Category Archives: Healthcare

How to be supportive of women’s birthing choices

*Note: throughout I got tired of writing ‘women and their partners and families’, so I just wrote ‘women’. But I do believe wholeheartedly that birth decisions affect the whole family, and so should be a somewhat group decision.

Ah, the Mummy wars. Just as we might be close to reaching some kind of rapprochement over one issue (breastfeeding), we really hammer into a new one: birth. For the unenlightened, a war is indeed brewing. On one extreme, you have the group who think that any intervention is ‘birth rape’ (not kidding…). On the other side, perhaps as a backlash, you have the women claiming that allowing any kind of pain in childbirth is anti-feminist, and women who don’t give birth in a hospital are baby killers. It’s just another incarnation of the nipple waving breastfeeding sluts vs. the poisoning lazy formula feeders debate.

It would be nice if we could just ignore this. Let the extremists be extreme, and live in a happy middle road. But the knock on effect is that women are becoming miserable – people feel judged and found wanting, guilty, denied a right, some even feel violated for a medical professional doing their best. While I support attempts to improve medical care, and thus women’s birthing experiences, this does not seem the right way to go about it. I understand that is hard when people think they are fighting risk to babies, or denial of rights to women – both highly passionate issues – but it seems to me that the path we are going down is not working. Families and caregivers need to unite in support of one and another to enable informed choices and happiness with those. That’s not the same as inaction, nor will it lead to stagnation. I believe that within this modus operandi, there is still room for encouraging change and I also believe it is the way to help women and their partners make better choice.

Here is how I try to be supportive of all birthing choices:

(1) Everyone: Be realistic and scientific.

Don’t lie. Home birthers: admit that the risks to mother and child are higher (but very small) and note openly that scientific evidence shows that epidurals at the right time do not increase C-section rates. Hospital birthers: be open: yes, a C-section is more likely, even when other factors are controlled for. Yes, pitocin increases the likelihood one will want an epidural, and not due to this, also increases the likelihood of a C-section. Be honest: you are more in the doctor’s hands, and you may be pressured to make an alternative choice. Home birthers: women in hospital may also not be pressured to make choices against their will and may work with professionals who are incredibly dedicated to following their birth wishes.

I have seen both done. At my Bradley classes (a natural birth class), our instructor was having a home birth. In the discussion about risks and benefits she noted that the risk were higher, but in absolute terms extremely minimal. She told us to go away, read, and make our own decisions. When my OB told me I needed an induction and I was resistant, she honestly talked through the increase in C-section occurrence. She told me to go away, think and read, and make my own decision.

Only by talking through openly and honestly about the facts and figures can women* make informed choices, and research ways to mitigate unwanted outcomes. When my OB was open about the increase in C-section risk with pitocin, I was able to research how to deal with this, and constructed a careful plan which took 2 days to effect, but resulted in a vaginal birth.

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(2) Anti-home birthers: Accept that you cannot save all of the babies, all of the time.

It can be a very emotive subject, and anti-home birthers usually cite the well-documented and reliable statistics of increased mortality with home birth. It is a tiny increase, but the pleading ‘won’t you please think of the children’, often accompanied by a picture of a stillbirth, can be very compelling. But here is the thing: home birth is not the last bastion of child (or maternal) risk. Children are starving to death, being shot to death in war, being shot to death because of lax safety, dying of vaccine preventable diseases, dying of non preventable diseases, dying because the basic standard of medical care is not uniformly distributed across economic strata in the US. That’s not to say that we should be cavalier about infant mortality, but some perspective helps. If you are not pouring equal amount of vocal outrage into all causes of child suffering (especially given how many more children die from these other causes, than from home birth), I would ask you to reconsider your reasons for championing an anti-home stance.

(3) Home birthers: to use your own words: anyone could do it.

If forced to, then I am pretty sure (but have not checked the empirical evidence) that anyone could deal with the pain of childbirth. Some people choose to have an epidural (or other pain relief) and there is nothing ‘weak’ about it. It’s just a choice, like the one to go to Kroger vs. Fiesta (or Tesco vs. Sainsburys for my dear UK readers), and should not have a value judgement attached to it.

(4) Anti-home birthers: We all take risks with our child.

Accept it, we all take unnecessary risks with our child. To anyone taking a ‘holier than thou’ approach to their child rearing I could point out preventable risks you take. Take your child in a car? Increased risk!! Why not stay at home or within walking distance until the child is 16 ?  You might say: that’s not practical, the benefit outweighs the unrealistic cost.

