Monday, February 25, 2008

ACOG says homebirth is a fashionable trend

Pregnant women read the writing on the wall

A few years ago I noticed a sign on the wall at a local women’s clinic. It stated “Our doctors will no longer perform VBAC.”

The sign made me laugh. VBAC stands for vaginal birth after cesarean. Since the doctors in that practice were males, it was difficult to imagine them performing a vaginal birth. Doctors do not perform vaginal births. Pregnant women do.

For women with past c-sections, the sign is not funny at all. This prohibition jettisons women’s rights back to the 1950’s when the mantra was “Once a cesarean, always a cesarean.” Women are being robbed of a fundamental childbirth choice, even though studies confirm the safety of VBAC for most women.

Healthy People 2010 urges doctors to cut the cesarean rate in half, from over 30% down to 15% by 2010. According to Dr. Marsden Wagner, former director of women’s and children’s health for the World Health Organization, international studies show that the optimal cesarean rate for a country is 10-15%. “If the rate is below 10 percent, maternal mortality goes up,” he said. “If it’s over 15 percent, maternal mortality goes up.”

In fact, a study published in the February 13, 2007 issue of the Canadian Medical Association journal reported that women undergoing planned c-sections are three times more likely to die.

Cesarean section is major abdominal surgery. It exposes the mother to increased risks of infection, hemorrhage, anesthesia complication, organ damage, scar tissue, secondary infertility, postpartum depression, maternal-infant bonding complications, breastfeeding difficulties and death. Is it any wonder maternal deaths are on the rise here in the US?

Cesarean section subjects infants to increased risk as well. In November, the British Medical Journal published a study showing that the risk of neonatal death was 70% higher for surgically delivered babies than for normal deliveries.

The International Cesarean Network (ICAN) advises pregnant women that they have the right to refuse any medical treatment, including cesarean section. But how can a woman with a previous c-section refuse surgery when no physician around will attend a VBAC?

Obstetricians have pushed pregnant women into a corner. Some women are weighing their options: Unnecessary surgery vs. homebirth.

Homebirth is relatively rare these days. In 1900, 95% of babies were born at home. Since 1955, that number has hovered somewhere around 1%. Yet the practice persists, not only among VBAC-seekers, but also among women who were unhappy with previous vaginal birth experiences in the hospital, and even among some first-time mothers.

Homebirth is gaining recognition within the mainstream as the result of Ricki Lake’s highly acclaimed documentary “The Business of Being Born.” The movie focuses on the profiteering that goes on in the birth industry at the expense of mothers and babies, and offers a look at how empowering and thrilling natural birth can be.

The American College of Obstetricians and Gynecologists (ACOG) is striking back. On February 6, 2008, ACOG published a press release condemning homebirth. What the statement leaves unwritten is that every homebirth represents an economic loss of thousands of dollars for doctors and hospitals. After all, ACOG is essentially a trade union for the OBGYN industry. An anti-homebirth statement from ACOG is like an anti-tap water statement from Pierrer.

Taking a swipe at Ricki Lake, ACOG says, “Childbirth decisions should not be dictated or influenced by what's fashionable, trendy, or the latest cause célèbre.”

Calling homebirth “fashionable” or “trendy” is laughable. Hospital birth is the recent historical trend. Babies have been born in homes for thousands of years. Women birthed them, and women caught them, and women nursed them.

In fact, if ACOG members would cast their myopic gaze across the Atlantic, they would find that European births are primarily attended by midwives. One third of Dutch babies are born in their own homes. Or if they peered across the Pacific, they would find that 70% of Japanese births are attended by midwifes, often in dedicated birth houses or in private homes.

The CIA states that babies are more likely to survive in 41 other countries than in the United States. Babies fare better in South Korea and Cuba than here. The safest places to be born are Singapore, Sweden, Japan and Hong Kong, followed by a long list of European countries.

Are US newborn deaths the result of over-medicated birth, c-section, or lack of health care? Take your pick. Countries where babies are less likely to die typically offer universal healthcare and home midwifery.

ACOG seems more concerned with evoking emotion than delivering facts. Consider this statement: “Choosing to deliver a baby at home, however, is to place the process of giving birth over the goal of having a healthy baby.” Translation: Homebirthers are selfish mothers who put their babies at risk.

