within a few weeks after childbirth. In fact, depression often begins during pregnancy, researchers say, and can develop any time in the first year after a baby is born.

Recent studies also show that the range of disorders women face is wider than previously thought. In the year after giving birth, studies suggest, at least one in eight and as many as one in five women develop symptoms of depression, anxiety, bipolar disorder, obsessive-compulsive disorder or a combination. In addition, predicting who might develop these illnesses is difficult, scientists say. While studies are revealing clues as to who is most vulnerable, there are often cases that appear to come out of nowhere.

As public awareness has grown, often spiking after a mother kills herself or her baby, a dozen states, including Illinois, New Jersey, Texas and Virginia, have passed laws encouraging screening, education and treatment, and New York and others are considering action. The federal Affordable Care Act contains provisions to increase research, diagnosis and care for maternal mental illness.

Sometimes cases are mild, resolving themselves without treatment. But a large analysis of 30 studies estimated that about a fifth of women had an episode of depression in the year after giving birth, about half of them with serious symptoms.

Jeanne Marie Johnson, 35, of Portland, Ore., had a happy pregnancy, but she began having visions right after her daughter, Pearl, was born. She said in an interview that she imagined suffocating her while breast-feeding, throwing her in front of a bus, or “slamming her against a wall.”

She said she was horrified at the idea of hurting her baby, and did not carry out the acts she envisioned. Yet while overlooking a shopping mall skating rink, “I pictured myself leaning over the bridge and letting her fall and bust like a watermelon,” she said. “I was actively thinking of ways to harm her.”

Most women experiencing such “intrusive thoughts,” as experts call them, never hurt their children. Some take extreme measures to protect their babies. One woman “scooched downstairs on her butt for months because she’d imagined throwing her baby downstairs,” said Wendy N. Davis, the executive director of Postpartum Support International.

But studies indicate that maternal stress may undermine women’s ability to bond with or care for their children, and that children’s emotional and cognitive health may suffer as a result.

A complex interplay of genes, stress and hormones causes maternal mental illness, scientists say. “Hormones go up more than a hundredfold,” said Dr. Margaret Spinelli, the director of the Women’s Program in Columbia University’s psychiatry department. After birth, hormones plummet, a roller coaster that can “disrupt brain chemistry,” she said.
Continue reading the main story Some women are genetically predisposed to react intensely to hormone changes. And some are more sensitive to stresses like difficulties with family, finances, childbirth or parenting.

Maternal mental illness is not new. It was recognized as early as the fifth century B.C., when Hippocrates proposed that fluid from the uterus could flow to the head after childbirth and cause delirium. In the Middle Ages, mothers with such symptoms were viewed as witches or victims of witchcraft. In the 1920s, one Freudian-inspired theory attributed these mood disorders to frigidity, suppressed homosexuality or incestuous urges.

Scientific understanding has come a long way and continues to evolve. The Diagnostic and Statistical Manual of Mental Disorders, the established reference for psychiatric illnesses, first described these symptoms in 1994 as “major depressive disorder” beginning within four weeks of childbirth. The latest manual, published last year, said symptoms often include “severe anxiety and even panic attacks,” and estimated that half of what is considered major postpartum depression actually begins during pregnancy.

Depression in pregnancy can be missed because symptoms like trouble sleeping and moodiness also occur in pregnant women who are not depressed. And doctors have historically been taught in medical school that “women don’t get depressed during pregnancy because they are happy,” said Dr. Katherine L. Wisner, a professor of psychiatry and obstetrics at Northwestern University.

Bethany Winters who had a history of depression, experienced postpartum depression after the birth of her first son. An accident during her pregnancy with her second son triggered the return of her depression.

“I had a friend who said to me after the birth of my first son, ‘Aren’t you just in your own little bubble of happiness?’ and I so clearly remember thinking, ‘No, I’m in hell.’ I’ve never felt so alone in my entire life.” Kelly Barrows has a history of depression. She lost her appetite immediately after her daughter’s birth and a couple of months later began feeling numb and listless.

“I feel like it makes me an inferior mother, and it alienates me from my husband. I feel like it implies I don’t like or love my baby. I don’t feel like I can talk about it with anyone in my life because they don’t know how to help, and I don’t know how they can help, either.” Dayna M. Kurtz experienced postpartum depression immediately after the birth of her son. The experience compelled her to start a new career as a postpartum specialist.
“There are not ample forums that offer a place for candid, nonjudgmental discussion. Regardless of an actual ‘diagnosis,’ the transition to early mothering is one that impacts every woman, in every facet of her life. There needs to be greater access to support on both a micro and macro level.” Peggy O’Neil Nosti experienced extreme anxiety when her third child was 4 months old.