Sure – to *you*. There are people, I am sure, who follow this (small number though they are).  Ultimately: you don’t know the cost to someone of going into hospital. You don’t know their fears and needs, and how strong they are. You cannot judge for someone else whether the costs outweigh the benefits, because you don’t know them.

(4) Home birthers: We all take risks with our child.

You may tout increased bonding for a drug free childbirth, or a cite the evidence that some aspects of pain relief get to the baby and affect their immediate post-birth presentation. But again, you will do something that is sub optimal for your child’s development (although defining that is tricky), sometimes out of ignorance (and so some education is OK), but sometimes because to you and your family judge the benefit to be greater than the cost, as above. And that’s OK.

I could go on, but it has been (for me) a long post. I will always choose a hospital birth. I will always research and learn, but I will always reach an agreement with my trained medical professional. If I can’t do that, I will seek out a medical professional with whom I can, because this provider is obviously not right for me. For my birth, I agreed to an unwanted induction, but I worked out a fairly long and complicated plan for doing everything I could to ensure a vaginal birth. Indeed, this was necessary, if I had not worked with my OB on devising a 2-day induction, I would have been one of the ‘C-sections after a day on pit’ statistics.

That being said, if I had had a C-section, I hope I would have worked with my provider and still have thought it a wonderful experience. Many aspects of my birth sucked (or at least the aftermath), but I am delighted with the whole experience. Shit happens. But I got this thing out of it:

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My plea: chill, relax, channel your energy / outrage somewhere else [send refugees donations, volunteer at your local hospital, whatever], remember that you are not a bat, and don’t know what it is like to be a bat. Gain some perspective: birth is important, but it is just one aspect of a whole lifetime of wonderful experiences.

Peace. Love. Babies.

 

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Really Huffington Post? Really?

C’mon, I love the HuffPo. I like ‘crunchy’ / ‘hippie’ ideas – I even have such leanings myself. I proactively support women’s right to make choices about their healthcare. But can they not collide so horrifically in a piece such as:

http://www.huffingtonpost.com/2014/01/08/photos-home-birth-social-media_n_4549531.html?ncid=edlinkusaolp00000009

I’ll save you clicking the link. Ruth Fowler wanted to instagram every moment of her homebirth. She did – including her decision to have a whisky sour to take the edge off the pain (in her “all natural” [cough – alcohol?] birth]. She shared much of the pain, and the wait, and then boom: a cute little baby on an immaculate, naked mother… a big gap and ‘Oh, I woke up in hospital after a hemorrhage, took lots of fentanyl [a sedative] and ohmygosh my midwife and doula were amazing I couldn’t have done it without them’.

The Huffington Post called it the ‘uncensored… beautiful, messy, reality of homebirth’.

As someone who has been though a severe postpartum hemorrhage, let me disagree. That is bull. What we saw was beautiful, I will agree.

But I saw no mess. You want to know mess? It is when you bleed so much a biohazard bin is full, your blood runs off the bed, off the splash pads, can’t be absorbed and runs all over the floor for your husband to clear up. That is the mess.

This is the aftermath of a (much cleaned up) messy birth

This is the aftermath of a (much cleaned up) messy birth

And the reality? The reality is that in these births, the husband sits by helplessly, holding a newborn he is not sure he wants – if it costs him his wife.

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The reality is that it is not your midwife and doula you should be thanking, but the medical team (for me: 14 specialists and counting) and the nameless blood donors who allowed your child to have 2 parents.

The uncensored? The uncensored is not ‘yay I have a baby… ooooh fun! I am in hospital in soft focus and makeup with a cute baby 2 days later’. The reality is being wheeled to the operating room fighting the versed because you don’t know if you will wake up from it, it is waking up WITHOUT your infant despite wanting him desperately, it is waking up without you infant (fort he first time in 9 months) and being told they are ‘doing their best, but you are not out of the woods’, it is screaming in pain in the night, it is feeling blood transfusion after blood transfusion burn (10 units of such), it not being allowed to alone with your baby. It is gritty, and it is cold, and it is pale with blue lips and sadness.

Carefully place the baby by the mother... look, it is almost as if she got up and picked up the baby herself

Carefully place the baby by the mother… look, it is almost as if she got up and picked up the baby herself

Why do I say this? I do not think hospitals are perfect – I do think that unless you are informed and prepared to discuss and push for your views things may not go your way. I am not against home birth at all. AT ALL. I had a friend who just 5 months after Sam came told me that she was planning a home birth and I was all ‘OK, she knows what happened to me – cool’ and was pleased and supportive. But I am pro informed choices. And pieces like this spread the misinformation that if something goes wrong in childbirth its not that bad. It spreads the idea that hospitals are not necessary in any cases [Thanks to my doula! Thanks to my midwife! Umm… yeah… that’s all I needed].

