Saturday, April 29, 2006

Blogging the Draft

With the football draft slated to start tomorrow in a few hours, the hottest property right now is's Rumor Mill. Editor Mike Florio, when he isn't up all night blogging about the draft, practices law in West Virginia and writes fiction in his spare time. has developed a reputation as one of the top, if not THE top, independent football websites.

Hat tip to my husband, who has a blog but doesn't post to it, so sorry no linky love sweetie.

Tuesday, April 25, 2006

Blawg Review and other Carnival Rides

The first Pediatric Grand Rounds is up at Unintelligent Design.

I've not been linking to Blawg Review lately. Where is my loyalty? Sorry, Ed.

Last week, Prof. Maule of Mauled Again wrote a right-on description of The Mommy Blawg. Having hosted a Blawg Review, I know how hard it is to sift through all the entries, view all the blawgs, and make quick sense of them. Good job.

Blawg Review #54, on Brandy Karl's bk!, introduces my Placenta piece with this quote from Alice's Adventures in Wonderland:
Soon her eye fell on a little glass box that was lying under the table: she opened it, and found in it a very small cake, on which the words "EAT ME" were beautifully marked in currants. "Well, I'll eat it," said Alice, "and if it makes me grow larger, I can reach the key; and if it makes me grow smaller, I can creep under the door: so either way I'll get into the garden, and I don't care which happens!"
She writes, "More than you ever wanted to know about placentas and related curiosities from the Mommy Blawger, who explores the topic in near-excruciating (only so because of the topic) detail." You think that's excruciating? Just wait until my piece on umbillical cords. That will be excruciating.

Sunday, April 23, 2006

The Reluctant Lactivist

When Chris, a mom of two in Portland, Orgeon, was harassed while breastfeeding at Fred Meyer (a grocery store chain owned by Kroger), she decided to start a blog:
While I have always promoted breastfeeding in my own personal way, I never wanted to become a lactation activist. Read on to learn why I am now the Reluctant Lactivist.
She has a list of demands, is asking for supporters to write the grocery chain and is considering organizing a nurse-in.

Thursday, April 20, 2006

Inmate Shackling

The shackling of laboring inmates is once again in the news, this time in Pensylvania:
Sheriff's deputies are shackling some female inmates to the bed during childbirth at Magee-Womens Hospital, officials there said, and the practice has prompted an outcry from advocacy groups.

Sheriff Pete DeFazio said he had no knowledge of any shackling during labor. "That's crazy. It's hard for me to believe. To tell you the truth, I don't believe it."

But Trish Nelson, the hospital's unit director for labor and delivery, said of the 15 to 20 inmates from Allegheny County Jail who give birth every year, about half are restrained by one wrist to the sideboard of the bed by a deputy.
Even worse:

Witold J. Walczak, legal director of the Pittsburgh ACLU, which decries the shackling of women in labor, said many of the women in the county jail are awaiting trial, and don't pose a flight risk. "Most of them are not convicted of anything," he said. Why should they have tighter security than women sentenced to state prisons in various states across the country, he asked.
After the Pittsburgh Post-Gazette discovered the county's policy:
But the procedural manual in the sheriff's office stipulates that any prisoner admitted to the hospital or medical facility must be shackled by leg restraints.

"There are NO EXCEPTIONS to this rule," the manual says.

Sheriff DeFazio lashed out:
"You have to use your brain," Sheriff DeFazio said. "If you don't have a brain, you shouldn't have the job to begin with. You have to use common sense. These people want to be spoon fed. Even a lay person would know why you wouldn't shackle someone in labor. Where is she going to go? If someone is going to escape, she is going to do more injury to the fetus and herself than anyone else. It's crazy. "They are trying to say, 'That is the rule. We have to do it.' But that is stupid. ... They just want to shackle them so they don't have to worry about it, so they can sneak out and have a cigarette."

Hee hee, I like this guy!

Quotes are from the Pittsburgh Post-Gazette articles:

Shackling of inmates during childbirth protested
Sheriff bans shackling of inmates during childbirth

Tuesday, April 18, 2006

Placentas in the News (or: Everything You Ever Wanted To Know About Placentas But Were Afraid to Ask)

Item One: The Hawaii legislature has passed a measure allowing parents to take home their baby's placenta, a practice currently prohibited by state health rules. ("Hawaiian parents seek right for birth ritual")

Here's a question - what experience have any of you had requesting or receiving your placenta after a hospital birth? Please leave me a comment. I would also be interested to know what country, state, or metro area you live in. And what reason was given if the placenta was not released to you.