“You know that feeling you have right before you have to slam on the brakes to avoid an accident? I felt like that all day and night. I couldn’t sleep and burned through whatever calories I consumed. It was miserable.” Libby Bruce periodically struggled with anxiety since adolescence. She experienced more anxiety immediately after her daughter was born, and depression took hold four months later.

“The first symptoms were intrusive thoughts — sudden, disturbing visions of my daughter’s little head busting open, or of her falling on a kitchen knife, or worst of all, me hurting her. Slowly, other symptoms began to come up: horrible anxiety about SIDS [Sudden Infant Death Syndrome], deep lows, suicidal thoughts, panic attacks.” Cheney Luttich had postpartum depression that began three months after the birth of her second child.

“The first year of [my child’s] life was very hard for me. I wanted to hurt my baby. I wanted to kill myself to escape my pain. I didn’t feel like myself. I was scared of what I would do because I didn’t recognize myself.” Christine Lee has a history of depression, but felt unprepared to manage postpartum depression.

“When I pushed her into the world and they handed her to me, she felt like someone else’s child. I waited for the gush of joy, and I felt blank.” Catherine Harwell at first was asked by health professionals only if she wanted to hurt herself or her child. She did not feel a pull to do either, yet she knew something was not right. She was diagnosed with postpartum depression six months after giving birth.

“I was almost terrified to be around my baby and felt no connection with her. I did not want to leave my bed, and I felt like I was babysitting a stranger’s child when left alone with my baby.” In a 2013 study, the largest screening of women for postpartum depression to date, Dr. Wisner and colleagues found that 14 percent of 10,000 women had depression four to six weeks after birth, but that for a third of them it actually started during pregnancy.
Other research indicated that symptoms could emerge any time in the first year.

Another 2013 study assessed 461 women at two weeks and six months postpartum, and it found each time that 11 percent had obsessive-compulsive symptoms, about four times the rate for the general population of women. But it was “not the same 11 percent,” said an author, Dr. Dana Gossett, the chief of gynecology and obstetrics at Northwestern. “Half got better by six months and another half developed O.C.D.”

Research also shows that women can have several psychiatric disorders at once. In Dr. Wisner’s study, two-thirds of the women with depression also exhibited anxiety; nearly a quarter had bipolar disorder.

Tina Duepner, 34, of DeSoto, Mo., had symptoms ranging from racing thoughts to suicidal feelings. She said she heard God’s voice from a television, and other voices warning that her son, Landon, would be stolen from her.
She said stress in her life included a previous miscarriage, premature labor requiring bed rest, and a cesarean section.

Ms. Duepner said she was treated successfully, although she required three short psychiatric hospitalizations. She wanted more children, but said doctors advised against it so she had her tubes tied.

Previous depression puts women at greatest risk of maternal mental illness. Having immediate relatives with bipolar disorder also increases vulnerability. Ms. Duepner did not have prior depression. But her mother, Marie Carr, has bipolar disorder, and both maternal grandparents had psychiatric illnesses, Ms. Carr said.

Financial strain, isolation, breast-feeding difficulties or unplanned pregnancy can also increase risk.

Aleisa Schat after both of her sons were born, she experienced extreme dips in mood while breastfeeding.
“I wondered why something as human and elemental as feeding my baby would cause such emotional distress. I thought I was losing my mind. I started dreading feedings, and I had to brace myself for each let down, steering my thoughts from anything specific, anything oriented toward the future.” Natalie Vigil when seven months pregnant, felt an emotional detachment from the child she was carrying. This continued after the birth.

“I did not have a maternal connection with her. It felt as though I gave birth to somebody else’s child. It greatly affected our mother-daughter bonding. It was heartbreaking and scary. ” Sarah Kramer experienced postpartum depression that slowly built up after the birth of her first son.

“I felt like I was moving through the world under a heavy blanket. I didn’t realize I was depressed. I thought it was the lack of sleep.” Kate Palmer experienced postpartum depression that began two weeks after the birth of her son.

“I had three miscarriages, and after four I.V.F. cycles, we were finally pregnant, and I was able to carry a baby to term. It was a stressful and difficult pregnancy, and after my son was born healthy via C-section at 37.3 weeks, the last thing I expected was to experience postpartum depression. ” Kristi Clark after she gave birth, immediately began experiencing severe postpartum anxiety and depression. She has a history of generalized anxiety, which caused depression.

“Although I considered myself educated on PPD [postpartum depression], and knew I was at risk because of previous depressive episodes when I was younger, I really had no idea that severe anxiety was also a possibility. Or obsessive thoughts. Or thoughts of suicide.” K. Miller experienced postpartum depression after terminating a much wanted pregnancy because of a chromosomal abnormality.

“Learning that PPD [postpartum depression] can affect people who have suffered pregnancy loss has been important for my healing. It takes away some of the stigma and invisibility.” Amy Horowitz experienced postpartum depression after the birth of her first child.