This “uncensored.. [and]..messy reality” [sic]” gives a completely false account of the reality of when something goes wrong. Not to mention: where is the father in all this??? Where are his emotions? His experience?

Women need to know what happens when birth goes wrong. They need to see the actual messy reality. They need to hear doctors and nurses thanked and know they did something amazing. Then they need to look at the statistics, see how incredibly rare it is, and make their own decision – with their partner (please involve your partner if you have one). And be loved and supported through it. But just as I hate medical professionals who overplay risks and rush to C-sections, so I hate crunchies who downplay what what the reality can be.

Personally, I would much rather read “Wow… it went really badly, here is how awful it is, but I transferred to hospital, survived and so would make the same choice again. See if these are risks you are prepared to face’. Let people make the choice: unnecessary intervention (likely) vs. the real consequences if it goes wrong (unlikely).

Ugh.

Of course, the important thing is how well it all turned out:

Love being a Mum!

Love being a Mum!

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And iiiiiiiitttttt’sssss…..

…. Von Willebrand’s Disease. Type 1.

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Rewind. I was sitting in a hematologist’s office hearing the words ‘You’ve been dicing with death your whole life’. Wait. More information needed. Rewind further.

Birth did not go quite as planned. Actually the birth did – the postpartum period did not. My amazingly skilled OB (we still love Dr. Dryden to pieces, even if she isn’t Dr. Boswell) was torn, she wanted to be believe it was ‘just bad luck’ but could not believe that such extensive loss of blood could not be pathological, so sent me for a battery of tests. ‘On the off chance’. ‘Just In Case’. ‘To tick every box’.  8 vials of blood later (chance of a false positive anyone?) the results were in: they were suggestive of Von Willebrands, a condition where you either don’t produce enough Von Willebrand factor (a factor than carries factor 8, which is necessary for effective clotting) or where you don’t have any (I had some), or where you Von Willebrand’s was there, but it was’t very effective and so can’t recruit platelets into the clotting site.

ICU machines

Dear Tecas Children’s: Thanks for the blood. Love Lekki x

I now know far more about how blood clots than I am comfortable with.

So, off I went to Dr. Kelty Baker, who has an amazing reputation. And indeed – she was wonderful. Smart, funny, fascinated by hematological conditions and motivated to cure me. Unfortunately, her nurse wasn’t. This was the nurse who walked into the exam room where I was waiting, took my blood pressure and shoved a thermometer in my mouth, took reading and walked out, all without a single word. Lovely. Just lovely.

Dr. Baker felt it was Von Willebrand’s and asked if I minded having a genetic test to confirm. Me? A geneticist – mind? I’m positively enthusiastic. So we made a plan – I would have a genetic test done. This had to be done in Wisconsin for some reason (even though Baylor, just across the road, does this test). I would also (because we don’t know the full mutations contributing to Von Willebrand’s) have had some tests done which looked at whether the little Von Willebrand factor that I did have actually worked (the blood tests were borderline). Aaaaand, because of the fact that regardless of the cause, we would have to treat the fact that I did not have enough Von Willebrands, we would do a challenge to see if I responded to a drug (DDAVP) designed to increase Von Willebrand factor. All good. I agreed. She said that these non-genetic tests were only done in a field by a fairy under the full moon & I even agreed to this. OK, they were only done heinously early in Methodist hospital on Tuesdays and Fridays but that is basically the same thing.

Guinea pig at the ready

Guinea pig at the ready

Then we entered the vagaries of the American Healthcare System.

My insurance company said that Wisconsin was ‘out of network’ so I would in essence be responsible for the full cost, minus a teeny-tiny co-pay. Knowing that genetic tests can run into 1000s, I HAD to find out the cost. My insurance company also said that I should find out the name of the tests done at Methodist, to check that they were covered – or again, I’d be liable for the full cost as Methodist is not quite in network but some facilities are. It was complicated, but I called Dr. Baker’s office to get the name of all the tests – genetic and otherwise – to report back to my insurance company. And there I encountered the lovely nurse again. And problems ensued.

The nurse told me that Dr. Baker had ordered the following tests:

Platelet aggregation Panel ($256)

Risocetin co-factor ($184) and

Von Willebrand’s Antigen ($178)

I told the nurse that these were not genetic tests so at least one was missing, and furthermore that I had had already had these tests done for free in-network at Texas Children’s Hospital, so would she explain why they now had to go out-of-network. All she would say is ‘shall I tell Dr. Baker you won’t pay for these tests?’ over and over. Whatever I asked, she came back to that.

