The A-Word

Recently, I spoke at Perinatal: A Symposium on Birth Practices and Reproductive Rights at George Mason University. The task for the featured roundtable panelists was to determine legal and political strategies to advance reproductive rights in childbirth. My contribution included noting that childbirth rights advocates need to involve our work into the more mainstream causes of human rights and reproductive rights.

The audience, fellow childbirth advocates, ignored my comments on abortion. Apparently, the “a-word” is not acceptance language among childbirth reformers. I discussed the abortion debate from a mother’s perspective in a prior post, and understand that women who devote their lives to improving birth outcomes and lowering infant mortality rates are invested in the life of the fetus. However, my comments never took a side on the abortion debate. I merely observed an unfortunate consequence on childbirth rights from this debate.

I observed that one unexpected effect of the abortion debate was to give more importance to the choices and beliefs of third parties regarding the medical care of pregnant and laboring women than to the choices of the women themselves. Doctors and hospitals have relied upon Roe v. Wade and subsequent law to impose medical treatment on pregnant women in utter disregard of their legal rights to informed consent and informed refusal. Pregnant women’s rights are ignored while the fetus receives legal representation after the 26-week gestation period. The justification has consistently been that the government’s interest in the life of the fetus found in Roe overrides a woman’s decision in her own healthcare and medical treatments.

A 2003 University of Chicago study of the directors of 42 U.S. maternal-fetal medicine programs around the country found: 1) 14% reported that their hospital used court orders to compel unwilling women to have operating room (c-section) deliveries; and 2) 21% considered coerced c-sections ‘ethically justified’ to spare a fetus possible harm – even over the woman's physical resistance!

One example of forcing medical treatment against a woman’s will is court-ordered c-sections. To impose medical treatment on a pregnant woman is unethical as it does not necessarily even save the fetus and often endangers the mother.

In Pemberton v. Tallahassee Memorial Regional Medical Center, a woman named Laura Pemberton took her forced c-section case to court. The U.S. District Court found that “the state’s interest outweighed the mother’s interest” under Roe, because she was in her third trimester. Her labor was progressing well and the baby was not in distress, but the court found that her decision to give birth naturally was less important than the medical professionals’ opinions that there was up to a 5% risk in natural birth. (Note that there was also a measurable risk in surgical birth, but presumably, it was somewhat less. According to Childbirth Connection, the additional risk of a vaginal birth after c-section (VBAC) is only 0.14% in comparison to a repeat c-section.) After the forced c-section, the plaintiff went on to give birth naturally to three additional children, which demonstrates that the forced c-section was unlikely to have been medically necessary.

It is detrimental for childbirth advocates to continue to censor themselves from even mentioning the a-word, let alone any overlap between these two major reproductive rights issues. Women must combine forces to discourage these infringements on our reproductive rights by maturely finding common ground on the abortion debate. Otherwise, our own divisiveness on abortion restrictions will only favor third parties who use these controversial restrictions to further encroach on women’s reproductive rights. Just as the vast majority of society believes in exceptions to abortion restrictions for the health and life of the mother, let us educate society about the need for ensuring that these restrictions do not infringe on a pregnant woman’s right to make her own medical decisions during labor.

As a young birth advocate, I am truly standing on the shoulders of the leaders of this movement, as it only seriously began in the generation before me. Lamaze, one of the first philosophies of natural childbirth, was invented in France in 1951, and childbirth education courses were made widely available in the 1970s. Thus, the men and women who revolutionized childbirth are the same men and women who are guiding it today. I am filled with admiration and gratitude to these reformers, who often put in time and energy to mentor the next generation. They are ground-breaking leaders in a unique combination that few other fields encounter today. Therefore, the younger generation of this movement holds them in higher esteem than otherwise. Young childbirth advocates feel pressure to respect the established preference to separate from other reproductive rights proponents, especially abortion activists.

However, I also detect that the climate is changing within this movement as it reaches a tipping point. Childbirth rights groups are gaining momentum and mainstream acceptance; we are an “emerging market” in the fields of law and policy, especially in health reform, reproductive justice, and human rights. Today’s young birth activists will have the opportunity to have a larger-scale impact on birth reform as political leaders become more receptive to these ideas.

Childbirth issues are receiving increased media attention. On October 15th, CNN ran a story about Joy Szabo whose local hospital refuses to grant her wish to have another VBAC. This refusal goes against medical evidence, because Ms. Szabo has had a previous VBAC. Medical wisdom teaches us that another c-section after a VBAC is actually more dangerous for mother and baby than a repeat VBAC. In a prior post on this issue, I noted that the International Cesarean Awareness Network (ICAN) found that many hospitals were banning VBACs. Since that post, ICAN has done an additional survey and found the bans to be much more prevalent; 1434 hospitals out of the 3000 hospitals surveyed either have explicit or de facto VBAC bans.

Today’s young leaders are also more comfortable discussing abortion laws and how they are affecting childbirth rights, and acknowledging that abortion restrictions are being misused to disrespect pregnant and laboring women’s decisions on childbirth. While a diplomatic approach to the abortion debate will be helpful to making our cause a bipartisan issue, a self-imposed segregation from even tangential issues will prevent it from reaching its potential significance to women and reproductive justice. The current strategy, in other words, will eventually be ineffective in ensuring that childbirth rights are respected and valued, because there will always be the a-word loop-hole for opponents to capitalize upon. When we start to find common ground with fellow reproductive rights advocates, we will be as widespread and well-known as every other major women’s rights cause, including breast cancer, workplace discrimination, and yes, the a-word.

After all, it is not a bad word; the term is abortion.

One Mother’s Perspective on Reproductive Rights

The blog entry reposted below was first published here on Change.org.


What do you think of when you think of reproductive rights? Abortion? The recent octuplet birth? Infertility treatments?

If you believe in abortion, you may believe that any restriction on abortion is illegal (e.g., against the Constitution's guarantee of privacy). If you do not believe in abortion, you may believe that any leniency of such laws are illegal (e.g., against the moral, ethical, and criminal principles of murder). With infertility treatments, the same arguments exist; believing on one side that it falls under your right to privacy, or believing on the other side that it falls under the state's right to protect life. Both sides misstate and misuse Roe v. Wade, but before beginning with the law, let us view one mother's perspective.

Mothers are mothers because they have children, whether those children are biological or not. Even mothers who adopted their children would be saddened if they discovered that the biological mother had considered abortion. We all are deeply in love with our children and cannot imagine life without them (let alone if someone had purposefully killed them). Mothers who had previous abortions often think about their lost babies and wonder where those babies would be, especially now that they know what the bond of motherhood. Most women connect to her children before giving birth, when their babies are called "fetuses" to the scientific community. Abortion is thus a sensitive and personal topic for mothers. Childless women may not understand why it is difficult for a mother to abort one or two of eight fetuses. However, mothers can uniquely understand Nadya Suleman's decision to keep all her children once she discovered she was carrying eight fetuses. We, however, may not approve of the choices that led to that decision: Ms. Suleman's and the doctors choices to use so many fertilized eggs at one time with the risk that it would be a high multiple pregnancy.

In Roe v. Wade, the Supreme Court found that the government cannot restrict a woman's right to an abortion during the first trimester, but it can regulate it during the second trimester, and can prohibit it during the third trimester. If you disagree with the Supreme Court's finding, you may feel that abortion should be more restricted and you may feel that it should be less restricted. But, in any case, the government is found to have an interest in a woman's body during the third trimester of her pregnancy. Does that mean that the government could force a selective abortion on a woman in her third trimester to reduce the number of fetuses if she is planning a multiple birth? Selective abortion proponents argue that selective abortion is necessary to protect the lives of the remaining fetuses. Does that give a doctor the right to force medical procedures, including major abdominal surgery (a cesarean section) on mothers if the doctor finds that such a procedure will be in the best interest of the fetus? Some states have already started mandatory HIV testing for all pregnant women.

In the past month, President Obama has diplomatically avoided fueling fire in these questions related to reproductive rights. Indeed, President Obama is working on bringing both sides of the abortion issue closer together by solving the problems that leave women "choosing" abortion. These problems include: lack of access to contraception, social stigma, limited resources for pregnant and single mothers, and obstacles in adoption. I applaud him for recognizing and addressing these root problems, but it is insufficient in achieving reproductive justice, particularly outside of the abortion issue, such as regulation in infertility treatments, and court-enforced medical procedures on pregnant women.

A Review of the 2009 Mother-Friendly Forum

The blog entry reposted below was first published here on Change.org.

On March 5-7, the Coalition for Improving Maternity Services (CIMS) held its annual meeting in San Diego, California. Its long list of presenters, included the following: Henci Goer, the author of The Thinking Woman's Guide to a Better Birth; Maureen Corry, the Executive Director of the Childbirth Connection, and Debra Pascali-Bonaro, the filmmaker for the award-winning Orgasmic Birth.

The entire conference was energizing and illuminating, and I believe that the participants were at least as wonderful to meet, as the speakers were to hear. However, I would like to highlight three plenary session speakers. First, Dr. Michael Lu, UCLA Professor of Obstetrics & Gynecology, spoke about racial and ethical disparities in birth outcomes. Even in a room filled with experts on birth, Dr. Lu broke down stereotypes about causes of premature birth, showing that the major cause in the African-American community is not smoking, education, or nutrition, but stress. Second, Dr. Laurence M. Grummer-Strawn, Chief of the Nutrition Branch at the Center for Disease Control (CDC), shared the results from a first-ever comprehensive, nationwide survey of hospitals and birth centers on breastfeeding trends. Although the facility-level results are not public, Dr. Grummer-Strawn, hopes that the information will help each facility improve its own outcomes. Third, Mayri Sagady Leslie, Georgetown Faculty in its School of Nursing & Health Studies, led an open forum where everyone in the audience had individual remotes to respond to her polling questions. The audience-response system generated significant buzz during and after her session; it both allowed audience members to better understand our colleagues' experiences, and it allowed CIMS to gather important data for future conferences.

Last but not least, I would like to share a small portion of the presentation I gave with two of my colleagues in the Opening Ceremony of the Forum. The absolute best part of the 2009 CIMS Forum was co-presenting my work with The Birth Survey, a national online, ongoing survey of new moms about their specific prenatal providers and birth settings. Since it's recent nationwide launch, The Birth Survey already has 15,000 surveys started by new moms! Although this sample may not be representative of the 4 million births in the United States yet, The Birth Survey expects the number of surveys to increase exponentially once The Birth Survey reaches a tipping point. For now, however, from the moms who have submitted a survey, The Birth Survey was able to share some preliminary results that were not yet public! It received an extraordinarily positive response from CIMS Forum participants, who are anxious to hear more from The Birth Survey at next year's Forum in Austin, Texas. To participate in The Birth Survey or to view the results from the Survey, please visit http://www.thebirthsurvey.com/.

This sampling just barely etches the surface of the buzz around reproductive rights in birth. Larger organizations, including the National Partnership for Women and Families (NPWF) and the National Women's Law Center (NWLC), as well as the National Advocates for Pregnant Women (NAPW) have started to expand their work into this area, as reproductive justice advocates become more concerned with the treatment of pregnant, laboring, and breastfeeding mothers.

Moms Changing Society: Breastfeeding in Public & On Facebook

The blog entry reposted below was first published here on Change.org.

Breastfeeding in public is not illegal in any state. Moreover, there are 40 states, the District of Columbia, and the Virgina Islands which all have laws specifically protecting a woman’s right to breastfeed in any public and private location. Furthermore, there are thousands of benefits of breastfeeding, including reducing risk of cancers, diabetes, and other life-threatening diseases. There are no risks of breastfeeding except in very unusual circumstances (for instance, when the mothers has AIDS). Finally, through laws and education, breastfeeding is no longer shocking to most of society.

In November, actor Brad Pitt took photographs of his current partner Angelina Jolie breastfeeding for the cover of W Magazine. Just today, Time Magazine reported that Salma Hayek nursed a starving baby (not her own) in Western Africa while being filmed by ABC News.

Nonetheless, the social networking site, Facebook, has been intertwined in a controversy that has lasted for over a year by banning photographs of women breastfeeding. On December 27, 2008, there was a “virtual protest” when 11,000 Facebook users changed their profile photograph to a breastfeeding photograph and changed their status updates to “Hey, Facebook, Breastfeeding is Not Obscene.” Simultaneously, one woman led a 3-hour march in front of the Facebook headquarters in California.

Last month, breastfeeding moms had a big triumph when Facebook changed their policy. Facebook’s new official policy is to remove photographs that show “a fully exposed breast,” which it then defines as showing any part of the areola or nipple. The result is that photos where women are wearing nothing but pasties are allowed, but photos where women are breastfeeding and exposing a tiny part of the areola are banned. Thus, while this change is positive (before women, like Karen Speed, had their entire profile removed for photographs that showed no skin), it is insufficient.

A woman’s right to breastfeed in a private place such as a shopping mall is protected in all 50 states. Furthermore, her right to show a picture of her breastfeeding at that same private shopping mall is also protected. In 1980, the United States Supreme Court acknowledged that shopping malls had become equivalent to public squares of years ago.

Today, Facebook and other social websites are fulfilling that same role of shopping malls. While they are privately owned and privately run, they are considered “public squares.” To ban a women’s breastfeeding photographs from being uploaded because they show a tiny bit of her areola or nipple is as outrageous as banning a women from showing the same amount of skin breastfeeding in public.

Above is an example of an image banned by Facebook (banned January 10, 2009). It shows detail from "Virgin and Child Surrounded by Angels" (ca. 1450) by Jean Fouquet. The painting is in a museum in Belgium. Below is a drawing from a Facebook user; it was also banned last month.

The Newest Mommy War: Co-Sleeping & SIDS

The blog entry reposted below was first published here on Change.org.

When "Mommy Wars" originated, it related to the disputes between work at home mothers and stay at home mothers. Then came the Mommy Wars on breastfeeding, which was just fueled again by The Washington Post on Monday, finding that moms who don't breastfeed are more likely to neglect their children.

