Earlier in the semester, we have had class discussion about racial health disparities. We’ve discussed many of the ways racial experiences determine biological and social health of pregnant women, mothers, and infants. I briefly mentioned in class that the killing of black youth and young men by police officers could be a direct stressor to black mothers or soon-to-be mothers. The recent murders of black men and children (including Tamir Rice, age 12) and the failure of the justice system to indict their murderers is a violation of reproductive freedom, which includes the ability to choose to parent. Every mother is entitled to raise her child a safe environment. No mother should ever have to watch her child be murdered for existing and then watch his killer walk free. No woman should be afraid to become a mother out fear of bringing a child into a racist, violent system that will target him as a thug, a predator or a criminal.

Reflecting over the failure to indict Darren Wilson over the past week has caused me to wonder why some lives matter and why some don’t matter to our government. This question is connected to our last class discussion about what causes a political issue to receive attention or not. The murder of Michael Brown and the Ferguson protests have certainly gained attention in the media. But action against racial police violence has not received agency in our government. People are putting themselves in danger to protest racial injustice just as they have been doing for decades, but the government is taking little action. I believe that the answer to my initial question lies in century-old institutional racism that values white lives over black lives.

This article was posted in August, five days after Michael Brown was fatally shot. The following quote resonates with me conceding the connection of reproductive justice to racial justice:

It is here where the question of “Whose lives are valued?” enters into the picture, for how cheap must a life be if millions of onlookers can think that stolen cigars justify a murder? Can we have reproductive justice if the children of some are considered inherently less valuable by several orders of magnitude? If the life of a child or a young man or woman is so cheap that misunderstandings, small mistakes, or false accusations justify their deaths, what can then be said about the rights they enjoyed in life and how valuable they turned out to be?

Reproductive justice is about more than the right to choose whether or not to be pregnant. It includes ensuring that all lives are valued and each person has access to safety- free from violence against the body or livelihood. This can be applied globally; people deserve the right to reproductive justice no matter where they live, how much money they have, or where they stand in society. To ensure that reproductive justice is reached, we must work to dissolve the disproportionate violence faced by people of color and poor people. We must dissolve the devaluation of lives based on color. In America, we must start by protecting black lives from systematic violence and attaining justice for the lives that have already been lost.

In our last class we briefly discussed how giving birth is not celebrated, or recognized as a great feat like battling of cancer or surviving a disease. I thought about this some more over the course of the week and realized that we should be celebrating motherhood and one’s ability to deliver a baby safely. However, the difference between labor and diseases like cancer is that cancer is intended to kill you,childbirth on the otherhand is not.

I read a BBC article on how scientists are working towards understanding the reasons why some women have very easy births and some women have long hard labors that end in emergency delivery. The scientists are trying to figure out in detail, exactly how the womb works, so that they can learn more about prematurity, miscarriages, stillborns etcetera. According to the article, emergency caesarean births have risen by 50% in the last 30 years. At the centre for better births at the women’s hospital in Liverpool, a team of 20 scientists are looking at how the womb’s contractions are regulated and controlled. The article discussed determining having predictors for when a birth would be difficult (like the way they have biomarkers for diseases).

Going back to the class discussion on how and why certain people don’t die in childbirth, would expecting mothers in low income countries be a part of this research? Is this research going to encompass all people? are environmental and economic factors considered? ( availability of personnel and equipment/medicine, and like what happened with Monique?) How can these women be included? would this research only include women in middle/high income countries where maternal mortality is not as high?

http://www.bbc.com/news/health-22327882

Niger is a country in West Africa with the highest birth rate in the world – approximately seven children per woman. The government has recognized that fast population growth hampers the country’s development. Along with advocacy groups, the government has campaigned to delay marriage for teenage girls and encourage the use of contraception. However, in patriarchal societies, men are the primary roadblocks to social change. The “School for Husbands” is a program for husbands to discuss birth control, family planning, prenatal care, breastfeeding, etc. When the school started, only 5% of women in Niger used contraception. Now, up to 13% of women use contraception.

http://www.npr.org/blogs/goatsandsoda/2014/11/27/358113783/school-for-husbands-gets-men-to-talk-about-family-size

Do you have any additional ideas/suggestions for how husbands can be included in maternal health initiatives?

An article from Thanksgiving Day in the New Haven Register echoes the discussion we had in class on Monday. According to researchers, one in five new mothers may experience mental health challenges that impact their ability to effectively care for their children. A pediatrician is in a unique position to assess a mother’s mental state because that physician sees her so often at monthly well-baby visits. Generally, pediatricians believe it is important to promote maternal mental health at these visits because a mother’s mental well-being affects her child’s mental development. However, pediatricians sometimes struggle with how best to address maternal mental health concerns. Can you share any ideas/suggestions that were sparked by Monday’s discussion and/or the following article?

http://www.nhregister.com/health/20141127/study-pediatricians-could-help-identify-mental-health-illnesses-in-moms

PRONTO (a Spanish acronym for “Obstetric and Neonatal Training Program”) is a simulation-based training program in Emergency Obstetrics supported by the Bill & Melinda Gates Foundation. The basis for this training program is that healthcare workers in poor regions often do not get to practice for life-threatening emergencies. Read the following article for an example from Guatemala’s geographical “Corridor of Death”, where maternal mortality is triple the national average: http://www.impatientoptimists.org/Posts/2013/01/Combating-the-Daily-Tragedy-of-Maternal-Mortality-in-Guatemalas-quotCorridor-of-Deathquot.