Me: ‘Are you sure these are the tests?’ Evil-face: ‘Are you going to pay for these tests?’.

Me: ‘ICould you ask Dr. Baker if I could have the tests done in network?’ Evil-face ‘You have to have these tests where we say. Can I tell Dr. Baker you will pay for these tests or not?’.

Me: ‘There is not a genetic test here – why not?’ Evil-face: ‘Look, are you going to pay for these tests or not?’.

Me: ‘I have test results for these. TWICE! I can read them to you’. Evil-face: ‘You have to have these tests. Can I tell Dr. Baker you will pay for these tests or not?’.

Eventually I had to say ‘well, no, I won’t pay for tests where the cost can’t be justified’ and she hung up and I never heard from the clinic again, until they wrote to my OB and sent me a copy saying that I couldn’t afford medical care and that they would help me when I came to give birth next, if needed.

NOT AWESOME.

So, I transferred care to Dr. Mark Udden. First up: his nurse treated me like a human – you know: told me her name, warned me before jabbing things into my mouth… things of that nature. The junior doctor was nice – he had a daughter born 5 days before Sam and had lived in Lewisham (the site of my London flat). OK, so not medical-care necessities, but a good sign nonetheless.

Dr Udden wears bright bow-ties. Awesome.

Dr Udden wears bright bow-ties. Awesome.

Dr. Udden was the best of all – he was practical and smart. He laid it down: I don’t have enough Von Willebrand factor. Although Type 0 blood naturally has less Von Willebrand factor, he would expect Type 0 to have levels at about 50-60% less than non-Type O, and I was at 32-34%. He suspected that my Von Willebrand’s was working fine, the borderline reduced activity in my tests was just indicative of not having enough. Genetics were fun, he said, but we were still going to have to treat the lack of Von Willebrands so why spend the money? So, I am off for a DDAVP challenge test to see if I respond to DVAPP by making more Von Willebrand’s factor. We assume I will. So from there on, they will check my Von Willebrand levels before giving birth next time, and give me an infusion of the factor while pushing. If I go for minor surgery, I will take DDAVP. If I go into hospital for an emergency: more DDAVP, infusions of the factor if extensive surgery is needed, or I am smashed to bits in a car accident or something.

I objected to all this drug talk. I pointed out that I had got this far and been just fine. Turns out hormonal contraceptive artificially increases Von Willebrand and I have been on those since I was 13 (due to heavy periods – another sign of Von Willebrand) so it had been masking any symptoms. Plus I had avoided any surgery except while pregnant (when I had dental surgery), and pregnancy is a time when you also produce more Von Willebrand, so I made it out without crazy bleeding. Lots of lucky co-incidences have got me thus far in life without incidence. Hence my ‘I am not sure I really need to do anything about this’ was met with ‘You’ve basically been dicing with death your whole life’.

Fair enough.

Unfortunately it is a heritable condition, and so we have to get Sam tested. But, my case is so mild, it is likely I am a heterozygote, meaning that Sam only has a 50% chance of contracting the disorder. And if he is not blood type O, he probably will be OK.

And I have to have my IUD out. The extra bleeding that goes with IUD and non-clotting blood is just a bad combo. It is true that things are pretty bad on that front, like today is Day 6 of my period and I still can’t get through the night without a horror show, but as I am allergic to latex and have a bad reaction to hormones, I was sticking it out. I am a bit stuck about what we will do now. Sam no. 2 anyone? 😉

How this right-wing Christian Tory girl ended up supporting Obama

… Or [alternative title]:

“I am sorry I was an ass-hat for the last 6 months”.

But it takes me a while to get to that part in this post. Patience if you will, please.

So, back in good old Blighty, I was actually noticeably right-wing. I was a Young Conservative. I dated a former Young Conservative. I was devastated when he broke my tax-reducing, spending-cutting heart. I cried when “New Labour” got in. I rejoiced when they were out (although not at the coalition replacement). I… OK, OK, you get the picture. So, it seemed clear to me that when I moved to the US, although I liked Obama as a person, I would support the Tory-party allies: The Republicans.  Right? Right?

No. I don’t so much hate them, as actively fear Romney becoming President. I cry at the thought of it. That’s one helluva turnaround in less than three years. So, I began to ask myself: why? How the heck did this happen? How did it happen living in Alabama (although, living in Alabama was probably causal, but that’s not the point of this post). While vaguely pondering it, I did notice other people making the same switch. Fellow displaced Brits looking confused and perplexed and going “hang on, when did I become a leftie?”. Indeed even the Tory party in the UK is struggling to love the Republicans: Cameron is trying to repair relations with his ‘sister’ party, but keeps making clear statements against Romney-Ryan.