One of the main weapons of the "war" is the use of misinformation and misleading statistics. Most women agree that a mom's choice to either work or not work often has more to do with the financial situation of the household (either they can't afford to stay at home, or they can't afford childcare) and less to do with personal choice. Even when it is a personal choice, however, mothers' have earned a right to make that decision to go to work (as men have done for centuries) or stay at home. A young infant (under one year) has some attachment difficulties if they are in daycare for longer than 20 hours per week, but there are many options for that first year, including a nanny, a relative, or the father. Similarly, moms are starting to understand that while breastfeeding is better, some mothers cannot handle the emotional, mental, and physical effort exclusive breastfeeding requires, and are more caring moms because they recognized their limits - a reality that is often misunderstood.

Lately, it looks like a new war is brewing about co-sleeping. Despite the fact that co-sleeping has been successful for centuries throughout Asia, Africa, and South America, as well as many parts of Europe and North America, suddenly moms are being are warned that it is causing infant deaths.

This of course begs the question: are co-sleeping moms (myself included) presenting daily dangers to their infants?

The Washington Post reported in an article titled More Accidental Infant Deaths Blamed on Suffocation in Bed in the first line, "Even while the rate of sudden infant death syndrome (SIDS) in the United States has declined, the rate of infant deaths from accidental suffocation in bed has quadrupled, a new study reports." The author of the study is then quoted: "‘The safest sleep environment for an infant is one that's close to the parent on a separate sleep surface,' said study author Carrie K. Shapiro-Mendoza, an epidemiologist in the division of reproductive health at the U.S. Centers for Disease Control and Prevention. However, on page two of the article, there is more information: "It seems that medical examiners or coroners seem to be moving away from SIDS as a diagnosis and more likely to report suffocation as the cause of death,' said Shapiro-Mendoza."

The article should have been titled Reclassification of SIDS Gives False Alarm on Co-Sleeping. The truth is that worldwide research has shown the safety of co-sleeping, such as significantly reducing the risk of SIDS. Besides the risks by not co-sleeping, co-sleeping has many benefits, such as fulfilling the emotional needs of their babies.

The truth is that mothers are working hard to get past constant misinformation. Even when mothers make decisions to stay-at-home despite their Harvard Law School degrees (a la First Lady/Mom-in-Chief Michelle Obama) or breastfed despite scientific advancements in infant formula, or co-sleep despite these campaigns (paid for and supported by crib manufacturers), let's respect them and end the mommy wars.

Back Alley Births

The blog entry reposted below was first published here on Change.org.

Research Supports Birth Choices as Insurance and Hospitals Limit Them

Most women's rights advocates know the phrase "back alley abortions."This phrase was popular before the passage of Roe v. Wade, when anti-abortion laws were not effectively reducing the number of abortions. Instead, the restrictions were, in effect, putting women's lives at risk by increasing unsafe abortions in "back alleys" or other unsanitary locations with no assistance from medical professionals.

Today, abortion is legal in every state. But today, a new problem has arisen as now birth is being highly restricted.

Birth advocates are trying to garner media attention regarding the rise of "back alley births." For a long time, insurance companies have deemed pregnancy a "pre-existing condition." For women who switch insurance mid-pregnancy, this switch can leave the pregnant women without the ability to pay for needed medical assistance during her labor. In June 2008, the New York Times reported that insurance companies are refusing to cover women with prior c-sections whether they are pregnant or not, leaving those women uninsured unless they submit to a hysterectomy surgery to remove their uterus. See also the ICAN press release.

Even when pregnant women are able to obtain insurance, the insurance companies may limit the care they receive. For example, Kaiser refuses to compensate home births despite the fact that home births average costs less than $2000 and the typical cost for a cesarean birth (c-section) without complications can range between $14,000 and $25,000 or more! Just last fall, Aetna insurance announced that they also will not cover home births, and in addition, that they will not cover birth center births unless the birth center is attached to a hospital. Recently, Blue Cross Blue Shield made the only birth center in the Northern Virginia area an "out-of-network" provider, which will increase the costs to patients who choose to birth at home. These insurance companies are essentially limiting the women's right to choose to birth at home.

The problem, of course, lies in the fact that many women do not discover the restrictions by their health insurance company until it's too late. But, even for informed pregnant women who use a mother-friendly health insurance company, they may not be able to find a doctor to support them in their birth choices. In 2004, The International Cesarean Awareness Network (ICAN) exposed that over 300 hospitals in the United States completely ban Vaginal Birth After C-section (VBAC) even though VBACs are safer for most women than a repeat c-section. And, the entire state of Oklahoma has basically stopped giving pregnant women the option for a VBAC due to the medical malpractice insurance company , which will not cover doctors who offer VBACs to their patients.

With these multiple, severe restrictions on pregnant patients' established right to informed refusal, there is a clear violation of women's rights that we need to fight. But, in these cases, the injury goes significantly further than just the theoretical right. C-sections, while a life-saving surgery sometimes, are to blame for higher maternal and infant mortality rates, as well as long-term harm, like increased risk of infection and decreased breastfeeding rates besides countless other more minor dangers. Women who do not want to be subject to these restrictions - either because they underwent a painful c-section birth with their first child or were informed before their first birth - are often forced to seek a "back-alley birth." This means that they either have no assistance ("free birth") or they use an unlicensed midwife or a midwife practicing outside the scope of her license. These choices are more dangerous for high-risk women with previous c-sections than attempting a VBAC in a hospital setting. For women who cannot find a provider who supports VBACs, however, this is their only choice.

Just last week, the Wall Street Journal reported that a study in the New England Journal of Medicine shows that one-third of c-sections are done too early, putting the mother and infant at increased risk. With more and more studies showing that hospital interventions are dangerous, while more insurance companies limit coverage of out-of-hospital births, more and more women will be left to do "back-alley births."

Will Stronger Equal Pay Laws Backfire on Moms?

The blog entry reposted below was first published here on Change.org.

Last month, Jen blogged about pay gap between women and men. She shared the campaign "Out of the Way of Fair Pay" by the Center For American Progress, which argued that there needs to be more laws to protect equal pay for equal work, and blamed the wage gap on discrimination of women by employers. In doing so, this followed the century-old rhetoric from women's rights advocates, starting before the 1960s. Equal pay has become a timely topic again as many political pundits think that it will be the top of President-Elect Barak Obama's agenda when he takes office next week. In fact, during the campaign, CNNMoney.com reported "It's baaaack!!" in reference to the "wage gap" debate.

Obama campaigned as a stout advocate of equal pay for women: He argued that women "women still make only 77 cents for every dollar a man makes." He pointed out that he supported the Fair Pay Restoration Act and promised to "close the wage gap between men and women." He blasted Senator John McCain's infamous remark that women need more "education and training" to close the pay gap.

Mothers in particular are affected by the pay gap. As MomsRising.org states: "Non-mothers earn 10 percent less than their male counterparts; mothers earn 27 percent less; and single mothers earn between 34 percent and 44 percent less." In other words, mothers are affected four times more than non-mothers.

Despite these alarming facts, more equal pay legislation is not the solution for the pay gap. First, there already exist many laws to guarantee equal pay for equal work, including the Equal Pay Act of 1963, Title VII of the Civil Rights Act of 1964, the Age Discrimination in Employment Act of 1967, and Title I of the Americans with Disabilities Act of 1990. Second, the U.S. Department of Labor, and many other economic experts, has already shown that the pay gap is not based on equal work at all, but instead due to so-called "fair" factors.

In fact, the "pay gap" is not a comparison of one woman and one man doing the same job, but just an average of all women and all men who work full-time doing unequal, very different jobs. For instance, in education, men often choose higher-paid majors than women choose. Eighty percent (80%) of engineering majors are men. Men also receive more-marketing training and experience for future promotions, as well. Men then take higher-paid jobs in the private sector where many women choose to become teachers in the public sector. In addition, men are also in the workforce longer and more constantly. Women tend to leave the workforce for a certain number of years to focus on child rearing. Men are also willing to take jobs that require longer-hour days. While many women choose "full-time" jobs that require 30-40 hours per week, men mostly fill the jobs that require 60 hours and more per week. Therefore, the "77 cents on the man's dollar" myth (which is now statistically 79 cents on the dollar) has been debunked. Blogger Glenn Sacks pointed out "When men and women of matched qualifications are working in matched jobs, women earn as much as men do." The Bureau of Labor Statistics (BLS) of the U.S. Department of Labor publishes the statistics on women's earnings every year.

However, that does not mean that the pay gap is not a major problem for mothers' and women's rights. Indeed, the pay gap is even more alarming because it cannot be solved by simple anti-discrimination laws. A truth that may disturb some Obama fans is that Senator McCain's solution, while incomplete, is a better answer. In fact, unnecessary equal pay legislation may just create a bias against hiring women in the first place, or to increased unsuccessful litigation. If the pay gap is not due to discrimination, anti-discrimination laws will not lead to any actual increased pay for women. These unintended consequences have already been seen in the UK and in Germany and were reported by the Washington Post last October.

Instead, there needs to be a new way of solving the pay gap through a combination of the methods below. First, during elementary school, there needs to be more math programs for girls to help them learn and gain interest in the higher-paid science-based vocations as compared to the lower-paid arts-based vocations. Second, at the high school level, women need to receive the salary data for various careers to make informed decisions on their college major or technical training.

Most importantly, there needs to be better protection for all workers so that there is less of a gap between all workers - men or women. By better protection, I mean that there needs to be: 1) higher minimum wages; 2) paid sick leave; and 3) stated maximum hours in a work day for overtime purposes without exceptions. By doing so, we will increase the benefits for the employees with the lowest paying jobs with no benefits - namely, moms - and make the choice to higher men who can work longer hours less seductive for employers since overtime pay will include all workers, including salaried workers.

Finally, although slightly less important, we need more funding for school loans so that women can afford the "education and training" that Senator McCain correctly pointed out that women need, and a universal childcare system. Without subsidized childcare, in the same manner that states subsidize state university systems, women are sometimes forced to leave the workforce to rear children since they cannot afford the childcare.

In other words, lets stop treating the symptoms (wage gap) and start treating the root cause (worse, lower-paid jobs for woman who cannot work as many hours as men or who do not have the training to take higher-paid jobs). This solution does not mean that men and women would have equal pay - and it shouldn't. It just means that the "wage gap" would be due to educated choices that women, or men, may make to take lower paid jobs for the simple reason that those jobs interest them more.

Changes in FMLA Limit Maternity Leave Options

The blog entry reposted below was first published here on Change.org.

Major changes to the Family Medical Leave Act of 1993 (FMLA) will take effect on January 16, 2009. The U.S. Department of Labor published amended FMLA regulations for the first-time in the Act's 15-year history in changes released in the Federal Register on November 17, 2008. The FMLA effects mothers particularly as it covers leave for the birth or adoption of a child, as well as leave to cover a sick child.

Although the enactment of the FMLA was an important success for moms' rights advocates, the law has always been arguably limited. For instance, the FMLA does not cover moms who work for a company with less than 50 employees, or moms who have been working with the employer for less than one year. Therefore, if a woman discovers she is pregnant soon after she changes jobs (when she would already be one-month pregnant), the new employer is not required to provide maternity leave under the FMLA. This case holds true even if the woman would have been covered by FMLA under her former job and did not know about the pregnancy at the time of starting her new job. New mothers with new jobs have no job protection since there are no exceptions for women who did not know they were pregnant or would become pregnant during the 3-month crack in the FMLA.

Furthermore, the leave granted by the FMLA is completely unpaid, so that many women are forced to return to work immediately after the birth of their newborn, simply because they cannot afford to take unpaid leave like these two bloggers: I am ohsoblessed and Historiann.
Beyond these prima facie problems, new mothers have also had further problems in application of the law. Employers have denied FMLA rights to new mothers who qualified for the leave, and have retaliated against new mothers for taking the leave. These amendments to the FMLA were drafted to correct some of these issues, which caused confusion and resulted in litigation. However, certain aspects of the new regulations will clearly hurt mothers in need of maternity leave to care for their newborns or newly adopted children. Among them:

• Employers will be allowed to require "fitness-for-duty" evaluations to decide whether employees who took FMLA leave are fit to return to their specific jobs.


• Employers will be allowed to consider FMLA absences to disqualify employees from bonuses or other incentives when the employee has not met a specified job-related goal due to FMLA leave.


• An employer can force the employee to use all or part of her accumulated vacation, personal, family, medical, or sick leave concurrently with the FMLA leave, potentially eliminating an employee's ability to take any additional leave for the next year.

The changes do not guarantee any pay during maternity leave, and therefore will not guarantee women will be able to take the leave for childbirth. In addition, the new regulations apparently do not help with the problems of retaliation against employees who take leave, a problem compounded by maternal profiling. Indeed, the changes will arguably be more beneficial to employers than employees, since fewer people will qualify for leave under the new amendments according to the U.S. Department of Labor. The result: supposed clarifications with the new FMLA may actually cause increased confusion and litigation.

Newest Change.org Blogger

Change.org has asked me to be a permanent guest blogger on its Women's Rights Blog. I will start posting next week about issues that affect mothers, including: maternity leave; equal pay; reproductive rights; childcare; health care; education; and more. In particular, I am interested in creating a bridge on issues where mothers are divided including natural birth, breastfeeding, co-sleeping, public education, abortion, and fertility treatments. Over 80% of women are mothers, and therefore, these issues affect most women. To make our voice as women stronger, we must make it harmonious, and so, we must find common ground.

I look forward to the serious research required for the monthly posts, but more importantly, I look forward to the responses from my readers.

Making the World a Better Place

I want to make the world a better place. It sounds cheesy, but it's 100% true, and lately, I've started to lose a little of my idealistic self from childhood, so to get it back, I've made 2 lists. First, 5 things I want to do in the next year to make the world a better place:

1. Dedicate my full-time career to a (non-profit) cause I believe in.


2. Start using 100% cloth toilet paper & cloth towels.


3. Grow & eat exclusively my own vegetables & herbs.


4. Use only public transportation & my own 2 feet.


5. Buy old used/recycled goods.

I also realized that there are things I do everyday already to make the world better. Here are 5:

1. Volunteer everyday for a (non-profit) cause I believe in.


2. Use 100% cloth diapers & cloth wipes.


3. Breastfeed exclusively.


4. Recycle & reuse a lot with freecycle and more.


5. Exclusively cold cycle my laundry (except diapers).

It is a start, and I know that I care about the environment and our society, but I'm not satisfied with the status quo. Scott & I are very lucky people, and we can do so much more, and I'm very grateful to be married to a man who understands this ability, and appreciates the idea of giving in this world. Right now, he's volunteering on his leave from work to protect voter rights for all sides of the red/blue (green/yellow) divide. What can you do to make this world a better place for our children?