Does ACOG at least support their contention with scientific data? Perhaps a study actually showing that hospital birth is safer? Not a chance. The studies, in fact, offer the opposite conclusion: Uncomplicated pregnancies end just as well at home.

In fact, US hospitals aren’t doing so well. Our country has the highest rate of cesarean sections, and the second worse newborn death rate in the developed world.

According to the 2007 State of the World’s Mothers report, “The United States has more neonatologists and neonatal intensive care beds per person than Australia, Canada and the United Kingdom, but its newborn [death] rate is higher than any of those countries.”

All ACOG can say about studies is: “It should be emphasized that studies comparing the safety and outcome of births in hospitals with those occurring in other settings in the US are limited and have not been scientifically rigorous.” In other words, the studies do not support ACOG’s contention that hospital birth is safer – which makes it completely irresponsible for them to assert that homebirthers have misplaced their priorities.

ACOG has apparently done enough market research to determine one of the factors drawing some women to homebirth: America’s soaring cesarean rate. The obstetricians have a response to this, too: “Multiple factors are responsible for the current cesarean rate, but emerging contributors include maternal choice and the rising tide of high-risk pregnancies due to maternal age, overweight, obesity and diabetes.”

Translation: “The only reason we’re cutting 1/3 of American mothers is because they’re old, they’re fat, they’re lazy and they want to be cut.” These doctors refuse to take responsibility for America’s outlandish c-section rate, even though the rate varies widely between practices and is lower in natural (drug-free) labors where women are allowed to eat, drink, and move around.

The ACOG statement even addresses VBAC, stating that women with cesarean scars are more prone to uterine rupture and thus VBAC should always take place in a hospital, never in a home. Anyone smell a rat? It’s dishonest to say VBAC should be hospital-bound and obstetrician-supervised, when obstetricians and hospitals refuse to participate.

Whoever penned the ACOG statement needs a crash-course in marketing. Obstetricians will find they are unable to shame homebirthing women back into the maternity ward. Given a choice between fat & lazy vs. selfish, we prefer to selfishly protect the precious lives of our little ones.

Wednesday, February 20, 2008

Homeschooling grows up

Self-educated families enjoy more options than ever before

If the term “homeschool” conjures images of identically-dressed elementary students filling out workbooks around the kitchen table and later winning the state spelling bee, your ideas about the practice are outdated. That’s not to say there are no kitchen tables or spelling bees involved, but there are as many ways to homeschool as there are families who fill out the Declaration of Intent each fall.

In some families, homeschool literally means school at home. You’ll find the walls lined with shelved textbooks and dry-erase boards. Carefully designed curriculums and meticulous schedules guide the students from one grade to the next, following a scope-and-sequence much like that found in public schools. A transcript is steadily assembled which looks very much like a public school transcript, with standard classes listed, a GPA calculated, and extra-curricular activities noted to the side.

In other homes, learning is far more organic. The textbooks are still around, but are currently being used for reference guides, booster seats, or anatomical models for a budding artist. Students may be found lying on the floor playing with a scientific calculator, hunched over a laptop writing a novel, or out in the driveway on rollerblades. More likely, the students won’t be home at all. The parents have become facilitators, relinquishing their teaching roles to spend their time obtaining requested materials or driving their students around town. These kids direct their own education without regard for whether it can be articulated in the common language of transcripts and GPA’s.

While some homeschool families are learning outside the box, others are finding innovative ways to recreate the box. The array of classes, co-ops and alternative learning groups continues to grow. Students can take classes ranging from core subjects like Algebra to extra-curriculars like fencing or writing fantasy literature. They can dress up for the homeschool prom and even participate in a graduation exercise.

Many of the efforts are student initiatives. Consider the Homeschool Shakespeare Troupe, for example. Originally launched by parents, the eight-month-long endeavor is now led mostly by homeschool graduates. They conduct auditions in February so the actors will have months to learn their lines. During the summer, organizers host a week-long Shakespeare camp where students learn stage terms and participate in drama workshops. The actors sew their own costumes and speak to each other in Elizabethan English, creating their own Shakespearean culture. The week culminates with dress rehearsal and then a very professional performance in a packed theatre. The troupe is growing so rapidly, organizers have decided to schedule two shows this year.