How did this happen? I was genuinely curious. After much thinking and mulling and chatting and yelling and crying, I believe it came down to this: in the UK a lot of the ‘social’ policies are pretty done – yeah we tweak them, yeah there are groups asking for more, yes there is inequality It’s no wonderland). But it not on the same scale as the US. The decision, when voting, comes largely down to economics. Even ‘social’ policies: education, welfare etc are largely discussed in purely economic terms. I tend to be right wing economically (a fiscal conservative?), and so to vote right was an easy decision.

In the US many, many mainstream (by which I mean large) groups are fighting for basic civil rights, which I believe should be extended to them: I am socially liberal. So, with my broad sense economic views not changing, I had to choose: Right vs Left: Economics vs. Society. I chose civil rights. Here is why:

I looked at the economy, and the economic policies offered by the two candidates. I do buy the argument that Obama maybe could have done better economically. I don’t know this, I am sort of 55% on that side, 45% on the side that he couldn’t. I don’t know if Romney would do better, because he won’t lay out a damn plan, nor stick to a stated policy. (I did go and read his 8-page plan on his website. About 3 pages was criticizing Obama, about 3 were saying right wing in general is wonderful. ~2 concerned his actual plan, which was vague and non-specific).

Romney changes all the time, many people say Obama could have done better. So, while I may not be confident handing the economy over to Romney, I am not confident handing it over to Obama either. Kind of a dead heat. My history is to think of more fiscally conservative policies as better in times of strife, so I might actually just tip in favor of the Republican party. But. And it is a big but:

If Obama could have done better (and we don’t know that he could have), I don’t think it is significantly better. That is: the world is in a huge economic recession. The Western world is collapsing under financial distress. I doubt anyone could have done more than Obama, such that enough people’s lives were hugely significantly changed. We don’t know if traditionally left- or right- wing policies really work better. Historians and top economists argue about it. But it does seem pretty clear to me that no one in the current world situation could have made a giant leap of difference to the lives of most every day Americans (sure… ‘tell that to someone unemployed’ you say… but I am talking here on a grand scale). Sadly we do vote for ourselves, and our friends, and our situation and looking around, on an economic level I don’t see anyone changing the lives and happiness of those Americans I see by ‘fixing the economy’ on such a scale that it out-weighs the difference social change could make.

This point was first brought home to me when I was hiking with a girl (let’s call her Hot-Stuff A) living in Colorado. She was given great job offers at my Alabama institution and I said to her “Come on, you have to be tempted to take one up, right?”. She looked at me and said: “I can’t. I simply can’t. I am married to a woman, and she would have no rights. No protection.” I was floored, because I suddenly realized it was true. Hot-Stuff A is indeed married to Hot-Stuff B. If they moved to Alabama, both could legally be fired for being gay. Unlikely, but LIKELY s that Hot-stuff B could be denied healthcare, because Healthcare policies are allowed to only be extended to spouses ‘as recognized by the state of X’. Alabama does not recognize gay marriage. So Hot-Stuff B could, and would, be denied it. Furthermore if either got sick, their life long partner could be denied hospital visitation rights: because they are not recognized as family. Their wills could not be recognized, or legally contested by family, because in the eyes of Alabama these girls are not married, and so not family.

That’s bad. That causes actually misery and pain. Britain may wrangle about whether gay people are ‘married’ or in a ‘civil partnership’ but they do not wrangle over basic civil rights. I was horrified, horrified, that two law-abiding people were prisoners in their own state, because they happen to love someone of the same sex.

It was, really shocking to me. And I think it was the turning point. I opened my eyes to the media portraying real, and horrendous stories of people in these situations and saw the misery it caused.

Then I met a girl, a single-Mom at my new job. She works hard. She is what the rightest-of right would call a maker, not a taker. Her 13 year old girl has a genetic condition. The 13 year old (not that it should matter) is a very smart, very functioning girl – I think I last saw her reading an adult book. A very smart, very functioning, very happy and productive 13 year old, who happens to have expensive physical needs. That’s crummy enough, but the Mum was offered another job, and couldn’t take it, because the insurance offered with the job did not cover pre-existing conditions.