Equal Pay for Equal Work: Europe Shares the Pain

This article from the Washington Post titled "In Affluent Germany, Women Still Confront Traditional Bias" on discrimination of women in Germany is powerful. It's harder to ignore the facts when viewing it as an outsider, and it reminds me that other nations are viewing our inequalities with the same harsh perspective. The newspaper version of this article had a chart that showed the per-hour percentage higher that a man makes above a woman for the same job and the same qualifications in each country in Europe. If you don't want to read the whole article, please read these quotes from it:

• German government statistics show that men typically earn 24 percent more per hour than women, among the widest gender pay gaps in Europe.
• Women rarely hold top posts in German business. There is only one woman among the 200 people who sit on the executive boards of the top 30 companies on the German DAX stock index, according to Christian Rickens, editor of Manager magazine. Those companies include global powers such as Lufthansa, Volkswagen, Bayer and Adidas.
• "You can't say this is just because women choose to stay home with their children; one-third of women with university degrees don't have children."
• German employers are legally obligated to rehire women who go on maternity leave, even if they stay at home for as long as three years. But to get around the law, firms avoid hiring women or promoting them to high positions.
• Ralf Braun, 40, an Internet marketer, said it is only natural for a boss to think that a woman "at some point will get pregnant and stop working," causing problems for the workplace.
• Hans Meyer, 72, a retired engineer who used to run a Hamburg toolmaking company with 1,500 employees, said ... "The public view today is only concerned with the well-being of women, not of children."
• Stefan Linz, 32, said it makes "no sense" to fight for equality on the job because men and women are not the same...."We should cherish the differences," Linz said. "Women are the ones who get pregnant. Families are falling apart because women don't stay home. Isn't it time we just face the facts?"
• The derogatory words "raven mother" ... means one who abandons her young in the nest to go off and pursue a career. "It's a really ugly term. People say this about you behind your back," said Miriam Holzapfel, 33, a university graduate and mother of two in Hamburg who lost her job after she had a baby.

It leaves a bad taste in your mouth.

Twitter

After The Birth Survey started a microblog on Twitter, I grew curious about the terms "Tweeps" and "Twitters". Yesterday, I also started my own Twitter microblog, mostly so I could "follow" The Birth Survey's twitter blog. After less than 9 hours on the site, I had 400 followers of my microblog. TBS's micro blog is @ http://twitter.com/thebirthsurvey; my microblog is @ http://twitter.com/MothersWork.

1 out of 3 women will be cut up in childbirth

A Mother's Story: My doctor induced me because my amniotic fluid was low. I wasn't worried because my baby was in a perfect position. But, after many drugs, including Pitocin and an epidural, my doctor decided to "section me" because he said that my baby was like a key in a lock that wasn't turning.

Shel's Comments: Doctor, do you realize that our babies cannot act like keys when you dope them up with enough Pitocin to drop their heartbeats and enough pain-medicine for the contractions you created with the Pitocin to knock them out. Of course our babies cannot make any turns with these interventions, drugs, and heartache. Our babies and our bodies are tired and they collapse. You give us "combo drugs" and then you blame our babies. Babies know how to turn. Women, look around at your friends, and cry for them, and cry for yourselves, and cry out, because at least one out of every three of your dearest friends is going to be cut-up and experience pain of a c-section that could have been prevented if the doctor didn't induce you, drug you up, and rip out your baby. Cry out with me, and say: "No more." Low amniotic fluid before 41 weeks is not a reason to admit a pregnant women and induce her. This women's pain could have been stopped if someone had stopped her doctor from inducing her based on "low amniotic fluid."

Quote from Pushed (page 11) by Jennifer Block: "Amniotic fluid is also estimated by ultrasound, and the literature does not support it as a reason to induce. 'An ultrasound is not exactly a Kodak picture of the baby,' says Hodnett, although the results given to women often read out like a page out of a field guide: weight, fetal head measurement, amniotic fluid levels, and length are expressed down to the second decimal point, giving the numbers an aura of certainty. Amniotic fluid level shift constantly, with more being produced all the time. 'The predictive ability of amniotic fluid volume as an indicator of anything for an otherwise healthy pregnancy is extremely low,' says Hodnett. 'There's just not he evidence to support it.'"

Please support ICAN International today.

Making Mothers to Screen at BirthMatters NoVA!

After giving the premiere of Making Mothers a 5-star review, I'm happy to report that the filmmakers agreed to screen it at BirthMatters NoVA's December meeting. This documentary is fantastic, and if you have not yet seen it, please make the effort to come to our December meeting. I'm finalizing all the details now, but please feel free to contact me directly for more information. It is a not-to-be-missed event!

Candidates McCain and Obama: Do you care about Moms?

Since I already posted to the Barack Obama website last year with my concerns for Mothers' Rights, I also posted to the John McCain website today with those same concerns. My blog entry last year on these issues is available here, and my new entry on the McCain website is here, which I now repost below:

My vote this presidency turns on mothers' rights, which include the following four issues:

1. LONGER MATERNITY LEAVE: The US needs to guarantee a maternity leave for at least one year, whether paid or not, so women can breastfeed their children for at least a year. Recent research has indisbutably shown that babies do not develop as well with just pumped breastmilk but need the nurturing of breastfeeding. While the US does not (and perhaps should not) guarantee paid leave for the entire year, we must guarantee unpaid leave and paid leave for some of the time. Many countries offer paid leave of 14 weeks or more; the US needs to guarantee paid leave of at least 2 months just for the mother to recover from labor. The recent study from McGill University's Institute for Health and Social Policy, shows that the only 5 countries (in the 173 studied) that do not guarantee any paid leave for mothers in the world are: the United States, Lesotho, Liberia, Swaziland, and Papua New Guinea. Is that the list where we want to belong?

2. BREASTFEEDING PROMOTION: The U.S, must adopt international standards of promoting breastmilk and discouraging bottle-feedings. The US must make a committment to educate mothers about the benefits of breastmilk to combat infant formula companies who use aggressive tactics to advertise infant formulas and give away free formula for just long enough that a mother's milk dries up. These tactics go contrary to the International Marketing of Breast-Milk Substitutes Code, a code that over 125 countries of the WHO have all adopted into national law or have given it effect and a code that only the US and 8 other WHO member states have failed to do anything to give it effect. The same study from McGill University's Institute for Health and Social Policy, shows that the United States' workplace policies for families (like paid sick days and support for breast-feeding) are worse that all other developed countries, as well as many less developed and developing countries.

3. LOWER C-SECTION RATES: The U.S. must make a committment to lower c-section rates and to end unnecessary, scheduled c-sections that go against the mother's and child's best interest. The US has the worst infant and maternal mortality rates of other developed nations - behind Cuba, Czech Repulic, Taiwan, Aruba, and 30 others. Recent research shows that c-sections are related to 10 times higher infant & maternal mortality rates in the U.S. and yet the US continues to be the country with the highest c-section rates in the world - twice as high as England and 4 times higher than Sweden. C-sections also lead to higher stillbirth rates in future pregnancies, so it should not be a surprise that the stillbirth rate in the US is twice as high as that in Europe.

4. FLEXIBLE WORK SCHEDULES: The U.S. must allow flexible work schedules for all of its own employees and encourage corporations to allow flexible work schedules for employeees. Federal government workers should have a guaranteed option to work part-time and/or telecommute, and private corporations should receive tax benefits if they incorporate similar policies. Today is an age where many parents both work, and yet, parents do not have an option for part-time, even parents who work for the federal government.

Moms Voting '08

Today, my husband spent the day protecting our right to vote. For the next two weeks, he will be working 12-20 hour days, including Saturday and Sunday, volunteering for the Lawyers' Committee for Civil Rights under Law, a bi-partisan non-profit that runs a hotline for voter protection. When he went to volunteer today, I started thinking about the Mom Vote, and whether our vote can change issues from paid maternity leave to universal childcare to equal pay to support for single parents to home birth choices. I hope so, and I'd like to believe so, but it appears that once again, these issues are taking a backseat to the economy and health care and social security, instead of realizing that these issues are a vital part of the economy and health care and social security! Thankfully, the Families and Work Institute has information on the presidential candidates' platforms on work-life issues for the first time. However, presidential candidates are not discussing the rising c-section rates, the lack of support for breastfeeding mothers, and the witch hunt of midwives at all. The only way for the Mom Vote to count, for mothers to be recognized in future elections as "key" to the presidential race, is if Moms vote in unprecendented numbers.

MomsRising is encouraging women to register and vote with its MomsVote 2008 campaign. You can find out more information on the MomsRising site, and can also learn about paternity leave, flexible schedules, childcare, and TV programs, which are issues that need to be part of your decision when picking a candidate.

Food Allergy in Kids Up 18%

With food allergies at an all-time high, and the phenomenon limited to Westernized countries, where countries in Asia and Africa don't have these problems, I cannot help but wonder if there is a connection to breastfeeding. For example, this article quotes, "[C]hildren in China eat just as much peanut-based food as U.S. children do. But peanut allergy is almost unheard of in China." Well, unlike in the United States, breastfeeding is widespread in China. Has no one noticed the correlation? I did in the posting in June 2007.

The Birth Survey

After being a major supporter of The Birth Survey for 6 months, and taking the demo survey before TBS launched nationally in August, I finally took The Birth Survey today! It was wonderful to share my experience and know that I could reach fellow pregnant and new moms with this great information. Please join me, and take The Birth Survey today, and share your positive and negative experiences with your care providers and hospital/center, so other women can navigate through such a difficult and new system and learn from your expertise!

The Birth Survey

Share: Give your personal feedback about the care you received and share your birth experience with others.

Connect: View consumer feedback on hospitals, birth centers doctors & midwives in your community.

Learn: Find the information on local hospital intervention rates you need to make informed choices.

Women providing women with insight into maternity care practices in their communities.

It has been easier to get consumer satisfaction information about a camera than about maternity care services - but no longer. The Coalition for Improving Maternity Services (CIMS) has developed www.TheBirthSurvey.com a consumer feedback website where women provide information about the maternity care they received with specific doctors, midwives, hospitals, and birth centers. Families choosing where and with whom to birth can utilize this consumer feedback, along with data on hospital and birth center intervention rates and practices, to make informed health care choices.

Have you given birth in the last three years? If so, take The Birth Survey and provide feedback on your experience, your doctor, midwife, birth center, or hospital at http://www.thebirthsurvey.com/.

Film Review: Making Mothers

I saw Making Mothers, a half-hour documentary about the DC Birth Center, tonight. It was fantastic, and both the filmmakers were amazing - smart, insightful, and giving. The film focuses on two African American caregivers who help pregnant women in their transition to motherhood. Midwife Lisa strives to provide a peaceful birth experience, and Breastfeeding Counselor Joan uses her own experience as a teen mom to help other clients. The film is funny, sweet, and powerful. The filmmakers website, http://www.eidolonfilms.com/, states, "The film will eventually become a part of the Birth Center’s educational outreach to local communities, helping to encourage African American girls to enter the health care profession." It is a wonderful goal that I know we can all support. Meanwhile, I've asked the filmmakers to screen the film for Birth Matters NoVA in December for those in the greater DC area who missed the World Premiere tonight. Kudos to co-directors Ben Crosbie & Tessa Moran on such a success!

Study: High-tech interventions deliver huge childbirth bill

USA Today came out with news that a new study found out that high-tech interventions in childbirth such as: IVs, epidurals, Pitocin, electronic fetal monitors (EFM), c-sections, and more is responsible for the rising cost of healthcare. The article states, "Childbirth is the leading reason for hospitalization in the USA and one of the top reasons for outpatient visits, yet much maternity care consists of high-tech procedures that lack scientific evidence of benefit for most women."

Among other factors, this article, discusses how unnecessary c-sections raise the health care costs for everyone, which is a situation birth advocates have understood for years. For instance, here is a quote from the DC New Moms Guide I wrote last year:

Additional interventions result in higher medical costs. In 2005, the U.S. spent $2 trillion on health care, which represented 16% of the gross domestic product (GDP). The U.S. has higher medical costs than most of the developed world. 66% of all hospital revenue in the U.S. comes from hospital births, 33% of births in the U.S. are via c-section delivery, and c-sections cost $2,000 to $7,000 additional per birth. In 2004, there were 4.1 million babies born in the U.S., and 1.2 million were born via c-section deliveries. C-sections thus represented a $6 billion cost.

Organization for Economic Co-operation and Development, OECD in Figures 2006-2007, available at http://www.oecdobserver.org
/news/get_file.php3/id/25/file/OECDInFigures2006-2007.PDF; Centers for Disease Control and Prevention. National Center for Health Statistics. VitalStats http://209.217.72.34/VitalStats/TableViewer/tableView.aspx?ReportId=321.

If you want to see the rest of the guide, visit:
http://www.motherswork.org/downloads/EarlyDraftNotForDistribution.pdf.

April is C-section Awareness Month

Definition of C-section:

a) An abbreviation for cesarean section.

b) A major abdominal surgery where the uterus is cut open to extract the newborn instead of allowing the newborn to be born naturally and normally through the vagina.

c) A very important medical procedure that is necessary to save the mother's or child's life for about 10% of pregnancies, but is being abused, used in over 30% of pregnancies in the United States.

Definition of VBAC:

a) An abbreviation for a Vaginal Birth After Cesarean.

b) A birth option that allows a pregnant woman to have a natural and normal birth in a pregnancy after a possible traumatic experience with a cesarean, and an option that is medically possible for over 75% of women with previous c-sections without risk to the mother or child.

c) A birth option that many hospitals and doctors limit, ban outright, or discourage improperly.