In California, you must have a license to transport medical waste, which makes things a little tricky for homebirth midwives (Placenta Disposal).

With my first birth, I merely requested in my birth plan to be shown the placenta, something which did not happen. (The Doctor or Midwife has to look it over anyway, they might as well do it in front of you.) With my second, a homebirth, I got to examine it but I did not choose to keep it, something I now regret. I think it got thrown out with the trash. Our third son's placenta is happily sitting in our freezer next to the ground beef and frozen chicken breasts. Some day we will plant something nice over it, like a tree or a rosemary bush. Then we will never be able to sell that house. Just kidding.

Once I blogged about a thief who stole food from a freezer - including a placenta.

The placenta was, after all, a baby's companion since, well not quite since conception, but close. It was the source of the baby's nutrition, oxygen, and so forth, and it deserves some respect. I'm not really a fan of lotus birth, but I can definitely see the attraction.

Item Two: Okay, this happened in February, but I had a one month old baby and didn't get around to blogging it:

From 1996 to 2003, hospitals throughout Oregon, Washington and California quietly collected the placentas of as many as 700 women who suffered difficult births. They sent the placental tissue to a Portland institute underwritten by the insurance industry. The institute, called Cascadia Placenta Registry, was separate from the hospital's own pathology labs; it existed in large part to help doctors sued for malpractice.

This marshaling of evidence often happened without patients' knowledge or direct consent. One of the patients, Angela Desbiens, didn't know her placenta had been squirreled away as evidence until after she sued Providence St. Vincent Medical Center for failing to prevent fetal distress.

In the process, Desbiens learned that Cascadia had sliced her placenta into chunks, making it harder for other pathologists to analyze. She also discovered that Cascadia used incorrect information about the birth, as well as genetic data from some other patient, to draw its unsurprising conclusion that the hospital wasn't to blame for her child's brain damage.

Hat tip to the American Journal of Bioethics Blog.

Item Three: Tom Cruise and the very, very pregnant Katie Holmes have been the subject of much birth gossip lately, but Tom doesn't do much to squelch those rumors, does he? He is reported to have told GQ Magazine he would eat the placenta ("Is it safe to eat a placenta?"), but later made it clear to Diane Sawyer that he wouldn't ("Cruise Downplays Placenta Plan").

Ok, let's answer that question. Placentas have a great deal of prostiglandins and oxytocin, and they can be used in an emergency to slow postpartum hemorrhage when eaten or placed in a woman's mouth between her cheek and gum. Personally, I think it would be much saner just to let midwives administer pitocin. Ya think?

Placentas also have, apparently, a large amount of iron and other nutrients, so if they are consumed, after either being cooked or freeze dried and placed into capsules, they supposedly help the woman gain back her strength after the birth (see Medicinal Uses of the Placenta). Ok, I am going to draw a line here. If you want to eat your own placenta, fine. Personally, I would have to be bleeding to death before I would do so, but that's just me. But please, don't eat anyone else's. That's just gross. And probably not safe, either.

Must we go here? Apparently we must:
Placentophagy from Wackipedia
Wikibooks Cookbook

Unassisted Childbirth

Thanks to Hathor the Cow Goddess for this one. CPS in Spokane, Washington, removed a baby from his parents after an unassisted homebirth (a sucessful footling breech, if the facts are correct). This hasn't hit the mainstream media (yet), so I hesitate to publish facts that are unconfirmed, but here you go:

Midwifery Today Forums

Baby Davies

The baby was returned to the parents after a hearing. Apparently, mom is on some anti-depressants considered incompatable with breastfeeding, so she has agreed to wait until the drugs have cleared her system before resuming breastfeeding. The medical facts may be incorrect (there are very, very few drugs which can't be taken by a breastfeeding mother), but not an entirely unreasonable stipulation.

I hear this question a lot: Is homebirth legal? And I can't emphasize this enough - There is no state in which homebirth (attended or otherwise) is illegal. I heard someone say recently (thanks, Steve!) that "homebirth" is a noun, and nouns cannot be illegal, only verbs can be illegal; that is to say, only acts are illegal. There are many States in which a person (such as a midwife) performing certain acts at a birth (such as catching a baby, checking dilation, or administering pitocin for postpartum hemorage) are performing acts which are illegal (i.e. they constitute the unlicened practice of medicine or nurse-midwifery); therefore we say that "midwifery is illegal" in this State or that State.