So… she could not advance her career, she could not make more money (be more of a ‘maker’), because she could not guarantee her daughter adequate healthcare (she would earn too much for Medicaid in that State). As if that wasn’t bad enough, the Mum told me that she had sat down and worked out that the daughter would exceed her lifetime maximum by the time she was 17. What is this lifetime maximum of which you speak? I hear you Brits say. Oh… well, that is the maximum U.T.’s health insurance will pay out, over a lifetime, for any one person. I.e. at 17 this girl will have no medical coverage. No guarantee of such. I can’t even imagine what it is like to be facing that, at her mother.

Another case: when signing up for health benefits I met a lady from CA who had moved because her cancer treatment exceeded the cost her insurance company would pay. U.T. did accept pre-existing conditions, so she moved here to get it covered. Let me spell it out: the woman had breast cancer. She was afraid of dying. She had to move across the country, away from her friends and family, support and medical doctors to be able to afford treatment.

I looked around and really saw that some social change could make a whole lot of difference to people’s lives. I may not think ObamaCare is the best solution. But it is, at least, a solution. ‘Repeal and Replace’ with some unclear (and frankly untrustworthy) hazy guidelines is not a solution. ObamaCare will at least improve the lives of these individuals. Immeasurably. More than I think an upswing in the economy – or at least, more than I think an upswing in the economy attributable to just one person / one party – could do.

I don’t have time to write about all the cases I have met / discovered. People unable to get safe abortions (do I ‘agree’ with abortion? No. Would I ever deny anyone their right to follow their own ethical code and chose? No.). Kids committing suicide because many politicians in the US want to send out the message ‘being gay is wrong’ (according to who? YOUR God? That is not MY God? What if I don’t believe in God?). Ryan who signed a bill trying to make IVF and IUDs illegal. Endless examples of people’s lives getting worse that Obama would make better.

And lest you think I support Obama because I am a do-gooder only looking out for others, let me assure you, this is not the case. Because then, then, it got personal.

First I went to get birth control for my impending marriage. My insurance company didn’t cover the IUS / IUD (‘tiz abortion, doncha know. Sigh.). I couldn’t afford it. Instead, I got a prescription for valium and some hormones that sent me insane. I gave up on those (it was either that or give up on my marriage… which nearly happened as I went so loopy) and failed to find an affordable solution. By January I was still saving up for the cost of an IUD. By February I was pregnant. Nuff said.

I moved to Texas in June. 4 months pregnant. Not sure why, but I suffered pre-term labor. Sadly, Texas doesn’t cover individuals healthcare when they first move. I had only a ‘help hotline’ to call. I spent many night in tears, scared I was losing my baby, until my coverage kicked in. It worked out well, but for the first time I was forced to face the consequence of putting healthcare in the hands of money-makers with minimal regulations: the loss of people’s children.

Then I was denied maternity leave. FMLA doesn’t kick in as I have not been at U.T. long enough, and anyway, I am the only earner. I can’t go unpaid for 3 months. Luckily, I have a very flexible job, which I can do from home, and very kind and understanding mentors and bosses. We have figured it out. But there was no guarantee of that. The suggestion of healthcare companies I called trying to find short term insurance coverage for pregnancy (which is, of course, a pre-existing condition)? “Don’t change jobs”. Ah, so stay at a lower status, lower paid job and lose the opportunity to do well (academic jobs are scarce) because I am a woman? I see.

Oh, and I find out that C-sections are considered by some insurance companies to be a pre-existing condition. So, should I have one, I may have to make the decision: change jobs and not have children (because their birth would not be covered, and I am not sure I’ll ever have a spare $30,000 lying around), or stay where I am and have the possibility of more children. So, essentially: my career will be held back, because I am a woman. Because – I don’t see men having to make this choice… I suppose they may have to make it on their wife’s behalf. But, overall, I still see this as a woman’s rights issue.

I also have written about this before. I am sick of being told how to live out my religion. Yes, I am Christian. Yes, in my eyes I am a practicing Christian. But no, in my eyes, this does not mean gay marriage should be illegal (if Christians are harping on about the term ‘marriage’ know it was around before the Bible. So just get another term. Let gay people be married, and straight Christians be ‘Bible-married’ or whatever, just don’t base rights on that). I am used to being in a country where I am able to choose how I live my religion (no, I won’t have an abortion, yes, I will attend a gay friend’s wedding) and not told that my interpretation is wrong. I have never lost so much religious freedom as a Christian as when I came to the US.

So, I guess I looked at the options. And, no, I don’t think Obama is perfect. No, I don’t think he has done the perfect job. Nor necessarily the very best. But he has done something, and he will reach in and improve the lives of many – far more than Romney will. Romney will not make changes that affect so many people’s lives this profoundly – is my belief.