In every sizable town, classes and tutoring are offered by homeschool parents who are especially proficient in a specific area such as foreign language. Sometimes the tutoring becomes a lucrative business or even a small school with multiple teachers offering weekly classes to area students.

Other times it happens the other way around: The parents join together to form a cooperative and bring in a teacher. One of the most successful area co-ops is right here in Catoosa County.

On Friday mornings, students from all over the tri-state area converge on Poplar Springs Baptist Church in Ringgold. The parking lot is filled with mini-vans. Teenagers mill around the yard with backpacks slung over their shoulders, greeting each other and talking to the younger children who stream past. Some of the students carry musical instruments. Another has a basketball tucked under his arm.

The range of electives offered by the co-op continues to grow, including foreign language and upper math classes at the request of parents, and a journalism class at the request of students. The kids at the co-op form their own coalitions, organizing pickup basketball games and Friday night bowling plans.

One day a girl brought her fiddle to the co-op. The next week, a viola and a harp appeared on campus. Soon the students had formed their own Celtic ensemble called The Revelations.

Today’s homeschooling families are less rigid than in the past. Some make occasional use of public and private schools, as well as participating in the aforementioned co-ops and classes. Many families have some children in school and others learning at home.

As the homeschool population has grown, expanded, and become more mainstream, colleges have become more accepting of students educated at home. Some colleges actively recruit them. Covenant College, for example, boasts that 17% of new admissions are homeschooled students.

Homeschoolers are not so different from other kids. They grow through the same ages and stages, finding their identity and ferreting out their interests like anyone else. Some of them are brilliant, and others struggle with basic math.

Still, these students are growing up in a different paradigm. Their world is structured to meet their needs and help them grow. Public and private schools attempt much the same thing, but with the necessary assumption that most kids need the same things at the same times. The homeschool world is far more individualized.

Homeschooling is not new. Throughout history, families have educated their own children for numerous reasons. Pioneers taught their own children when schools were not available. Author Louisa May Alcott recounts in the autobiographal “Little Women” how her mother pulled her little sister out of school in response to a teacher’s cruelty. Thomas Edison, Benjamin Franklin, Virginia Woolf and other well-known geniuses received their educations at home. Figure-skaters, child actors and other prodigies have often been tutored privately.

Ansel Adams, arguably the greatest photographer of the twentieth century, was educated at home. In his autobiography, Adams wrote, “I often wonder at the strength and courage my father had in taking me out of the traditional school situation and providing me with these extraordinary learning experiences. I am certain he established the positive direction of my life that otherwise, given my native hyperactivity, could have been confused and catastrophic. I trace who I am and the direction of my development to those years of growing up in our house on the dunes, propelled especially by an internal spark tenderly kept alive and glowing by my father.”

Nurturing the internal spark inside each student is the true goal of home education. It is a goal shared by quality educators everywhere, whether they teach students in a two-story public school house, around a kitchen table, or in the church gymnasium.

Thursday, February 7, 2008

Understanding God's economy: an attitude of abundance

For years, self-help gurus have been trying to help us understand what makes some people happy and successful, sometimes in spite of tremendous personal tragedy, while others are miserable even when healthy, well-fed and solvent. One of the key differences is a belief in abundance.

Some people view the world as a basically good place with an abundance of resources. Others have a scarcity mentality. They think in terms of getting “a piece of the pie.” In the scarcity mentality, there is only one pie. To get more of it, you must slice it differently or take a piece from somebody else. The abundance mentality is more like the old Dorito’s slogan: “Crunch all you want, we’ll make more.”

Scarcity says “I hate campaign season. All those politicians waste millions of dollars that could have been spent on something important, like housing the poor.” Abundance says, “I love campaign season. All these crazy rich people voluntarily pump millions of dollars into the economy. We don’t even have to tax them!”

Scarcity is the root of jealousy. When others succeed, those of the scarcity mindset count it as a personal failure. Someone is getting more pie! It stands to reason, then, that someone must be getting less pie. They start eyeing their own pie critically. Has it been sliced a tad skinnier while they weren’t looking?