In honor of C-Section Awareness Month, I make the following oath and committment:

Except in the case of a true emergency:

1. I will not go to a hospital with c-section rate above 30%, and will travel to another state or country if necessary, or forgo medical treatment if possible.

2. I will also not go to a hospital that has any (implicit or explicit) VBAC ban. If the hospital has a VBAC rate below 30%, I will consider there to be an implicit ban even if the hospital officially states that it allows VBACs.

3. I will not seek care from a physician whose c-section rate is higher than 15%.

4. I will not participate in conversations about physicians who have cesarean rates higher than 15% unless it is to explain the dangers of such physicians to our society and to each individual woman.

5. I will see midwife for all well-woman care who is either affiliated with an OB that meets the above criteria or who is not affiliated with any OB.

6. I will write to my congressional representative this month, encouraging him to help pass legislation in favor of mother-baby friendly birth practices and midwifery.

7. I will never recommend an OB to a woman with a low-risk pregnancy.

8. I will write an extensive blog entry at least once a year with a focus about the dangers of the current c-section rate in this country.

9. I will support women in their pregnancies, births, and postpartum with their rights to be protected against unnecessary c-sections, and in their recoveries of unnecessary c-sections.

10. I will raise my daughter to know, see, and appreciate normal birth, whether it is through the birth of her siblings in our home, the birth of friends' children in their homes, or the birth of complete strangers. I will not allow her to grow up never seeing a normal birth, or being under the misconception that .

For more information on C-Section Awareness Month, c-sections, or VBACs, visit http://www.ican-online.org.

Interesting Trivia in Honor of C-section Awareness Month: Home birth is safe, as many women who have had no other option to avoid a c-section have discovered. Remember that there have only been THREE U.S. presidents born in a hospital. The first U.S. president not born at home was Jimmy Carter in 1924 (about 150 years after our country was founded). The second U. S. President born in a hospital was twenty-five years later with Bill Clinton in 1946, which was the same year that U.S. President George W. Bush was also born in a hospital.

First Talk on Hospital Births

Yesterday, I gave my first talk on how to have a safe, complication-free birth at a hospital for the ICAN of DC at their March Meeting. The discussion was very productive, although it quickly got off-topic from my prepared talk. If you would like to see a copy of the talk, it is available for download here. The official invitation read:

Planning a Good Birth:
Five things you need to know to prepare you and your baby for a healthy and happy birth.

Featuring invited guest speaker, Shel Lyons, Executive Director of Mothers' Rights Network, a non-profit organization dedicated to mothers' rights.Join us and learn about what you can do to promote a healthy birth for youand your baby.

The program will focus on birth class alternatives, pros and cons of epidurals and other interventions, questions you need to ask yourcare provider, nutrition tips and resources to get more information forplanning your birth.

Family room, 411 8th St. SE, DC Sunday, March 30, 7 pm to 8 pm.
FREE! Spouses, Babies and siblings welcome.

Early Draft of DC New Mom Guide '08 Available

I have finished a very early draft of the DC New Mom Guide '08. The final copy (after many edits) will be available for free distribution early next year. At that point, any reproductions, including photocopying, will be allowed, as long as there is no financial or other gain. However, this current draft is available only for comments and feedback. No reproductions are allowed without written permission.

Starting next year, the DC New Mom Guide will be given free for all moms, although it is written for low-income moms and moms with a high risk of unnecessary interventions. If you would like to be notified when the final publication is available, or have other questions, please send a detailed e-mail.

Yet Another C-Section...

We received great news that another friend had a beautiful baby, and it was another c-section. While our nation has one of the world's highest c-section rates at 33%, our friends appear to have an even higher c-section rate at 40% (excluding all the wonderful home births we know from friends at Birth Care). We've had 4 friends end up with c-sections - 2 because of breech, 2 inductions (one at 38 weeks), 2 friends who went into premature labor over a month early, and only 2 normal births (both with epidurals and probably pitocin to counteract the epidural, but otherwise normal). What is extremely surprising about the breech births is that they are a statistical anomaly, since nationally, only 3% of births at full-term (40 weeks) are c-sections. Of course both were scheduled for c-sections before 40 weeks, so it is difficult to know if these babies would have turned.

Frank breech is the most common of all breech positions - about 70% - and the safest of breeches to deliver naturally - studies have shown that breech deliveries are just as safe with a c-section. However, c-sections are always more dangerous for the mother (3-4 times higher mortality rate). While 7% of babies are breech at 38 weeks, that number drops to 3-4% at 40 weeks. With a breech delivery, version is not necessarily the safest way or most effective way to turn a baby (it has a 65% success rate), but moxibustion has over a 75% success rate - a rate so incredible that it was picked up by The NY Times. Do not be under the misconception that breech babies (especially frank breech) requires a c-section, or that c-sections are safer for the mother or the baby when natural delivery is possible, even if your doctor tries to convince you to schedule one (c-sections are more convenient for doctors, doctors receive an extra $3-$10k per c-section birth even though c-sections take less time, and doctors feel pressure to do c-sections to avoid "liability" since they are less likely to be found liable if a mom ends up with a hysterectomy than with anything wrong with her baby).

Now that I am pregnant again, it is very unnerving to me that the c-section rate in this country is sky-rocketing and as a result, our maternal mortality rate is now ranked 41 in the world, below most developed countries and some developing nations.

If you have had a c-section, visit the ICAN website (International C-section Awareness Network) for support and information on your VBAC (Vaginal Birth After C-section) options.

Talk by Author of Pushed

Jennifer Block, the author of "Pushed: The Painful Truth About Childbirth and Modern Maternity Care" spoke at Georgetown University today. Her talk was thoughtfully titled, "The Painful Truths About Childbirth and Modern Maternity Care" as she spoke about eight painful truths:

1. Women are not receiving optimal care.
2. Babies are not receiving optimal care.
3. Women do not (even) have access to optimal care.
4. The maternal mortality rate in the US may be rising.
5. Women are denied normal, vaginal births (VBAC, Breech, Twins)
6. Doulas cannot solve this problem.
7. Women are being pushed out of the system entirely (forced to choose freebirths instead)
8. Women are not demanding better care.

Ms. Block's talk went very well. There were a lot of women there (and two men), but there were no doctors (perhaps the section of our population who most needed to be there!). There were a lot of midwives, doulas, nurses, advocates, and moms. Ms. Block began the talk by defining "optimal birth" as birth that: 1) begins on its own; 2) progresses on its own time; and 3) ends with minimal intervention possible. With this definition, she continued her talk in the eight areas mentioned above and explained in further detail below.

1. Women are not receiving optimal care.

• Women have up to 16 tubes/drugs/attachments in them during labor (EFM, pitocin, anti-biotics, IV, anti-acid-reflux drugs, etc) - leads to lack of mobility.
• 1/2 of first time mothers are induced.
• There is directed pushing.
• There is thus an "85% morbidity rate today" (with morbidity defined as an adverse impact beyond the expectation of a normal birth, which includes c-sections, episiotomies, etc).
• There are only 2% optimal births.

2. Babies are not receiving optimal care.

• Babies do not go through spontaneous labor (b/c induced) and have resultant asthma and respiratory problems (since evidence shows that labor starts on its own when the lungs are mature).
• There is often no immediate skin-to-skin contact with mother (shown to lead to higher breastfeeding rates and bonding).

3. Women do not (even) have access to optimal care.

• Birth centers and planned home births offer optimal care for low-risk women (9% pitocin v. 53% in hospitals, 4% c-section v. 19% in hospitals, 2% episiotomy v. 33% in hospitals, 2% forceps/vacuum v. 7% in hospitals, 5% epidural v. 63% in hospitals)
• However, many low-risk women do not have option to be in birth centers (location, insurance, cost, waiting lists).
• Also, birth centers may not accept higher risk women.
• Either way, hospitals (where most women birth) are not offering the advantages of birth centers, which would give more women access to optimal care.

4. The maternal mortality rate in the US may be rising.

• Rank of US among industrial country in maternal mortality: 41
• Coincides with rising c-section rate.
• C-sections lead to placenta problems which lead to hemorrage. (see chart below)
  year c-section rate placenta accreta risk
  1970 5% 1/19000
  1980 15% 1/2500
  2005 31% 1/500
• C-section scar leads to ruptures which lead to hysterectomy
• Moms with c-sections are 2-3 times more likely to die, and also more likely to have an emergency due to the c-section that requires at least a 1-week hospital stay

5. Women are denied normal, vaginal births (VBAC, Breech, Twins)

• There is a distortion of the risk of a VBAC. Women are told that there is a higher risk of uterine rupture and that the child will more likely, therefore, suffer servere harm or death from uterine rupture with a VBAC. However, the chance that a baby won't survive a VBAC is 1/2000, which is the same chance that a baby won't survive a vaginal birth to a first time mom (also 1/2000).
• With a VBAC, a women has a 75% chance of a vaginal birth and a 99.5% chance of no rupture. With a repeat c-section, a women has a 100% risk of surgery and a 99.8% chance of rupture (because there is still a risk of rupture).
• 300 hospitals has banned VBACs as of 2004

6. Doulas cannot solve this problem.

• (This point received some criticism from the doulas in the audience, but she made a good point, which is that doulas are filling holes in the system instead of requiring the system to get rid of the holes.)
• The result is that doulas are just letting the hospitals slack on getting more nurses, yet meanwhile the doulas have *no* medical authority at the hospitals (so the doctor can still push their "hospital policies" on women.
• Also, doulas are then expected to act as "bodyguards" for the women, instead of requiring doctors and hospitals to end their agressive and invasive methods.
• In the end, doulas have limited or no power to do what the women hired them to do (which is to provide optimal births, with minimal intervention).
• Our system now has a "BYOB" (bring your own birth assistant) policy because the care is so inadequate instead of requiring the care to improve.
• It's difficult to expect a doula to shoulder all this responsibility because doulas are trying to support their patient and their patient's choices and are not always in the position to inform the women that the doctor or hospital will likely ignore the woman's birth choices.

7. Many Women are being pushed out of the system entirely (forced to choose freebirths instead)

• This is mainly for VBACs and twins where birth centers can't accept them.
• Her example is Mindy Goorchecko (page 97 of her book), pregnant with twins, where the only midwife with experience with breech who would accept her lived 3 hours away and could not arrive in time for the birth (first one easy, second one footling breech).

8. Women are not demanding better care.

• This is the "saddest truth of all" (according to Block)
• Where is the outrage? Why are women defending the mistreatment and poor care they receive during prenatal appointments and the actual labor? Why are most women denying the trauma that occurred to them from unnecessary c-sections? Why are women falsely believing and stating that their c-section was truly an emergency? Do women have misinformation or lack of resources, or are women just in denial of the physical and emotional violations they suffered from their birth?

Breastfeeding Mother Sentenced to Jail

Maryland Judge Barry Hughes held a breastfeeding mother of a 12-week old infant, Elizabeth Jett, in contempt of court for failing to show up to her jury summons. In early Fall 2007, Jett sent a written request for postponement until the summer, but after the request was denied, Jett did not show-up for duty on October 9, 2007. At that time, Jett's son was 12 weeks old. In January, after Judge Hughes offered Jett the opportunity to serve that month and Jett explained it was insufficient time (Jett's son was only 6 months old), Judge Hughes held Jett in contempt of court, fining her to a night in jail or a $150 fine. See news stories here and here.

As a result, on February 20, 2008, Senator Nancy Jacobs (Maryland State Senate) again introduced Maryland legislation to exempt a mother breastfeeding a child under 2 years old from jury duty. (See the text of Senate Bill 921 here, and see the status of Senate Bill 921 here.) Jacobs had previously sponsored similar bills both in 2003 and 2004.

On February 26, 2008, Senate Judicial Committee Proceedings Chairman Brian Frosh sent a letter to Chief Judge Robert Bell of the Court of Appeals, on Senator Jacobs behalf. Frosh asked Chief Judge Bell to take action “to ensure that the statewide policy for excusal from jury service is family-friendly.”

A quick search shows that many states have some form of exception for breastfeeding mothers in serving jury duty, but the laws are often incomplete - either limited in application to only state or only federal courts, or limited in scope to only certain mothers. For instance, in Alabama, there is a pending bill (House Bill 347) that will allow deferrals of jury duty in state court for breastfeeding mothers as long as they are breastfeeding only. Separately in Alabama's federal court system, there are exceptions to jury duty in place for primary caretakers of children under age 10. To find out whether your state has family-friendly jury duty rules, click here.

Lead Poisoning

Since being quite scared out of our wits when our daughter was diagnosed with lead poisoning in September, we have learned quite a bit about lead paint poisoning in the District of Columbia:

A home built before 1960 is much more dangerous than a home after built 1960 (there are higher concentrations of lead in the paint and lead paint was more often used). You can only be safe if your home was built after 1978. (Our home was built between 1912 and 1925.) Even if an inspector finds your house to be "lead-free", it does not necessarily mean that there is no lead in the paint, but just that the levels are within federal safety guidelines. There were many areas in our house that had lead paint, but the only areas that were found to be unsafe (above federal safety levels) were: 2 doors, 2 door jams, 5 windows, and 1 floor molding. It is a misconception that children are only poisoned if they "eat" the paint. Our daughter never ate paint, the entire house had been renovated and repainted over old lead paint (theoretically "sealing in the lead" we were told by our real estate agent). However, any cracks in the paint from vacuuming (and banging the floor trim) and from opening/closing doors/windows allowed lead dust to be inhaled and both our daughter and I were seriously infected (and no, I don't eat paint). Once we knew what to look for, we could spot miniture cracks everywhere in the paint and sure enough, there were tiny areas showing the green of lead throughout our home, allowing dust invisible to the naked eye to spread.

Since we had a child under age 6 living in our house, the lead testing was free (it was done by the District of Columbia). We were given a list of certified abatement professionals and had to use someone from that list. If we could not afford the abatement (it was about $4000), there would have been financial assitance.

If you live in a home built before 1978, the first thing to do is get yourself and your family tested for lead at the doctor's office. It's a simple blood test and it's free (covered by insurance). If the tests come out negative, it is possible that your house does not have lead paint or at least that the levels are low enough that they are not dangerous. If the tests come out positive, you can move yourself and your family out of the home temporarily (lead leaves your system relatively quickly, although the damage may be permanent) while you find a professional to do lead abatement.