So why do I write all this? Well, thinking it through made me realize two things, that made me happier.

(1) I don’t have to hate all Republican supporters.

This is my “sorry I was an ass-hat for 6 months” moment.

I always realized that there were many Democrats I did not agree with, and did not respect. But, I found it hard to see the flip side with Republican-supporters. That there are some I realy can respect and love. There are still many Republican supporters I do not agree with, and pray hard not to judge (no… I really do). But there are also many who would like to see the problems above ‘fixed’, they just don’t have the ‘at any cost’ stance that I do. Or, they don’t think Obama can fix them. Or they think Romney can. Or they just prioritize differently.

I  fully admit there are many worthy and good causes I just don’t feel passionately enough to be swayed by: saving the environment is one of them. It is not a good thing, but it is true. I try to recycle, I try to minimize waste, I am happy to do my part. But I am not going to seriously put myself out, and  don’t really care about it (sorry 😦 ). It is what it is. People can have different priorities and can be just as compassionate. Who is to say which priorities are ‘right’ or ‘more worthy’. Not me guv’nor.

So, thinking through calmly and logically helped me remove my animosity to some people I dearly love. And I am sorry if I seemed mean or judgmental of you before – truly. That is indeed not how I live out my faith.

(2) It helped me navigate the insane media circus that is the US at election time.

Seriously Brits, think of the mud-slinging we do to our celebs. The US is actually nicer to its celebs than we are, but seems to treat its politicians as we treat Jordan. The US media at election time is an ugly, ugly place. And I used to read all the left media and get so outraged and angry at the right. Furious. Upset to tears. Almost beyond reconciling. The right does it too… and then I would get mad at how misrepresented the left was.

Then, I realised that 1/2 of what the media was up in a furor about, I didn’t care about. Do I care that Tagg Romney said he wanted to punch Obama? No. Looking above, that has nothing to do with why I support Obama.

Do I care that Mitt Romney said the humorous comment that he was brought “binders full of women”? No. He mispoke, but it was a debate and I don’t think the hysterical interpretation was what was in his heart. But I do care that when asked the question of what he would do to help women’s equality, he basically said “I’ll create more jobs in general and women can then have access to them” because that does not even touch on what bothers me so much about women’s rights (or lack of) as laid out above.

So, that is how I became an Obama supporter. But that is also how thinking through why that happened helped me be a little happier.

Oh, and to all those who want to say ‘If America is so tough for you: GO HOME’ I do understand your viewpoint. And I don’t mean to whale on America. There are a lot of great things here, and this country has been good to me. And, much as I appreciate a lot about this country, I would like to go home, very much. Indeed, I got married under the supposition that that would likely happen. But my husband examined it some more, and if I did go, I could have to choose between him and my country, and I couldn’t legally take my child. So, while I may have annoyed you, please have some sympathy too. I am not sure I wouldn’t live my life a little differently if I had known this is how it would end up.

On a more positive note, here is the top Google image for the search ‘cutest kitten ever”:


Image credits

http://egbertowillies.com/2012/10/10/jon-stewart-deconstructs-mitt-romneys-promisesliesjournalists-no-longer-serve-their-purpose-video/

http://www.addictinginfo.org/2012/05/11/stephen-colbert-slams-anti-gay-christians/
http://cutestkittenever.tumblr.com/ <— check this website out.

…Hello third

29 weeks

Nicely zooming into the third trimester. We have insurance, we have an OB, I feel great (although my body is giving up a little) and we have a high risk doc monitoring us (but all seems to be well)… yes, quite a bump ride to get here 🙂

New Obstetrician

Just a small bit of politicizing and I will move on, I promise: Look, I’ll even put a spoiler so you can skip past my bleeding heart liberal views if you like – just scroll right down until you see the ‘end spoiler’.

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Hmmm… well, I finally found a doctor who would give me prenatal care. Due to Texas’ wonderfully sensible state laws… I could not have health insurance sponsored by the state (I am technically a state employee) for 2 months. And due to health insurances reticence to cover any ‘pre-existing conditions’ (which I do understand) I couldn’t get temporary care. Wonderful. To those like the genius Ron Paul (and I use the term ‘genius’ in the same tone as ‘wonderfully sensible’ above) who say:

Know this: your views are as old as you. You do not understand that we now save lives (and a heap load of money) initially through learning to enact preventative care programs, and then latterly through increasing the efficacy of those programs by enacting screening programs. Some would say NIH are investing vast sums of frikkin’ money on developing the best early markers with which to screen for diseases… so we don’t end up in emergency care. But you know – what do public health researchers know?

