To be a kid again...

Do you remember what it was like to, on a crisp fall day, run and play in the leaves?
Intead of thinking "OMG, when the hell am I going to have time to rake all those leaves?"











Do you remember the awe that you felt when going to the fair or festival and seeing those huge tractors and just itching to ride one?

Instead of looking at it like a hunk of metal used to get the work done?










Do you remember the excitement of the first snowfall of the year? Running outside to make that first snowball, that first snowman?
Instead of looking at it snowing in October and thinking "WTH?!?! Seriously, I don't have my leaves raked, the fertilizer down, the trailer put away" and on and on and on?














That's one of the greatest things about having kids. Seeing all those first and awe-inspiring moments again through their eyes. But truth is, I don't take enough time on a daily basis to really enjoy those moments. Or take the time to play with them in the leaves, or in the snow. "I'm busy right now" seems to be heard more than "the laundry can wait". And that's sad. Because I want to build those memories and traditions with the boys and our next child. I've been reading the The Happiness Project and finding quite some inspiration in it. I need to focus on my happiness in order for my family to be happy too. So, while I'm not going to intentionally step on someone's toes, I'm also not going to worry about other's opinions. I control my own mood. I choose my temperment. I choose to make memories and have fun with my kids.

They are sleeping right now. Snug in their beds. And I rocked my 4 1/2 year old to sleep tonight in front of the fire and loved it. WE played in the leaves in the front yard today and I saw a ton of smiles. From everyone. That's happiness.

Pregnant Women Support Act

In a previous post, I mentioned that I would provide some summary information on the Pregnant Women Support Act. I finally had time to wade through the bill (HR6145), so here are some details.

The findings (essentially the case for why the legislation is needed) are as follows:
1) There are 1.29 million abortions annually in America.
2) 48% of all pregnancies in America are unintended. Excluding miscarriages, 54% of unintended pregnancies end in abortion.
3) 57% of women who have abortions have incomes below 200% of the poverty level.
4) "Cannot afford a baby" is the second most frequently cited reason women choose to have an abortion; 73% of women having abortions cited this reason as a contributing factor.
5) This Act is an initiative to gather more complete information about abortion, to reduce the abortion rate by helping women carry their pregnancies to term and bear healthy children, and by affirming the right of women to be fully informed about their options when they seek an abortion.
6) The initative will work to support women facing unplanned pregnancies, new parents and their children by providing comprehensive measures for health care needs, supportive services and helpful prenatal and postnatal services.

Unfortunately, the statistics presented above do not appear to be cited in any way in the document. They do seem to correspond approximately with data I found on the Guttmacher Institute website; the most recent data from the CDC is from 2002. However, the data seems to be questionable, as a Health United States report gives two figures for 2002: 854K from the CDC, and 1.29 million from the Guttmacher Institute, with the difference reportedly being that Alaska, California, and New Hampshire did nto report this data to the CDC for 2002.

Moving on, with some notable highlights...

"The Secretary shall enter into an agreement with the Institute of Medicine to study the reasons why women choose to have an abortion. The Secretary shall ensure that a report from the Institute describing the findings of the study is submitted to the Congress not later than January 10, 2010."
I'm looking forward to seeing this, although it seems like it might have been more efficient to conduct a study on why women have abortions prior to introducing legislation purporting to reduce them.

"IN GENERAL.—Health facilities that perform abortions in or affecting interstate commerce shall obtain informed consent from the pregnant woman seeking to have the abortion. Informed consent shall exist only after a woman has voluntarily completed or opted not to complete pre-abortion counseling sessions."
Informed consent is good, and one hopes it's already in place everywhere.

"Counseling sessions under subsection (a) shall include the following information: (1) The probable gestational age and characteristics of the unborn child at the time the abortion will be performed. (2) How the abortion procedure is performed. (3) Possible short-term and long-term risks and complications of the procedure to be performed. (4) Options or alternatives to abortion, including, but not limited to, adoption, and the resources available in the community to assist women choosing these options. (5) The availability of post-procedure medical services to address the risks and complications of the procedure."
Not sure what is meant by "characteristics." Otherwise, everythiing else seems like standard practice. Civil remedies will be available where informed consent was not obtained.

There are several provisions in Title IV of the bill that prohibit insurers from imposing preexisting condition exclusions on pregnancy or denying coverage on the basis of pregnancy, requires insurers to notify women about adding their newborn to their coverage, etc.

"The Secretary may make grants for the purchase of ultrasound equipment. Such ultrasound equipment shall be used by the recipients of such grants to provide, under the direction and supervision of a licensed medical physician, ultrasound examinations to pregnant women consenting to such services."
Grantees are required to be eligible for Public Health Service Act funds, offer women the option of viewing the ultrasound images, and inform women that they have the right to know the general anatomical and physiological characteristics and approximate age of the fetus. I suspect this is a way to increase funding to "crisis pregnancy centers," where the ultrasound is not really being used for medical purposes, but as a tool to steer women into making a specific choice, not necessarily their own choice.