10 Tips for Working While Pregnant

Many women find themselves trying to work full-time while they are growing a baby full-time. Here are 10 Tips for working while pregnant:
Tip 1: Tell Your Boss
If you intend to stop working after your baby comes, give your employer time to find a replacement.
Tip 2: Use Caution
If you want to return to your job after the baby is born, use caution. You need to protect your position, because although it is illegal to discriminate against someone who is pregnant, the corporate world does not necessary obey these regulations
Tip 3: Timing
The best time to tell is just after people begin to suspect you might be pregnant and before they are sure. Do not reveal your pregnancy too soon or wait to long.
Tip 4: Do homework
Ask if you could work part-time, do some of your work at home, or have flexible hours where you could work harder or longer on more comfortable days.
Tip 5: Explore options.
Determine what you ideally want, what you can afford and what's best for your pregnancy and your family. Would you rather start maternity leave early? Continue your job on a part-time basis from home? After the baby is born, do you want to come back to your present job, or one that is more compatible with family life? Do you want full-time work or part-time?
Tip 6: Enjoy work and motherhood.
You can do both. Whether you want to take off and return as soon as possible or work as long as possible and return as late as possible, you should be able to work out the best plan for you, your baby, and your family.
Tip 7: Know your rights.
Know your company's maternity leave policies and the laws.
Tip 8: Review your company's policy.
When reviewing your company's policy, be sure you understand:
Whether maternity leave is paid, unpaid, or partially paid;
Whether you are eligible for disability insurance benefits, complete or partial;
Whether the company has a medical disability insurance policy that pays a portion of your salary while on leave;
Whether the company's policy guarantees you can return to your same job or one that is equivalent in pay and advancement possibilities;
How much time off you are allowed'
Whether you may use your present benefit days (sick leave, personal leave, vacation time) to extend your paid maternity leave; and
Whether your health plan is still in effect while you are on extended leave, and whether it is partial or full coverage.
Tip 9: Think before you speak
After selecting the time and person to tell (and preferably when that person is having a good day), present your case. As in any negotiations, consider where the other person is coming from. Your supervisor wants to know when you are leaving, when you are coming back, and how best to fill in the gap while you're gone. Be ready with those answers. Realistically, your supervisor is more concerned about the company's operations than your personal needs.
Tip 10: Work out the right maternity leave for you
Only you can guess how much maternity leave time you need; only your company can guess how much time they can afford to be without you. Remember, your bargaining power depends not only on how you present your case, but also on your value to the company. Remember that companies want to be seen as family-friendly in their maternity leave policies.

My Daughter's Birth Story

My daughter, Calla Rae Lyons, was born a year ago today, and although she told her story a year ago (you can see it here), let me tell it again in a different light, as a woman who is now starting a non-profit, the Mothers' Rights Network, http://motherswork.org/, to teach woman to ask their doctors about c-section rates, and attitudes about breastfeeding and rooming in. So, in the story below, I focus on these questions I never asked.

My pregnancy was unexpected. It was almost March when my husband stared at my belly and told me I was pregnant. Well, that's impossible, I thought, and I told him so. But, the next day, my period hadn't come and I knew he was right; I took a pregnancy test and felt nervous and excited, and mostly happy, but in a oh-my-goodness-how-am-I-going-to-tell-him way. My gynocologist no longer delivered babies and I was going to need a obstretician. Unfortunately, the first doctor sent us away in tears as he refused to do an ultrasound so I could see my baby and make sure everything was okay. At that time, it was already April - I was already eight weeks pregnant, it was the first visit he could squeeze us into, and he spent an hour discussing Tay Sachs syndrome (my husband and I are both Jewish), despite promising at the beginning of the visit to make time for an ultrasound. I was devastated. At the end of May, the second doctor recommended by my gynocologist squeezed me into an appointment. He seemed nice, but there was a catch - although he was in a separate practice group, he was in a larger group that took turns delivering babies - and the first doctor was in that same group. So, a doctor that left me in tears could be delivering my baby. Well, I didn't see any other option, so I decided to stick it out with doctor number two. That was until I started my birth course - the Bradley method with Kelly in August.

Kelly emphasized that we needed to empower ourselves and ask our doctors about c-section rates and episitomy rates. Well, no problem, I thought, doctor number two would pass that test in a heartbeat. The answer through me in a spin. He said 35%, the national average. But, when I asked him what my chance was as a low-risk pregnancy, he said 35%; it would be 100% if you were high-risk. I stayed calm. What can I do to lower my risk, I asked. Look, he said, growing impatient, looking at his watch without attempting to be discreet, if you don't want a c-section, go deliver in a log cabin. My pleasure, I thought. I called Birth Care that same morning and asked for the earliest appointment. They fit me in at the end of August. I don't know why I had resisted for so long. At first I was afraid I'd be endangering my child by birthing at a midwife center, but after my experiences with doctors, I was afraid of endangering my child by birthing anywhere but a midwife center.

By the end of October, I was huge and uncomfortable. I had gained almost 50 pounds, which was exactly what my mother gained with me and what I had promised to never gain in my pregnancy. I was constantly waiting for labor and constantly afraid it would actually come at the same time. When November arrived, I was angry that I was still pregnant. I was calling my parents constantly, bothering them out of boredom. My mom asked if I urinated often. Of course, I responded, I'm pregnant! No, my mother explained, more than usual, she inquired. No, it's been about the same every night, I told her, I wake up once in the middle of the night and go back to bed. Oh, she said, well, when you pee a lot, that is when you are going to go into labor. On the night of November 1st, after a romantic night of cuddling up with my husband, I started to get up at least once an hour with an urgent need to go pee. I knew I was going to start labor, but I tried to focus on sleeping, as our Bradley instructor had grilled into us - I was going to need the rest.

At 4 AM on November 2, I saw bloody show, and called birth care. Susan (a midwife) reminded me that it did not mean that I was going into labor and to focus on resting. At 6 AM, I felt my first contraction; they were 10 minutes apart. I was too excited to go back to sleep, and with a full night rest and the average labor lasting 17-19 hours, I thought I didn't need it. Twelve hours later, the labor had continued to progress, my contractions were only 5 minutes apart, and I was ready to go to Birth Care. At 8 PM that night, I was only 2 centimeters dialated and the pain was unbearable. By 9 AM, the next morning, I had finally started to get in a rhythm with the contractions. I was swaying the entire time and moaning the entire time, with just a slight increase in intensity during contractions, as they became a part of me. Marsha insisted on checking to see how far I had dialated, but I refused, knowing that the pain had become bearable and figuring out that labor couldn't have progressed. Marsha explained that without knowing how far I had dialated, it would be impossible for us to make a decision on my labor. When she checked me, her response was clearly worrisome. You won't believe it, she said. Oh, no, I thought, I hadn't progressed at all, and I was going to end up having a hospital birth. Whatever it is, just tell me, I said. You are fully dialated, she exclaimed. No, way, I thought. With such a long labor, my body was tired, so Marsha insisted on breaking my water so that I wouldn't waste more energy. My belly was still gigantic and Marsha guessed that the baby was 8-9 pounds. After six hours of pushing (well, we thought it was a big baby!), I finally pushed as if I didn't care if it meant my own death (morbid, but that was how I felt), and Marsha put a small, precious baby (less that 7 pounds) on my belly and asked my husband to tell us if we had a little girl or boy. We had a girl - she was perfect with a large head (over 13.5 inches!) and a short umbilical cord (thus, the difficulty in pushing). My labor was 33 hours and 33 minutes - my daughter was born at 3:33 pm on November 3rd. Eight days later, at a naming ceremony, we named her Calla, after our wedding flower.

A year later, when I look back on this story, the parts that touch me most was how ill-prepared I was for pregnancy, labor, and breastfeeding, and how our society as a whole, and perhaps family life in particular, do not prepare women to be mothers. I didn't know how to tell my boss I was pregnant, or how to go part-time. I didn't know if I could trust DC water or how to know which toys were safe and which have lead, unless they are recalled. I didn't know about the dangers to circumcision, and as a Jewish mother, I had felt a lot of pressure to circumcise - thank goodness we had a daughter! With this experience, I left my job as an Honors Attorney at the U.S. Department of Justice, to start the Mothers' Rights Network (http://motherswork.org/) with the concrete goal of creating a guidebook available without charge to low-income mothers, and at-cost to all mothers, that lays out 10 questions to ask your obstetrician (including vacation plans!), how to childproof your home, how to test for lead, and more. I expect it will be out in January 2009, and I'm sure I will officially post on the Birth Care group (and show it to everyone at Birth Care) once it's closer to completion.

My daughter's view of her birth is available on her blog here.

A Quick Report on the Conference

The conference is great. The Opening Remarks by Jill Sheffield of Family Care International really showed how much work and love she put into making Women Deliver a reality. There are many different panels and events, as well as exhibits from organizations dedicated to women's rights and women's health from around the world. I've met wonderful people and attended powerful talks, including one with Mary Robinson, as you can see in the photograph to the left.


I also took a quick break to check out the Tate's latest exhibit titled Crack. That is me crouching down in the blurry picture on the right with the large crack in the cement down the entire length of the Tate. The exhibit may be infamous in the United States, but I found it refreshing and innovating.

The best part of the WomenDeliver Conference is meeting all the participants from Family Care International, including Jill Sheffield herself. We've become a mini-family in this brief time of working 20 hour days with no sleep and I think we've really come to rely upon and respect each other for our dedication to women's issues and mothers' rights.

Why I Am Going to London

Tomorrow, I fly to London to work as a Youth Advocate for the WomenDeliver Conference. This conference is so important to me that I am flying 9,000 miles to London for the weekend to go to there.

This year represents the 20th anniversary of the global Safe Motherhood Initiative, launched in Kenya in 1987. There are very high maternal mortality rates around the world. 1 in 16 women in Africa die from pregnancy and childbirth. I am deeply interested in the outcome from the 30-country coalition that will attend the conference this weekend.

On October 18, 2007, a conference held only once every ten years will once again put the high rate of maternal mortality at the forefront of the international public health agenda. In 1987, the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the United Nations Population Fund (UNFPA), the World Bank, and other organizations first addressed maternal mortality with the global Safe Motherhood Initiative. The 1987 conference was held in Nairobi, Kenya, with the goal of halving the maternal mortality rates by the year 2000 by calling on national governments to invest funding and to create legislation to improve maternal health. Today, twenty years later, much more work needs to be done as international standards are ignored and forgotten unless they are adopted by national governments to be given effect.

So, this year, an international delegation of thirty countries that face some of the highest maternal mortality rates will attend the conference to devise strategies and build political will to adopt national legislation that will assure skilled doctors or midwives at every delivery, greater prenatal and post-natal care, guaranteed back-up emergency obstetric care, and family planning services. I am excited to be a part of this momentous occasion.

Lead Poisoning Alert

We received the test results two weeks ago that our daughter has lead levels above the federal standard. We do not yet know the cause, but we spent last week at a friend's house, and are now temporarily moving to California to stay with family while our home and Calla's toys are being tested and we figure out how to take the next step. For now, please get your child tested today!

Article Published By UN Vision

My article titled "UNICEF and WHO Combat Aggressive Infant Formula Advertising in Asia" was published by UN Vision , a publication of the United Nations Association for the National Capital Area, this month. You can read the article here. If you have trouble accessing the link, please copy and past the following website address into your browser: http://www.unanca.org/unvision/UN%20Vision%202007%20Fall%20.pdf.

Acceptance Letter from WomenDeliver.org

Today, I was invited to the WomenDeliver Conference in London, England to be a Youth Advocate. Therefore, as planned, I will be spending October 18-20th at the Conference, and now I will spend the day before, October 17th, at a training session for Youth Advocates.

Twenty years ago, the Safe Motherhood Initiative was launched. Its goal was to cut maternal deaths worldwide by half. At the Women Deliver conference, advocates and leaders from around the world will unite to make that goal into a reality. I am excited and honored to be a part of this conference.

The acceptance letter read:

The WOMEN DELIVER Youth Advocacy Working Group has developed plans for anadvocacy desk in the Youth Zone area of the conference center. We think you will be a wonderful addition to this team. We will be working to gather commitments from conference participants to advance the solutions to thecrisis in sexual and reproductive health among the world's young people and to support local young advocates in following-up on these promises. Our priorities include:
* Involving as many young people as possible;
* Bringing out the conference themes as they are affecting young people all over the world, including unsafe abortion and complications due to early age of marriage;
* Strengthening linkages between issues and sectors from a youth angle;
* Building multisectoral dialogue and partnership;
* Spotlighting this young generation, because we are most affected by poor pregnancy outcomes;
* Contextualizing safe motherhood, especially by looking at poverty and lack of education; and
* Creating opportunities for youth involvement and sustained advocacy when youth participants go home.

Medical: Natural Childbirth

As many of my friends know, I have chosen to deliver our baby with a natural birthing center. Many people are unfamiliar with a natural birth in this country, thinking, mistakenly so, that "vaginal birth" and "natural birth" are synonymous. They are not. A natural birth is a drug-free birth, without an epidural or any other drugs at all in my system. It has been proven, although these statistics seem to be hidden from many moms-to-be, that epidurals lead to a much higher chance of fevers in laboring moms, which, of course, then require an emergency c-section. My husband and I dearly want a large family, and one c-section, statistically, leads to another c-section (indeed, many doctors refuse to deliver a vaginal birth after a c-section), and two c-sections are the limit for most women (women with multiple c-sections often end up with hysterectomies - removal of the uterus). To avoid any complications, I plan to birth at a natural birthing center in Alexandria, Virginia, called "Birth Care" where the c-section rate is under 5%, versus the national average of 35%.

Why you should join MothersWork.org

I am a lawyer, an advocate, a scientist, and an intellectual. But, most importantly, I am a mother. Since the birth of my daughter, Calla, in November 2006, my priorities in life changed, and I realized that families, not just mine - but all families, must be a priority in our society and they are not.