When CPS investigates a family for homebirth or UC, what is really of legal concern is medical neglect. If the baby is not sick or injured, or is under the care of a doctor or other professional (such as a midwife in States where the scope of their license includes newborn care), there's not really any issue. Really.

Monday, April 17, 2006

Hot hot hot

It's mid-April and we hit 100 degrees in the DFW area today. That's 5 degrees higher than the record high, and 25 degrees above average.

The high in Green Bay, Wisconsin was 62, which is a little bit above average. For instance.

Friday, April 14, 2006

Breastfeeding Legislative Update - Mississippi

Miss. Gov. Signs Bill Requiring Designated Places for Women Breast-Feeding at Child-Care Facilities:
Mississippi Gov. Haley Barbour (R) this week signed a bill (SB 2419) that requires child-care facilities to designate a suitable place for women to breast-feed their infants or use a breast pump, the AP/Biloxi Sun Herald reports. Under the law, the location -- which cannot be a bathroom stall -- must have a comfortable chair, an electrical outlet and access to running water. Day care centers also are required to provide a refrigerator for women to store their pumped milk and must train employees how to handle it correctly, the law says. In addition, the law says that breast-feeding in a public place cannot be considered indecent exposure or disorderly conduct.
Oh yeah, that too.
It also allows any woman who is nursing an infant younger than age one to be exempt from jury duty and requires employers to allow a woman to use her lunch break or other designated break times to pump milk.
Looks like Mississippi did it all in one bill, instead of most states which needed to use four separate pieces of legislation to get the same effect.

Midwifery Legislative Update - Wisconsin

The Governor of Wisconsin signed SB 477 (PDF) into law on Monday. The bill provides for licensure and regulation of Certified Professional Midwives (CPMs), effectively legalizing direct-entry midwifery in that state. The effort was almost derailed - or perhaps bolstered, depending on your perspective - after the homebirth death of an infant attended by midwife without credentials:
"Because there is no regulatory law now, if someone is saying they are a midwife when they don't have all the training, the only thing the state can do is go into court," [Katie Prown of the Wisconsin Guild of Midwives] said.

"You have to wait for something bad to happen. Investigating health care practices through the court system is expensive. It makes much more sense to bring things under a regulatory structure," Prown said.
With regulation, you also get peer review, administrative hearings, and civil litigation. When a baby dies in a hospital, is the doctor ever arrested? Of course not. It would make no sense. If the doctor is incompetent or acted with negligence or worse (and sometimes when she hasn't) she gets sued, investigated by the state licensing board, and so forth. The criminal justice system is just no place to deal with a birth gone awry.
Although the legislation was introduced in the Assembly before the baby's birth and death during delivery, it gained momentum after the death. The prosecution, meanwhile, is something seldom seen anywhere in the country.

Helen E. Dentice, 51, of Milwaukee has been charged in a criminal complaint with second-degree reckless endangerment, unauthorized delivery of a prescription drug and practicing medicine without a license.

The charges were filed in Waukesha County Circuit Court last month after a lengthy review of the circumstances of the Nov. 28 stillbirth at the rural Vernon home of Brian and Bridget Stoiber.
I wanted to point out that midwives in illegal or "alegal" states have a real dillema when it comes to carying pitocin, oxygen, and other drugs and medical equipment. On the one hand, these supplies can save lives in an emergency. However, they open the midwife up to more charges such as "unauthorized delivery of a prescription drug." A midwife could go to jail for saving the life of her client.

Quotes above are from the Milwaukee Journal Sentinal article; and also see the Kaiser Network article.

Thursday, April 06, 2006

Midwifery is not the Practice of Medicine

This week, someone pointed me to a law review article by Suzanne Hope Suarez entitled Midwifery is Not the Practice of Medicine, originally published in the Yale Journal of Law and Feminism.

Wednesday, April 05, 2006

Making Memories

Today I donated my wedding dress (pictured, though that is not me wearing it :) to the Making Memories Breast Cancer Foundation. Just placed it in a box along with my shoes, my veil, some undergarments, my mom's mother-of-the-bride dress, and her veil, circa 1970.

Although I think it's cool that my aunt has her 25-year old wedding dress and my mother-in-law has her 50-year old wedding dress (that she sewed herself), I just can't bring myself to let my beautiful dress spend the rest of its useful life hanging on the back of the closet door. So, faithful flygal that I am, I flung it, ever so gently, off to a more useful existence.