“What a cosmic joke, after all the struggle to have a baby. Once I had him, I thought it was a terrible mistake. I wanted to put the baby up for adoption, or get divorced and let my husband raise him. It was just the darkest, most confusing time. ” “It felt very natural to become a mother to him,” she said.

Then, despite using contraception, she conceived again. Overwhelmed, she said that she and her husband agreed to abort but reconsidered after learning she was 20 weeks pregnant. She said she descended into depression during pregnancy, feeling “like my body had been invaded.”

When Benjamin was born, six weeks premature, Ms. Guillermo recalled thinking, “You’re not supposed to be mine. You were not supposed to be made.”

She had loved breast-feeding Christopher, but pumped milk for Benjamin. “I could not stand to have him at my chest,” she said. “I was like a robot. I changed him, I fed him, I burped him. Because I never held him, he started to get a flat head.”

She fantasized about abandoning Benjamin at a fire department, or faking an accident. She imagined driving at high speed into a wall, sparing Christopher’s life by intentionally wrecking the side of the car where Benjamin was strapped into a car seat.

Postpartum disorders can involve more intense visions than mental illnesses unrelated to childbirth, said Dr. Wisner.
Terrified she might hurt Benjamin, Ms. Guillermo said she thought about finding a family to adopt him. One night, “I just blurted out, ‘I don’t love Benjamin.’ ” She said her husband, stunned, assured her they would get her help, and said, “Until then, I will love him enough for both of us.”

Her first medication failed. Once, she forcibly shut Benjamin’s jaw when feeding him. During several baths, “I held the water over his face until he started to flail, he could not breathe,” she said. “I was hearing a voice saying, ‘Do it and he will stop crying. He’s not going to wake Christopher from his nap.’ ”

Something would make her stop and put him in his crib. But for a few seconds, she could not remember “if I had killed him, or if he had drowned, or what I had done,” she said. Benjamin became frightened. “When I’d walk into his room, he’d burst into tears.”

Suicidal, she tried to jump from a car as her husband drove, their sons in back, but she said he stopped her, telling her: “You will love Benjamin. We just need to get you on the right medication.”

The third drug combination she tried worked when Benjamin was 9 months old. She started feeling love toward him, and with Postpartum Support International’s help, worked to improve their relationship.

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She said his development had regressed. Instead of distinct cries for hunger or sleepiness, he reverted to “one hysterical cry because he had grown accustomed to me taking my time to meet his needs.”

Benjamin is now 21 months old, and his development is back on track. “He still has a long way to go with me,” she said. “I’m his mother now, and he knows that, and I think Benny loves me now too.”

As more states pass laws relating to postpartum depression, the hope is to catch problems early. Symptoms are frequently treatable, though finding effective medication or therapy can take time.

Only New Jersey requires screening under a 2006 law championed by Mary Jo Codey, then the state’s first lady, who had had postpartum depression. That mandate has drawn mixed reviews. A study in New Jersey of poor women on Medicaid found that required screening has not resulted in more women being treated. Katy Kozhimannil, a University of Minnesota public health professor and an author of the study, said the law educated pediatricians and obstetricians, but did not compensate them for screening.

There are also not enough treatment options, Dr. Kozhimannil said. “If a woman comes with a baby, and it’s a place treating people with substance abuse or severe mental illness, she may be uncomfortable.”
In New York, State Senator Liz Krueger has introduced a bill to encourage screening and treatment, a proposal that will most likely pass and be approved by Gov. Andrew M. Cuomo, who vetoed a 2013 bill on technical grounds but encouraged the revised legislation.

Jeanne Marie Johnson, in Oregon, may have benefited from state laws encouraging awareness of postpartum mental illness. At her daughter, Pearl’s, two-week pediatric checkup, Ms. Johnson received a questionnaire. Her answers raised red flags and were forwarded to her midwife and a social worker. Ms. Johnson also called a number for a hotline the hospital gave her after a panic attack.

She saw a social worker, but resisted taking medication for months. Afraid to be alone with Pearl, she would insist her mother come over when her husband was out. “I called the doctor hotline constantly,” with nonexistent concerns, “because if I was talking on the phone I wouldn’t do anything harmful.”

She said she felt suicidal and escaped emotionally by drinking wine or gin while taking bubble baths.
Finally, after a nerve-racking emotional explosion, she agreed to take medication. That, combined with a support group and Pearl’s lessening colic, helped.

Until Pearl was 4 months old, “I did love her but I didn’t like her,” Ms. Johnson confessed.

Now, her relationship with 2-year-old Pearl is loving and untroubled, said Ms. Johnson, who sees a therapist, partly to grapple with three recent miscarriages, but no longer takes medication.

“I don’t know if I’ll need it if I have a baby again,” she said. “There are still times at the end of the day where I don’t have energy left. But even at really big stressful times, I haven’t felt panicky feelings or intrusive thoughts. It’s just a whole world of difference.”