If you don't have a child, and you never had a mother, and you don't have any brothers or sisters with children, and all of your friends are childless, maybe you don't know how difficult and how important it is to raise children as a priority, and you don't think families should come first in our society, but let me give you a few reasons why you are wrong:

1) Children today will be the soldiers, leaders, and taxpayers of tomorrow. So, when you are old or disabled or poor, and you want an army to defend the country, a president to lead the country, and taxpayers to pay for these benefits, but you cannot have these benefits without today's children being raised right. Children with parents who are there to help them with their schoolwork are the children who finish college, who become leaders, and who find high-paying, stable employment.

2) If you do not raise children with love and hope today, with healthcare and education, you are raising criminals and the unemployed of tomorrow. So, when you are old or disabled or poor, and you wonder why the crime rates have soared and the number of skilled professionals have plummeted, it will be because we did not make families a priority today. Latchkey kids without a stay-at-home parent or after-school care are the children who commit crimes and get into trouble.

3) Even if you don't care about tomorrow, so reasons (1) and (2) don't resonate with you, there is something that you care about, whether it is your spouse or your pet, or your career. Family and medical leave acts (including the Federal FMLA act, and the California leave act) give time off for everyone to take care of their loved ones, including sick spouses and parents, and not just babies. Everyone will benefit with legislation that gives paid, longer leave for medical and family reasons, such as childbirth and adoption.

If you want to learn more about these issues and related issues for mothers' rights, please visit my non-profit organization, the Mothers' Rights Network at http://www.motherswork.org - you can get the facts, learn how to become involved and support us either by volunteering or donating.

Medical: Mothers' Rights in the News

In reading the newspaper, I find about 10 articles every day that relate to mothers' rights. Often these news reports are on the front page, and it makes me realize that mothers' rights are more important than ever to the general public, and yet, we do nothing about improving them. Here's just a handful of examples - check them out and maybe you'll realize that you care about mothers' rights, too. If you do, check out my new non-profit - http://motherswork.org/:

• 40-year Term Handed Down in Day-Care Death in The Washington Post, Aug. 18. 2007 at B5
• Experts Advice Parents to Inspect Recalled Toys: Child Needs Lead Test if Paint Is Sullied in The Washington Post, Aug. 18. 2007 at A3
• FDA Warns Nursing Mothers of Possible Codeine Risk in The Washington Post, Aug. 18. 2007 at A2

I could go on and on and on, but I think it's time that you read more about it at the Mothers' Rights Network at http://motherswork.org/.

Official Announcement

I have officially left the Department of Justice to pursue a career in mothers' rights advocacy full-time! I will be posting progress on this website, but plan to launch a separate non-profit.

Launch of the Mothers' Rights Network

I have put into motion the Mothers' Rights Network with the launch of our website at http://www.motherswork.org/.

Mothers' Rights Advocate

A mentor from NOW's legal division, Legal Momentum, wrote today: "I actually thought of you this morning because I got an e-mail that might be of interest ... Mary Robinson appears to be organizing an October conference on motherhood issues." She was discussing the WomenDeliver.org conference in October that I plan to attend. It is very exciting that I am already known among women's rights advocates as a mothers' rights advocate!

Invitation to WomenDeliver.org Conference

Here is the official invitation from the Women Deliver Conference, sent out months after I have already put my plans to attend in the works.

REGISTER TODAY - JOIN MARY ROBINSON TO SAVE WOMEN'S LIVES

This October, more than 2,000 global leaders in human rights, health,and development from more than 75 countries are gathering to generatethe changes that will save women's lives and build a more just andhealthy world for all of us.

WOMEN DELIVER is a landmark global conference that will focus oncreating political will to save the lives and improve the health ofwomen, mothers, and newborn babies around the world. It will be held18-20 October, 2007, at the ExCel Centre in London.

According to Mary Robinson, Honorary Co-Chair of WOMEN DELIVER,"Maternal mortality is not improving in many poor countries because ithas not received the priority it deserves. This is a huge human rightsissue which will be highlighted at the WOMEN DELIVER conference. It isappalling that more than 500,000 mothers die each year when we know thisis largely preventable."

You are a part of changing this tragedy, and we invite you to join us inLondon.Help ensure human rights.

Register today at www.womendeliver.org or email womendeliver@profileevents.com.

Registration fees for NGO delegates will jump to 400 GBP on September14.

Join Ms. Robinson along with:
* Honorary Co-Chair of WOMEN DELIVER, Dr. Asha-Rose Migiro ofTanzania, Deputy Secretary-General of the United Nations;
* Dr. Mushtaque Chowdhury of Bangladesh, Deputy ExecutiveDirector of BRAC, Bangladesh Rural Action Committee and Co-Coordinatorof the Millennium Task Force on Child Health and Maternal Health;
* Dr. Ana Cristina Gonzalez of Colombia, advocate, International Planned Parenthood Federation - Western Hemisphere Region and UNFPA;
* Kate Gilmore of Australia, Deputy Executive Director of Amnesty International; and
* Dr. Dorothy Shaw of Canada, President of FIGO - the International Federation of Gynecology and Obstetrics.

The program includes plenary panels and seventy five simultaneousworkshops, panels, and presentations as well as regional caucusmeetings, strategy sessions, networking opportunities, and more. Pleasevisit the WOMEN DELIVER website at www.womendeliver.org for more details.

Please share this message with your colleagues worldwide.

Sincerely,

The WOMEN DELIVER Planning Group

Department of International Development, UK * Dutch Ministry of ForeignAffairs * Family Care International (Organizing Partner) * InternationalPlanned Parenthood Federation * Norwegian Agency for DevelopmentCooperation * Partnership for Maternal, Newborn, & Child Health * Savethe Children/Saving Newborn Lives * Sida, Swedish InternationalDevelopment Cooperation Agency * Unicef, United Nations Children's Fund* UNFPA, United Nations Population Fund * The World Bank * The WorldHealth Organization

Possible Media Rep at WomenDeliver.org

The United Nations Association of the National Capital Area and its quarterly publication, UN Vision, has agreed to sponsor me as a media representative at the WomenDeliver.org Convention in London this October.

Workplace: Vote for Mothers' Rights in 2008

This post is also published on the Mothers Rights blog here, which I created on the Hillary Clinton website, and here on the Barack Obama website.

My vote this presidency turns on mothers' rights, which include the following four issues:

1. LONGER MATERNITY LEAVE: The US needs to guarantee a maternity leave for at least one year, whether paid or not, so women can breastfeed their children for at least a year. Recent research has indisbutably shown that babies do not develop as well with just pumped breastmilk but need the nurturing of breastfeeding. While the US does not (and perhaps should not) guarantee paid leave for the entire year, we must guarantee unpaid leave and paid leave for some of the time. Many countries offer paid leave of 14 weeks or more; the US needs to guarantee paid leave of at least 2 months just for the mother to recover from labor. The recent study from McGill University's Institute for Health and Social Policy, shows that the only 5 countries (in the 173 studied) that do not guarantee any paid leave for mothers in the world are: the United States, Lesotho, Liberia, Swaziland, and Papua New Guinea. Is that the list where we want to belong?

2. BREASTFEEDING PROMOTION: The U.S, must adopt international standards of promoting breastmilk and discouraging bottle-feedings. The US must make a committment to educate mothers about the benefits of breastmilk to combat infant formula companies who use aggressive tactics to advertise infant formulas and give away free formula for just long enough that a mother's milk dries up. These tactics go contrary to the International Marketing of Breast-Milk Substitutes Code, a code that over 125 countries of the WHO have all adopted into national law or have given it effect and a code that only the US and 8 other WHO member states have failed to do anything to give it effect. The same study from McGill University's Institute for Health and Social Policy, shows that the United States' workplace policies for families (like paid sick days and support for breast-feeding) are worse that all other developed countries, as well as many less developed and developing countries.

3. LOWER C-SECTION RATES: The U.S. must make a committment to lower c-section rates and to end unnecessary, scheduled c-sections that go against the mother's and child's best interest. The US has the worst infant and maternal mortality rates of other developed nations - behind Cuba, Czech Repulic, Taiwan, Aruba, and 30 others. Recent research shows that c-sections are related to 10 times higher infant & maternal mortality rates in the U.S. and yet the US continues to be the country with the highest c-section rates in the world - twice as high as England and 4 times higher than Sweden. C-sections also lead to higher stillbirth rates in future pregnancies, so it should not be a surprise that the stillbirth rate in the US is twice as high as that in Europe.

4. FLEXIBLE WORK SCHEDULES: The U.S. must allow flexible work schedules for all of its own employees and encourage corporations to allow flexible work schedules for employeees. Federal government workers should have a guaranteed option to work part-time and/or telecommute, and private corporations should receive tax benefits if they incorporate similar policies. Today is an age where many parents both work, and yet, parents do not have an option for part-time, even parents who work for the federal government.

Workplace: F*&^ Discrimination

Today, we received an e-mail from our engaged cousin who is planning to get married at the Bel Air Bay Club in Malibu. The e-mail stated that this private club prohibits infants from being anywhere on the premises. While a no-infant-on-property rule may not automatically scream discrimination, it should. This rule prohibits only women, specifically nursing moms, from attending the wedding, or any function at this club. Even if the moms planned to hire a babysitter to watch their children in a different room than the wedding so that they could take breaks to breastfeed, the no-infant-on-property rule would prevents them from attending a wedding or any function longer than a nursing baby could last between nursing sessions. I have sent an e-mail to the club confirming their policy and asking if they make exceptions to nursing moms. If not, I would argue a boycott of this club and any other club with discriminatory practices.

WomenDeliver.org Conference in October

Through different avenues, I have heard the wonderful events and speakers at the WomenDeliver.org Conference this October in London, England. With my dedicated interest in mothers' rights, and especially in birth rights, I have decided that this conference is a top priority. I sent in an application today to the conference organizers.

Mothers' rights is both a passion, and in many ways, a full-time career, whether I wanted it to become one or not. I am interested in the same issues raised by Women Deliver.org, including medical policies (prenatal care), product safety (infant formula), and workplace protections(nursing mothers). I believe this work is 100% important and 100% necessary. I have applied to attend the conference as either a media representative or a youth advocate.

Attending the conference is the first step in professional training in these areas that have come to hold my attention so dearly these past two years. In addition, by attending, it will benefit the mission of the conference by allowing me to bring back knowledge and skills I will gain from the conference to Washington, DC, so that I can continue raising awareness, and separately, by continuing the discussion through this blog and future articles.

Product: WHO-UNICEF Meet on To Combat Infant Formula

On June 20-22, 2007, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) held a joint meeting entitled the "Consultation of Breastfeeding Protection, Promotion, and Support" in Manila, the Philippines. The four objectives of the meeting were: 1) to "review the status of adoption and implementation of the international and national Codes of Marketing of Breast Milk Substitutes" (Marketing Code); 2) to "discuss the status of the Baby-Friendly Hospital Initiative" (Hospital Initiative); 3) to share lessons learned in the continuous effort to encourage breastfeeding; and, 4) to discover methods to discourage bottle-feeding. Confronted with dramatic decreasing breastfeeding rates and corresponding increasing infant mortality rates throughout Asia, the WHO and UNICEF addressed concerns that aggressive advertising tactics in Asia by infant formula companies in a multi-billion dollar industry are contrary to international standards that promote breastfeeding.

The three most significant actions by the WHO and UNICEF in the global promotion of breastfeeding are the Marketing Code, the Hospital Initiative, and the Innocenti Declaration. All these documents are over fifteen years old, created in response to misinformation around the world that dismissed indisputable benefits of breast milk and minimized or falsified problems with infant formula. In the 1960s, as birth rates of industrialized countries tapered off, infant formula companies focused their advertising efforts on developing nations in Africa, South America, and Asia. The most well-known of these campaigns was headed by Nestlé, which dressed untrained women as nurses to hand out free samples of formula to new mothers. By the time the new mothers ran out of free formula, their breast milk dried up, forcing them to purchase expensive formula they could not afford. The water in these countries was often unsanitary, and furthermore to combat the cost, mothers would use less formula and more water than recommended. As a result, many babies died of malnutrition and disease. In 1977, the United States, followed by Canada, Australia, New Zealand, the United Kingdom, Sweden, and Germany, boycotted Nestlé products.

In 1981, as a result of the boycott and improved education, the WHO and UNICEF established the Marketing Code, adopted by the World Health Assembly (WHA). In 1982, Peru became the first country to adopt the Marketing Code as national legislation, but by 1996, 16 countries had adopted it into law and all member states of the WHO had agreed to adopt the Marketing Code into law or to give it effect through other measures. By 2004, 27 countries had adopted the Marketing Code as national legislation, 125 countries had taken some measure to implement the Marketing Code, and many other nations are studying it. There are only nine member states that have failed to take any action. The United States is one of those countries.
Under the Marketing Code, infant formula companies may not promote their products in hospitals, give free samples to mothers, give gifts or promote their products to health workers, or give misleading information. The Marketing Code, thus, laid out prohibitions against false and aggressive advertising of infant formula, but it did not address a need to encourage breastfeeding and to inform mothers about the benefits of breast milk.

In 1990, the Innocenti Declaration, adopted by 32 nations at a joint WHO-UNICEF meeting, met this need, declaring multiple benefits of breast milk, including preventing diseases in children and lowering the breast and ovarian cancer rates of nursing mothers, and laid out specific measures for countries to implement by the year 1995, such as legislation that protects nursing mothers and that promotes breastfeeding. The Declaration was followed by the Hospital Initiative in 1991, which recognized hospitals that followed the WHO-UNICEF Ten Steps to Successful Breastfeeding: 1) have a written breastfeeding policy; 2) train all health care staff to implement this policy; 3) inform all pregnant women about the benefits of breastfeeding; 4) help mothers initiate breastfeeding within one half-hour of birth; 5) show mothers how to breastfeed; 6) only give newborn infants breast milk unless medically indicated; 7) practice "rooming in" or having the infant stay in the same room as the recovering new mother; 8) encourage breastfeeding "on demand" or whenever the infant shows signs of hunger; 9) give no pacifiers to infants; 10) foster the establishment of breastfeeding support groups on discharge. The WHO has publicly recommended that mothers exclusively breastfeed for the first six months, and continue to breastfed in combination with food until age two.