Abundance loves to see others succeed. If my friends and neighbors are bringing in more money, scoring awards, enjoying good relationships or earning scholarships, then I have reason to hope, too. A prime example of this mindset is from the musical “Fiddler on the Roof.” When the poor peasant Tevye announces the engagement of his oldest daughter to the wealthy butcher, the other men in the town sing:

“We’ll raise a glass and sip a drop of schnapps
In honor of the great good luck that favors you,
We know that when good fortune favors two such men,
It stands to reason we deserve it, too!”

This is an attitude of abundance. It leads to generosity. Scarcity, though, leads to hoarding and hating. Scarcity says, “Immigrants are stealing all the jobs!” Abundance says, “Immigration creates job by increasing the demand for goods and services.”

Scarcity says, “Equal pay for equal work is a terrible idea. If companies have to pay women more, they might pay men like me less.” Abundance says, “Everyone should be treated fairly. Besides, if women are paid as well as men, we men won’t have to worry about losing our jobs to lower-paid female employees.”

Scarcity says, “I wish that I had Jessie’s girl.” Abundance says, “There are plenty of fish in the sea.”

Some resources really are finite or limited. Take oil for instance. Fossil fuels are, by definition, a limited resource. The scarcity mentality leads to blood-for-oil wars. Abundance says, “Let’s explore new technologies for wind power and bio-fuels. Together we can do it. Let’s get to work.”

We can find this contrast in the Bible as well. Isaac and Rebecca have twin sons, Jacob and Esau. The twins begin their lives with rivalry, Jacob grasping the heel of first-born Esau. Unfortunately for these boys, both of their parents deal in scarcity. They have only so much favor to bestow, so Papa Isaac favors the hairy outdoorsman Esau, while Mama Rebecca pities the softer son and teaches him to cook a mean lentil stew.

Jacob views the world as a pie. His brother has clearly been given the larger piece of pie, for no other reason than that he was born a few minutes sooner. Because of those few minutes, Esau will receive the father’s blessing and the larger inheritance. Jacob will be expected to serve his slightly-older brother for the rest of his life.

Jacob is determined to increase his share of the pie by stealing his brother’s piece. He conspires with his mother to trick his father into bestowing on him the blessings of the first-born. You probably know the story. Jacob uses goatskins to deceive his father, who is nearly blind. When the mistake is discovered, Esau begs, “Father, bless me, too!”

Isaac’s response is remarkable. He says that he has already given the imposter everything – not just a large piece, but the whole pie. That makes me feel more sympathetic to Jacob. It means that his own father had no intention of blessing him! Jacob’s clever ruse with the goat skins really is the only way he can obtain his father’s blessing.

Esau is the one who snaps out of the scarcity mentality. Sobbing, he says, “Do you have only one blessing, my father? Bless me, too, my father!” Somehow, Isaac finds another blessing to bestow.

Hundreds of years later, the descendents of Isaac and Rebecca are crossing the desert to the promised land. God is still trying to teach them about abundance. When they cry for food, God produces manna. This strange bread-like substance descends from the sky every night. There is always enough for today. When some of the Israelites try to hoard the manna, it rots within a single day.

Fast forward several more centuries and we find Jesus echoing this sentiment in the prayer he teaches his disciples: “Give us this day our daily bread.”

In fact, throughout the Gospels, Jesus teaches abundance. When his disciples tell him to send away the hungry crowds, Jesus answers casually, “Why don’t you just feed them?”

The disciples are stumped. With what are they expected to feed some 5,000 men with wives and children? The few coins in their bag will not go far. As for prepared food, they manage to come up with a few fish and a few loaves – only enough for a little boy’s lunch. Jesus multiplies the loaves and fishes, feeds the crowd, and passes baskets to collect the leftovers. That’s abundance!

We don’t have the option of praying over a lunchbox and feeding thousands with it. We are forced to be creative. First, we must recognize that the scarcity mentality has failed us. In a world of rapidly depleting oil, creeping unemployment, hostile governments, and starving children, we cannot afford to view our resources as a pie. Instead we must view them as seeds that can be cultivated and multiplied until there is enough for all.

Scarcity says “We’re all going to die.” Abundance says “We can all live. Let’s get to work.”