To Mr. Paul I say: My ‘routine doctor visits’ for the last 3 weeks have come in at over $3,000 (holy smokes). Covering the 6 week gap would obviously have been even more expensive. Do you really think it is reasonable to expect couples to find that money over the course of a whole pregnancy?? And what happens when you expect them to over a short period? No healthcare. Which is what I, a public health researcher, chose. Aye.

So no OB wanted to care for me as I had had a ‘gap in care’ until I stumbled upon the lovely Dr Boswell at Texas Children’s (Women’s Specialists of Houston sub branch). OK, no more politicizing for the whole of this post.

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Gaily I went off to see Dr Boswell, where we discussed (1) my signs of early labour, coupled with (2) my battered cervix (a colposcopy, cone biopsy and laser treatment in the past) which means it could either (a) not open at all, or (b) act like a pressure-triggered trap door at the slightest pressure like… er… a growing baby, tripled with (3) a septum (large piece of fibrous tissue) across my uterus, which means some of uterus is ‘cut off’ leading to more pressure overall as space becomes a premium. All-in-all she felt this combination of things may not be a good thing. So… off I went to Baylor to a high risk OB / GYN.

Woo-hoo extra ultrasound. This is Firework lying at the bottom, face up, flexing his muscles like his douchey Mum used to.

So the high risk OB did a whole anatomy scan, which (shutting my ears to the crusty side of me that wants to listen to voices saying that scans are not a good thing) we thoroughly enjoyed. Firework did not, he kicked and wriggled away, and kept PURPOSELY putting his hand in front of his face so we couldn’t see it. Git.

We did get a picture of the young ‘un though. He obligingly acted like his Ma in her pre-pregnancy days and flexed his muscles for larks (I used to be a body builder). I am suspicious that he was also acting like his Dad and showing off to any passing nurse. Hmmmm. He was also quite big at 3lbs when they would expect 2.5lbs. Good lad.

Anyhoodle. We discovered that FW, like the MMA fighter we would love him to be, had just kicked aside my septum and made himself some nice room. And that I have one hella long cervix (4.8 cm at 29 weeks, when they expect ~3 cm) which should hold him in tightly. Of course, you can’t go to any doctor and actually come out feeling healthy: they did find that I have vast amounts of amniotic fluid. Vast amounts, but not quite vast enough to panic.  Usually they suspect a baby with no stomach, or a genetic abnormality: but much searching found no evidence was found of such.

Personally, I am not worried. Back in my initial scans they said I had a giant uterus. No one was concerned then, and I am not now. I go back in 2 weeks to see if the fluid is increasing, decreasing or staying the same. Alrighty then. They did say that big ol’ amounts of fluid are heavy are so preterm delivery is more likely, but hey – nothing we can do about that now. So basically in the ‘will I give birth too early, or have to have a C-section in the end’ battle it is just a battle between:

Big baby and his excessive fluidy surrounds

vs.

scarred up (movement resistant) big ‘n’ tuff cervix.

I could deliver hella early or basically not at all and need a C-section (which TERRIFIES me). I am removing myself from the whole thing and tired of the medicalization, and – while I LOVE my whole OB practice, especially Dr. Boswell – just letting them poke me and prod me while I mentally skip through fields of daisies and ignore them and see what happens. THEY can fuss and worry, I can deal with the birth as it happens.

How I am feeling

29 weeks, 4 days

Other than that, I am blessed to be feeling super well. My bump has remained pretty small (in the clothes pictures I angle it to look nice and big) which has made it easy for me to sleep and move about and not feel icky and encumbered. I do generally sleep very well (even on my stomach sometimes) and can quite forget I am preggo.

My body is starting to give in though: my feet are swelling like balloons, my hips and legs often hurt if I try and run anywhere (like for an elevator) and I do get pretty tired pretty early (which does allow for DELICIOUS 10 hour sleeps). Also, as Firework and his home are very large (all that water) and I am pretty small still (a situation I like to call ‘bloody ideal and I am glad I worked on my abs for so long’) my insides really are squished. Really squished. But again, as FW seems to be getting all the energy he needs, I am happy my appetite is controlled and I have been able not to gain a whole heap load extra so far.

Weight gain at 29 weeks: 14 lbs. Just back from a road trip though (mmmm… ice cream) so I wouldn’t hold me to that trajectory at the next update 😉

Finally

FW is breech! Which is OK for now, but I am going try spinning babies alongside being better at doing my Bradley exercises – why not?

28 weeks, 3 days looks like:

This when in clothes!