Why do you think these simulations can lead to correct responses in actual life-threatening emergencies?

Bihar, India is the state with the highest fertility rate – 3.6 children per woman. Dr. Anita, a recorded voice, is a tool for community health workers that are reaching out to Bihar’s 27 million women of reproductive age. This mobile initiative is part of a Bill & Melinda Gates Foundation program to reduce maternal, neonatal, and infant deaths in Bihar by 2017. Health workers dial a toll-free number and ask women to listen to Dr. Anita, who validates the credibility of these community health workers. What do you think are other potential benefits of this audio tool?

Read the article here: http://www.hindustantimes.com/comment/sanchitasharma/a-mobile-key-to-maternal-health/article1-1284139.aspx

We’ve learned that restricting abortions leads to an increase in illegal abortions and an increase in complications from unsafe illegal abortions. Chile prohibited abortion in 1989. However, the number of hospitalizations due to abortion complications has declined by two percent every year since 2001. What do you think could be some reasons for this paradox?

http://dailydigestnews.com/2014/11/the-chilean-paradox-great-maternal-health-despite-abortion-prohibitions/

http://http://www.theatlantic.com/health/archive/2014/10/your-babys-leftover-dna-is-making-you-stronger/381140/

Part of the reason I am posting this is to know if anyone else knows anything about this? I am incredibly intrigued by this. I would like to see a study that outweighs the stress of parenting versus these biological benefits. And since the study was easier with males I would like to see more with females to see what the difference is, if any (they said it was more costly to study with female babies).

“There’s so much [epidemiological] observation out there,” Kamper-Jørgensen said. “Having kids protects you from breast cancer, but we don’t really know why. If you have kids, you live longer, but we don’t really know why. Women live longer than men, but we don’t know why. This phenomenon, this may be it.” I feel like this quote encompasses the mystique around the phenomenon, and therefore I believe there is much more to be studied. I am wondering if anyone else finds this interesting or even useful, or just a natural occurrence of no value?

http://http://www.huffingtonpost.com/2014/11/05/paolo-patruno_n_6101602.html

So when I saw the title of this article I expected to see women in absolutely unfit conditions to give birth. Now while these may not be ideal settings, I keep thinking of the idea that comes up in class that women have, and will continue to give birth. This comes to mind, because even with the limited resources associated with the locations of these countries, these women are still able to give birth to babies that look fairly healthy and the women look like they are in decent condition. The midwives and doctors serving them looked to be trained birth attendants as well. So while I think the article wanted to say these pictures are supposed to make one shocked at how poor the conditions are, for me it was a reminder that life finds a way. Now with this being said there is so much work that can be done to improve the birthing conditions in this part of the world as we discuss at length in class. Yet, I just wanted to post this article because the pictures are striking, but not for the reasons I expected.

Raine’s presentation on illicit drug use and alcohol consumption during pregnancy intrigued me a great deal. However, I left the class wondering about the relationship between over-the-counter medications and pregnancy. Thus, I perused the literature and the internet to learn about various medications’ effects on the fetus.

As Raine explained, the mother passes chemicals to the fetus through the placenta. Therefore, some medications that may benefit a mother’s ailment has the potential to harm the fetus. As a result, the U.S. Food and Drug Administration has developed a system for categorizing medications based on their potential to cause birth defects to the fetus. As a way to filter the information for pregnant women, various sources have posted lists of “safe” medications to consume during pregnancy. The first link contains a table of such medications. For example, the website states that acetaminophen (Tylenol),  guaifenesin (Mucinex), and loratadine (Claritin) pose low risk to the fetus. Unfortunately, however, these websites may misguide pregnant women. According to the study in the second link, sufficient evidence and research on the medications’ harmless effects on the fetus does not exist. Therefore, the “safe medication lists” mislead women to believe that an increase in risk for birth defects will not occur. Furthermore, as shown in the third link, the Centers for Disease Control and Prevention also report that sufficient information on the relationship between medication consumption and birth defects does not exist, stemming from the lack of studies including pregnant women to test the safety of the medications. Thus, various credible sources criticize the “safe medication” lists floating around the internet.

The idea of internet sources or media misleading pregnant women reminded me of Raine’s discussion about the Cosmopolitan article that promoted alcohol consumption during pregnancy. As we discussed in class, a woman may read that article without further investigation and assume that she can consume alcohol during pregnancy. The same situation may occur with these “safe medication lists”, for women may not conduct additional research or read the fine print that explains that the over-the-counter medications on the lists may actually increase the risk of birth defects.

http://www.babycenter.com/0_chart-over-the-counter-medications-during-pregnancy_1486462.bc

http://onlinelibrary.wiley.com/doi/10.1002/pds.3410/abstract

http://www.cdc.gov/pregnancy/meds/