These three actions had positive global impact. Since the Hospital Initiative was launched, more than 15,000 hospitals and clinics in 134 countries have been recognized for adopting the Ten Steps. In Cuba, the number of mothers exclusively breastfeeding their children tripled in six years, from 25% in 1990 to 72% in 1996. In sub-Saharan Africa, the number of infants exclusively breastfed for six months rose from 15% in 1990 to 32% in 2004. However, most of Asia still trails behind. Countries in East Asia have a 35% breastfeeding rate of infants at six-months old, and many countries are far behind this average. In Thailand, only 5% of infants are exclusively breastfed for six months, and in Vietnam, the rate halved in four years from 29% in 1998 to 15% in 2002. Breastfeeding is the single most effective prevention of diseases that kill more than 750,000 children under five years old in the Western Pacific Region of Asia, which includes China, Malaysia, Korea, the Philippines, Singapore, and Vietnam, among other nations. These countries have failed to meet specific obligations under international human rights laws and rights for children. The Universal Declaration of Human Rights states in Article 25(2): "Motherhood and childhood are entitled to special care and assistance." The International Covenant on Economic, Social and Cultural Rights states in Article 12-2(a): "The provision for the reduction of the stillbirth-rate and of infant mortality and for the healthy development of the child."

Asia currently accounts for 36% of worldwide sales in the multi-billion dollar market of infant formula. Due to its increasing economic strength with more mothers working outside the home, Asia is a current focus of marketing campaigns, including questionable advertising methods, by infant formula companies, which is leading to lower breastfed infants and higher infant mortality rates throughout Asia. These companies, including many U.S. companies, have allegedly advertised that formula-fed infants are more intelligent, more loving, and healthier than breastfed infants. Hospitals that were recognized for promoting breastfeeding by the Hospital Initiative fifteen years earlier no longer follow the Ten Steps. Public health groups are failing to equip health workers with skills and knowledge to promote breastfeeding. Health workers, poorly paid and misinformed, are accepting gifts from infant formula companies and touting false benefits of formula and telling pregnant mothers that they are unlikely be able to produce sufficient breast milk for their baby. The Philippine National Statistics Office states that 31% of Filipino mothers do not breastfeed because they believe that they do not have enough milk, despite the fact that all women, with very few exceptions, are able to produce enough milk for their infants. As a result, mothers are opting for formula, particularly in more urban settings where they often work and can afford it, but at the same time, poorer communities also see the advertisements. UNICEF’s Regional Director for East Asia and the Pacific, Anupama Rao Singh, has stated, "Within the region, child survival is affected by poor water quality, hygiene, and sanitation. Combine unsanitary water with the replacement of breastfeeding by infant formula and the threat becomes even deadlier."

The new advertising focus is the forefront of current legislation in the Philippines. The Philippines and Palau are the only two countries in Asia that have legislation prohibiting infant formula companies from falsely advertising formula as an equal or superior substitute for breast milk. Regardless, infant formula companies spend a $100 million annually in advertising in the Philippines, and annual sales of infant formula in the Philippines alone are $465 million. In the Philippines, many mothers struggle to afford the minimum of $43 per month that formula costs, and dilute it with rice flour that lacks the essential nutrients, leading to higher infant mortality. In a country where one out of every three infants under one year old are underweight and where economic savings are critical for the poorer communities, public health officials are going head-to-head with infant formula companies by trying to extend a 1986 law that limits marketing practices. The regulation would ban advertising formula to parents of children under age two with claims that formula fosters smarter and stronger babies; the current law only prohibits such tactics targeted to parents of children under age one. UNICEF has supported similar legislation, stating, "Marketing practices that undermine breastfeeding are potentially hazardous wherever they are pursued: in the developing world, WHO estimates that some 1.5 million children die each year because they are not adequately breastfed. These facts are not in dispute."

Nonetheless, on June 19, 2007, infant formula companies contested the regulation imposed by the Philippine Health Department in the Philippine Supreme Court. The attorney for the infant formula companies, Felicitas Aquino-Arroyo, argued that U.S. based formula companies, such as Wyeth, Mead Johnson Nutritionals, and Abbott Laboratories, will lose $208 million as a result of lost sales, changing current labels, and destroying formula products already in circulation. In addition, Ms. Aquino-Arroyo argued that the regulation would deprive mothers of information that would allow them to freely choose to use formula. Philippine Health Department Undersecretary Alexander Padilla said, "We have seen an increase of the profits and sale of infant formula companies. They say it makes geniuses out of babies, promotes love and affection, promotes family." The U.S. Chamber of Commerce intervened, sending a letter to Philippine President Gloria Macapagal Arroyo stating that the stricter regulations were risking the Philippines’ "reputation as a stable and viable destination for investment." The WHO supported the regulation, arguing that infant formula companies are violating international standards. Despite support from the WHO, the Philippine Supreme Court temporarily blocked enforcement of the new regulation on June 27, 2007, although it has not yet decided the case, an outcome that will be watched closely not just by the WHO and UNICEF but also by the WHA and the International Baby Food Action Network (IBFAN). [On June 20, 2007, Alessandro Iellamo of the WHO Regional Office, told a press conference "All the companies in one way or another violate the national code and the international code as well."]

Confronted with this alarming environment in Asia, the WHO and UNICEF opened the Consultation of seventy global health experts on June 20, 2007, at the WHO Western Pacific Regional Office in Manila, the Philippines. Countries involved in the Consultation included Cambodia, China, Cook Islands, Democratic People’s Republic of Korea, Fiji, Indonesia, Kiribati, Lao People’s Democratic Republic, Malaysia, Marshall Islands, Micronesia, Mongolia, Myanmar, Nauru, Niue, Palau, Papua New Guinea, Philippines, Solomon Islands, Thailand, Timor-Leste, Tokelau, Tonga, Tuvalu, Vanuatu, and Vietnam. The opening press conference was held just a day after the Philippine Supreme Court heard the challenge by the infant formula industry against tighter controls on advertising. The Consultation called for better government support of breastfeeding, declaring that the universally adopted international standards to promote breastfeeding, all over fifteen years old, are not being enforced to combat the aggressive advertising and lobbying methods by infant formula companies in Asia.

WHO Regional Director for the Western Pacific, Dr. Shigeru Omi, gave the opening remarks, demanding reassessment of hospitals recognized by the Hospital Initiative and calling for increased support by nongovernmental organizations for breastfeeding. Health experts declared that multinational infant formula companies, including U.S. companies, are using the same sort of tactics that led to the Nestlé boycott in 1977. In addressing the decline of breastfeeding rates, health experts noted the decline will lead to increased infant mortality due to diarrhea, pneumonia, and sudden infant death syndrome (SIDS), as well as increased chronic adult diseases, like high cholesterol, diabetes, asthma, cancer, colitis, and obesity. To combat the decline, UNICEF and WHO leaders called for countries to "to crack down on violations of the International Code of Marketing of Breast-milk Substitutes." In addition, they urged countries to invest more in educating new mothers about the merits of breastfeeding and the dangers of infant formula, and to better fund public health groups to deliver breastfeeding support services to new mothers.

Product: Dangers of Infant Formula

Happy Father's Day!!!

This article is also posted on Calla's blog.

I am a huge advocate of mothers, babies .... and also fathers. Dads have it rough out there: they don't feel they have a right to ask their wife to have a natural birth (and they kind-of don't), they were often circumcised against their will by their parents so they don't want to speak against it (although they should), and they know there is nothing enjoyable about pumping breastmilk at the office (even when they know the only alternative, formula, is not food).

I had already breastfed my daughter exclusively during my six months maternity leave (no bottles, no pacifiers, and definitely no formula), because she knew of the hundreds of benefits of breastmilk. Breastfed babies are smarter than formula-fed babies with an average of 10 points higher I.Q. (with the average I.Q. 100 points, that is 10%). Since there is a correlation between I.Q. & S.A.T. scores, breastmilk can determine which university your child attends. Breastfed babies also have a stronger immune system: less allergies, less asthma, less cavities, and less obesity. For some hard-core statistics, ponder over these: breastfed babies are 10 times less likely to have diabetes, 5 times less likely to die of SIDS, 5 times less likely to have a respiratory infection (pneumonia, bronchiolitis, and other life-threatening illnesses), 4 times more likely to have ear infections, and 4 times less likely to suffer from diarrheal infections. Breastfed babies are also less likely to get serious cancers (Breast Cancer, Leukemia, Hodgkins disease) by 25%. Breastfed babies are less likely to be fussy eaters later in life since they were exposed to more foods through breastmilk and less likely to get ADD/ADHD.

Breastfeeding is also better for nursing moms, since moms who breastfeed are 1/2 as likely to get breast cancer, 1/3 as likely to get ovarian cancer, and 1/4 as likely to get osteoporosis. Moms who breastfed are also less diabetic than before (their insulin doses actually reduce), they lose weight faster & healthier, and their uterus shrinks quicker. Breastfed babies also cost less. In the first 6 months, an average breastfed baby has $4,000 of medical costs, as compared to the a formula-fed baby's $68,000 of medical bills (excluding the additional costs of formula and bottles).

But six months later, when I was going back to work, I thought she could substitute formula during my 9-5 work schedule. My husband convinced me otherwise and I pumped for over two weeks until I could move my daughter to the day care in my building. During the transition period, however, I gave my daugther formula and I learned that formula is not food.

I glanced at the ingredients and found out that over 50% of formula was corn syrup solids! Now, no matter what anyone may say, corn syrup solids is not food for anyone, including a rat, let alone a baby. The ingrediants in my soy formula were (it's okay if you don't understand these words; either do we): Corn Syrup Solids, Soy Protein Isolate, Sucrose, Palm Oil, Sunflower Oil, Coconut Oil, Soybean Oil and less than 2%: Crypthecodinium Cohnii Oil (Docosahexaenoic Acid), L-Carnitine, L-Methionine, Mixed Tocopherol Concentrate, Monoglycerides, Mortierella Alpina Oil (Arachidonic Acid), Soybean Lecithin, Taurine. In milk-based formula, the ingrediants are just as foreign and scary, including: Nonfat Milk, Lactose, Vegetable Oil (Palm Olein, Soy, Coconut, And High Oleic (Safflower Or Sunflower) Oils), Whey Protein Concentrate and less than 1%: Mortierella Alpina Oil, Crypthecodinium Cohnii Oil, Vitamin A Palmitate, Beta-Carotene, Vitamin D3, Vitamin E Acetate, Mixed Tocopherol Concentrate, Vitamin K1, Ascorbyl Palmitate, Thiamine Hydrochloride, Riboflavin, Vitamin B6 Hydrochloride, Vitamin B12, Niacinamide, Folic Acid, Calcium Pantothenate, Biotin, Ascorbic Acid, Choline Chloride, Inositol, Calcium Carbonate, Calcium Chloride, Calcium Hydroxide, Magnesium Chloride, Ferrous Sulfate, Zinc Sulfate, Manganese Sulfate, Cupric Sulfate, Potassium Bicarbonate, Potassium Iodide, Potassium Hydroxide, Potassium Phosphate, Sodium Selenite, Sodium Citrate, Taurine, L-Carnitine, Monoglycerides, Soy Lecithin, Nucleotides. These ingredients mixed with water do not make food, but just a chemical experiment.

Thank goodness I made an appointment with the Breastfeeding Center in DC when my daugther was 6 days old and continued to breastfeed her for over six months exclusively.

While breastfeeding may not seem the right choice for every parent, it is the best choice for every baby. --Amy Spangler

Thinking that baby formula is as good as breast milk is believing that thirty years of technology is superior to three million years of nature's evolution. --Christine Northrup

Mothers need to understand that when they're deciding between breastmilk and formula, they're not deciding between Coke and Pepsi. They're choosing between a live, pure substance and a dead substance made with the cheapest oils available. --Chele Marmet

Medical: Dangers Of Circumcision

Happy anniversary to my husband, Scott!

This article is also posted on Calla's blog.

I advocate for mothers and I advocate for babies, as well. Having spared my daughter from drugs, dangers, and trauma of induced labor or a c-section birth with epidurals and other anesthesia, I really didn't want to give her drugs, dangers, and trauma of a circumcision. Luckily, she is a girl and female circumcision in this country is considered barbaric. But,, male circumcision is just as barbaric and I will spare my sons from it. Despite what anyone may tell you, circumcision is not safe, not needed, and not Jewish, unless of course that is your interpretation of Judaic law. But most Jews believe that their religion protects children, not harms them, and that, for 99% of babies, means no circumcision.

95% of the world's newborn males are natural (intact) and only 5% are circumcised; outside of the United States, circumcision is mostly for religious reasons. The United States is the only country in the world to circumcise newborns for non-religious reasons. We circumicise newborn males due to lack of education about its permanent damage (true), and the misconception about its ability to protect against penile cancer (false), HIV (false), and uterine infections (false). We also circumcise our children under the misbelief that he will look like other children (today almost 50% of newborn males are intact in the United States, with the number of circumcised newborns decreasing as parents become more educated; outside the United States, almost all children are intact), look like other Jews (many Jews, including my parents, are against circumcision, and no Jews circumcise newborn daughters - half of the Jewish population), or look like their fathers (the only benefit being for the father, while harming the son).

The truth is many Jews, including religious Jews, don't circumcise their sons. Moses refused to circumcise his son, forcing his non-Jewish wife to do it (Exodus 4:24). Moreover, Jews did not circumicise their children for the 40 years in the wilderness (Joshua 5:5). Many Jews in the Hellenistic period (circa 300 B.C.E.-100 C.E.) and during the Reform movement in Germany in the 1940s, including Theodor Herzl, refused to circumcise their sons. Today, 80% of Jews who circumicise their sons do it in a non-religious manner (at a hospital by a physician), and thus are not religiously circumcised, except having endured much more physical and emotional pain than an intact newborn male. Hundreds of traditional Jews in Europe, South America, and the United States choose against circumcising their newborn sons. 60% of Jews in Sweden do not circumcise their sons. Even in Israel, the Israeli Association Against Genital Mutilation publicly opposes circumcision.

The truth is that circumcisions are dangerous for newborn males, with a 38% complication rate, including infection and death. Circumcision removes the most sensitive part of the penis (and thus both the most enjoyable part during sex and the most painful part during the surgery), and the only part that naturally lubricates the penis (the inner foreskin). The foreskin contains over 240 feet of nerves and over 1,000 nerve endings, and despite the information given by doctors or some well-meaning old lady, cutting it off is extremely painful to the infant. Circumcision has long-term consequences, both physical and emotional, for the child, and for the parent who ignores her instinct to protect her child. Meanwhile, penile cancer only occurs in 1 out of 100,000 men and a circumcised child is just as likely to get penile cancer as a natural child. It is more likely for your son to die of breast cancer or the circumcision than penile cancer. Castration is the only way to prevent penile cancer.

On the same vein, there is no conclusive evidence that circumcision prevents HIV, and statistics can easily be presented to show the opposite. In the United States, 75% of adult males are circumcised and 61 out of 100,000 men have AIDS. In Norway, where only 2% of adult males are circumcised, only 7 out of 100,000 men have AIDS. In Finland and Sweden, less than 2% of adult males are circumcised; in Finland, only 5 out of 100,000 men have AIDS and in Sweden, only 8 out of 100,000 men have AIDS. Using those statistics, circumcision appears to increase your risk for HIV. Current studies argue that these statistics are inaccurate, because the risk of HIV is so low, and that only studies done within Africa can show a decreased HIV prevalence. There are recent studies that appear to show a decreased risk of HIV (up to 50%) in Africa only, but we don't live in Africa, and even these studies acknowledge that circumcision does not decrease the risk statistically for HIV in other countries. Furthermore, these studies acknowledge that there are many other factors. No study can ethically have a natural, intact man and a circumcised man have sex with the same HIV-infected woman and see which one gets HIV first; that study would be the most accurate but questioning morals. Instead, these studies are comparing the results of circumcised men with uncircumcised men and finding a greater amount of natural men appear to be contracting HIV. No study has ever argued that circumcision prevents AIDS or that moms in the United States should circumcise their newborn sons.

99% of natural boys will never have a urinary tract infection (UTI). That number is slightly lower than for circumcised boys at 99.9%, but much higher than for girls. If our desire is to prevent UTIs by harming our children, the answer would be to circumcise our newborn daughters, but that decision would be considered barbaric, as it should be. Hopefully, more moms can now see why circumcising their newborns sons is equally barbaric and definitely not Jewish.

With all these statistics, why would a doctor ever encourage you to circumcise your child? Doctors earn an more than $3000 extra for a cesearan birth as compared to a natural birth, and similarly, if a doctor earns $200 for a circumcision and does ten a week for fifty weeks a year (two weeks vacation), the doctor earns an extra $100,000 a year. Some doctors charge closer to $500 for the operation, and thus earn $250,000 extra per year. No matter what a medical professional says, it is not Jewish to harm your son. While Abraham did circumicise Isaac, later G-d made clear to Abraham to not hurt Isaac. Many other verses in the Torah appear to prohibit circumcision in Exodus, Leviticus, and Deuteronomy with specific prohibitions against sacrificing children, harming other people, marking skin, and cutting the body. Meanwhile, besides the barbaric commandment of circumcision, there are outdated prohibitions against homosexuality, and discriminatory practices for married women seeking a divorce, and laws allowing slavery in the Torah that we easily reject today, including the law requiring circumcision for non-Jewish household members, like nannies and chefs. Tomorrow, Jews will reject circumcision, but be at the forefront today.

So for all those moms out there who feel lost in protecting their son from circumcision, don't give up. Take your baby home whole.

Do not lay your hand on the boy, do not do the least thing to him. --Genesis 22:12.

Medical: Dangers Of Hospital Births

Happy Mother's Day!!!

This article is also posted on Calla's blog.

As most of my friends know, I birthed my daughter naturally for 33 hours and 33 minutes. By naturally, I mean without an epidural or drugs. I was just as afraid as every other new mom about the pain of labor, but I made a purposeful decision. Despite what anyone may tell you, it isn't a time to let others induce you, let others drug you, let others cut you, unless of course that is your educated choice. But, most women want whatever is best for their child and that, for 90% of us, is labor without interventions.

For the child, inducing labor is dangerous. For the child, it is best to allow labor to happen on it's own course (except where the child is 2 weeks overdue or the water has already broken). Inductions increase c-section rates, increase risk for the baby including oxygen definiciency, increase infection, and increase the mortality rate for the mom and the child.

For the child, epidurals are dangerous. For the child, it is best to have a drug-free labor (except where fatigue has set in and the mother needs to rest), since epidurals can lead to complications for the mother and child (infection, overdose, allergies, fever), longer labor, and an increased c-section rate and use of forseps. Epidurals are the number one cause of fevers during labor unrelated to infections. Fevers lead to increased complications (often c-sections), infant death, and low Apgar scores. Maternal fever is now also linked to newborn seizure.

For the child, c-sections are dangerous. For the child, it is best to have a natural delivery (except where the child is breach, the mom has a fever, or either one's heart rate has gone too low or high). C-sections are a serious surgery and are physically damaging. The risk of the need for a hysterectomy, maternal & infant death (3-4 times compared to natural birth), organ damage, respiratory problems, and many other complications all increase after a c-section. After a c-section, moms are more likely to be re-admitted to a hospital and are more likely to become infertile. Future babies are more at risk for preterm birth and have an increased risk of stillbirth. The consequences of elective c-sections are indisputable.

With doctors in the United States encouraging use of all these interventions, how can you protect yourself and your baby? Low risk pregnancies in this country still have over a 30% chance of a c-section; most of those c-sections are unnecessary, unwanted, and unsafe. But physicians earn an extra $3000 or more per c-section as compared to a natural birth, and with approximately 150 deliveries per year on average, doctors are doing 50 c-sections a year making an extra $150,000 per year. The number one reason for an unplanned c-section: "failure to progress". Or is that "failure to wait"? First-time moms normally have long labors, with the average labor lasting 19 hours. Failure to progress is defined as 2 hours of active labor without progress. First, doctors should not be putting plastic gloves, instruments, or anything else unsterilized in the canal every two hours, because that leads to infection. Moms should only be checked very rarely or when they feel an urge to push (to make certain they are fully dialated). Second, your body knows what to do, and sometimes it may take longer than others but with most c-sections given for "failure to progress," please consider whether your doctor has a "failure to be patient".

I did research on the web and found a Midwife-run birth center nearby, called Birth Care. There, the c-section rate is less than 4% (national average is 33%), the episitomy rate is less than 6% (national average is 25%), and the average Apgar score 5-minutes after birth is a 9 (out of 10). At Birth Care, the baby is brought to the mom's belly or breast right after birth, when she is still attached to the umbilical cord. The mom gets a chance to bond and breastfeed her child immediately. All these photos are from the Birth Care Center in Alexandria and show you the comfort of a Midwife-led birth.

These statistics and supporting studies clearer show that it is safer to birth your child outside the hospital for a normal birth despite what the medical model or some well-meaning old lady may tell you. In developed countries, the Netherlands has one of the lowest infant mortality rates in the world (approximately 3rd) and one of the highest rates of homebirth (two-thirds of all births with less than 3% c-sections). The U.S. has the one of the highest infant mortality rates (24th in the world) and one of the highest rates of hospital births (about 96% with 33% c-sections).

If you have a high-risk pregnancy and need to birth at a hospital, make sure to have a doula or birth assistant by your side, working for you and with you. Your doula can help you make educated choices when you are in labor and unable to rebuff the pressure from well-meaning nurses and doctors to have a c-section or induce labor. Your doula can be as an advocate for you when you are busy birthing your child and your husband is busy comforting you. Your doula can also act as a second pair of much needed hands, running to get you ice and giving your husband a chance to take a break after the first 24 hours. Not surprising, births with doulas are shorter, easier, and have less interventions (including less c-sections!).

So for all those moms out there who feel lost in getting the birth you want, don't give up.

A hospital is no place to be sick. -- Samuel Goldwyn

Workplace: Salaried Mothers

This figure is a gross understatement in my opinion, but the Salary.com report found that a mother is worth $138,095. See MSN Article for more.

Workplace: Welcoming A Girl Into the World

Our beautiful daughter, Calla Rae Lyons, was born this afternoon. She is already the joy in my life and the smile in my day, and I can't wait to show her so much about this world. She is truly perfect in every way, and if not for myself than for her, I want to make this world a better place. I want a world with lower infant and maternal mortality rates, with cleaner & safer hospitals for labor, with rights for mother's to take a year sabatical after birth to breastfeed their children, and with better protections for a mothers' and fathers' rights.

Making the decision to have a child is momentous. It is to decide forever to have your heart go walking around outside your body. --Elizabeth Stone

Medical: Protecting An Unborn Child

We are ecstatic to announce that we're expecting our first child this November! We're hoping for a Veteran's Day baby to fall with my family tradition of being born on national (and international) holidays. We don't know if it's a boy or a girl yet nor any name ideas, but we've absolutely, definitely, 100% eliminated the names "Alexander the Great" for a boy and "Petunia" for a girl, and we may indeed, just refuse to use any names that start with an A or a P.

To enter life by way of the vagina is as good a way as any. -- Henry Miller

Workplace: Making A Difference

As I started my new position as a trial attorney with the United States Department of Justice in the Entertainment & Media Section of its Antitrust Division, I look forward to investigating radio, television, and newspaper mergers for the next few years, and figuring out how I can apply this knowledge to become a star in a movie, make a difference in the world, or use antitrust analysis in the next Mothers' Rights campaign.

One idea is to compare the lack of Mothers' Rights - unpaid maternity leave; very few if any part-time and telecommuting options; available unpaid leave is limited to 3 months for maternity leave by the Federal Family & Medical Leave Act; difficulties in breastfeeding at work including lack of facilities and breaks during conferences, meetings, training to breastfeed or pump; absence of childcare at work and at conferences when away from the office; and pressure to postpone children until later in a mom's career or to schedule the birth of her child to a time convenient for her co-workers - with a Monopoly's actions. As long as the Monopoly holds the power and controls the jobs, it will require full-time employees with minimal leave options, no breaks after returning to work to pump breastmilk, and no on-site childcare. But if women (and men) were to unionize and fight against the Monopoly, and created "competition" for the best employees by luring the top qualified employees with better maternity leave, child-care options, and family-friend workplaces, corporations would no longer have a monopoly and would be forced to offer similiar benefits to compete for the best employees. I would like to convince a few top CEOs and other leaders to try this natural experiment. Offer top qualified employee candidates the following: part-time options, on-site childcare, and one-year maternity leave with six-months paid leave to breastfeeding mothers, and make your offers public. If you see a stream of the best-qualified men and women rushing to apply, there was a monopoly on employment positions and we can change these realities without legislation. The free market is a success. Otherwise, back to the drawing board.

The problem of social organization is how to set up an arrangement under which greed will do the least harm, capitalism is that kind of a system. -- Milton Friedman

Workplace: A Man Gave Up His Career For A Woman

Since my last post of chaotically looking for a position, I sent out fifty applications, received three interviews in New York City for positions in Monrovia, Liberia, and finally found an internship with Lawyers Without Borders. A week before I was due to fly to Liberia with a $3000 plane ticket in hand, Scott received news that I was not allowed to accompany him and that he would lose his job if I moved to Liberia on my own accord.

With those cards dealt, Scott chose to come home and we exchanged my ticket for two tickets to Australia to spend almost a month in an amazing country that is not war-torn. It's relieving that I will not have to give up my job or my fellowship, but I will always be curious how life would have played out if I had to choose between moving to Liberia or keeping my job at DOJ, if I had to see how women and children are living in a post-war country, and if I had a job doing a very different type of work - instead of mergers with large companies, I would be bringing together people. I wonder if it would have been too much for me to handle or if I would have flourished. Although I do not want to put my career on hold for another person, it is interesting how other people bring new career goals into our lives.

As the pendulum swings, I believe it will finally rest wisely in the center where women may choose a career or family or both. There is a price to pay for such choices, but that knowledge is part of our progress. --Elizabeth Dole

Workplace: Giving Up A Career For A Man

When Scott Lyons leaves DC in three weeks, he will a 20 hour flight ahead of him. Yesterday, he accepted a position as legal counsel in Monrovia, Liberia and invited me to come with him. Despite a position starting in December with the United States Department of Justice as an honors attorney and an accompanying Heyman Fellowship from Harvard Law School that I will likely need to turn down, I now find myself now in the very overwhelming position of looking for a job in West Africa with zero experience in post-Civil War countries. Although I have traveled extensively (throughout Europe including Spain, France, Monaco, Italy, Vatican, Germany - both West and East, Czech Republic, England, Japan, Korea, Singapore, Thailand, India, Israel, Egypt, Mexico), I have never been to West Africa nor a war-torn country.

I never thought, or wanted, to follow a man before, and it is a huge step. I am reminded of Hillary (Rodham) Clinton, who followed President Bill Clinton, despite his infidelities and other embarrassments. I am reminded of Tammy Wynette, a traditional-thinking country singer, who I am not sure shares my passion toward making my own footprint in the world. I aslo find myself thinking about Dean Howard's wife, Dr. Judith Steinberg, who was unfairly criticized for putting her career before his, simply because she had ill patients she needed to see. I do want to make a difference in the world, but I also want to have a husband, children, and a family. If I need to make a choice, and I felt like I did, I choose Scott and our future family. I am happy that our families and friends have supported our decision, as tough as it may have been, and this blog will follow my story around the world to meet Scott while he fulfills his dreams.

I am drawn to Mona Lisa's Smile, and , about the life choices women were forced to make in the 1950s and still face today. Must we choose between career and family and how does one make that choice? How can we carve our own path when our choices conflict with our friends', family's and, society's expectations of us? Why must we feel a need for approval?

And Ruth said: 'Entreat me not to leave thee, and to return from following after thee; for whither thou goest, I will go; and where thou lodgest, I will lodge; thy people shall be my people, and thy God my God.' --Ruth 1:16