Provides services to patients receiving Down Syndrome or other prenatal diagnosis - women should receive "scientific, and nondirective counseling" about the conditions and accuracy of tests. The purpose of this section is described as increaseing patient referrals to support services for women who have received a positive diagnosis, ensure that patients receive accurate information, and approve data availability. They would establish a phone hotline and website for patients, national and local peer-support programs, a national registry of families willing to adopt newborns with this type of condition, and establishment of a clearinghouse of information on thse conditions, and education programs for healthcare providers.
Education is good. Scientifically accurate information is good. Undue pressure to put up children for adoption is not good. Be careful there, fellows. (I just read "The Girls Who Went Away" - review coming soon)

States may obtain funding for a separate program for domsetic violence, dating violence, sexual assault, and stalking screening and treatments for pregnant women and new mothers. This would include training health professionals to identify and respond to patients experiencing abuse, and ensuring that services are provided in a "linguistically and culturally relevant manner." $4,000,000 would be authorized for appropriation for each of the fiscal years 2007-2011.

States could receive grants "to increase public awareness of resources available to pregnant women who intent to carry their pregnancy to term and to new parents." This would cover identification of resources, advertising campaigns, establishment of a hotline to direct people to support services, adoption centers, and organizations that provide support to new parents.

Grants (not to exceed $25K) to public higher education institutions (read: state colleges and universities) to assist pregnant students who intend to carry their pregnancies to term through on-campus facilities. There is also mention of grants for child care for parenting students, although the details are not entirely clear.

Grants to states for early childhood education programs (including Head Start) to work with pregnant/parenting teens to complete high school and prepare for further education.

Title XI provides for grants to homes for pregnant and parenting women. The group homes must provide upon request adoption counseling and counseling on parenting skills.

Would expand adoption credit to $15K from $10K, with increases for inflation

Authorizes appropriations to WIC of $5,388,000,000 for FY 2007, $15,000,000 of which would go for breastfeeding peer counselors, $14 million for "infrastructure" and $30 million for management information systems.

I'd like to see those last two spelled out a little better.

Grants can be made to local health departments to provide eligible mothers with free home visits by registered nurses. "Eligible" means the infant is 12 months old or less, the woman was <20yo at time of birth, and the infant is the first child of the mother.

I'm on board with all of the post-birth assistance, referral to community services, consent, education, and promotion of breastfeeding. I do think this bill does some very worthwhile things, and at least partially addresses the old argument that if you want to reduce abortions, you have to make it easier for women to have children and support them after birth. On the other hand, the folks involved with this bill have proposed it as a means to reduce abortion, and I don't see a single thing in it about comprehensive sex education (big surprise) or contraceptives. There is nothing in here that addresses preventing pregnancy in the first place. Also, I think it's good if more women are referred to appropriate community agencies, but outside of the public health and Head Start things, I don't see an increase in funding for existing providers. If they suddenly become swamped with women, will they be able to afford it, and will women receive good service? I also see that universities and schools have the option to apply for grants to help their childbearing students complete school, but I wonder how many of these institutions will have the time and resources to put such grant applications together and follow up with good programming. There is nothing automatic here, but hopefully some of the schools will apply. With regards to high school students, the language states that the money is for early childhood education programs, but is not clear on whether high schools can directly receive these funds. I also don't see much that truly makes it easier for women to afford to have a baby, because there isn't a lot of substantial funding increase for prenatal care, the actual birth, or all the expenses that come with children (especially after the first year covered by the home visits, which are education rather than medical in any care). The WIC increase is not an increase in the amount of money women can get to actually feed their children. Finally, this legislation could be read as an attempt to push women into carrying a pregnancy to term (even when there is a serious genetic defect - the language beyond Down Syndrome is very vague) and giving up the child for adoption, while it does not in any way address the psychological consequences or provide post-surrender counseling for these women. It will be interesting to see how this plays out. Talk to Action also has interesting commentary on this.

Technorati Tags: Pregnant Women Support Act
MeSH Tags: Legislation; Pregnancy; Social Work

Supreme Court Abortion Case: Gonzales v Planned Parenthood

The Supreme Court is scheduled to hear arguments on Wednesday in the case of Gonzales v Planned Parenthood, regarding the question of "Whether, notwithstanding Congress's determination that a health exception was unnecessary to preserve the health of the mother, the Partial-Birth Abortion Ban Act of 2003 is invalid because it lacks a health exception or is otherwise unconstitutional on its face." It is related to another case, Gonzalez v Carhart.

Resources:
I'll update with a link to the arguments when available.
New York Times: The Roberts Court Takes on Abortion
Planned Parenthood: U.S. Supreme Court to Review Gonzales v Planned Parenthood
Center for Reproductive Rights
Commentary from The Well-Timed Period

Technorati Tags: abortion; dilation and extraction; Gonzalez v Planned Parenthood; Planned Parenthood; Supreme Court
MeSH Tags: Abortion, Induced/legislation and jurisprudence; Jurisprudence [for articles 1974-2002]; Supreme Court Decisions [for articles 2003-present]; "partial birth abortion" [keyword search - this is not medical terminology]

I just noticed that the NLM folks are indexing some "partial birth abortion" articles with the term "Infanticide," although it generally falls under "Abortion, Induced." Is this appropriate indexing, or a political bias? Discuss.

Note to the Foot Flushers

This NYTimes articles, Germs Never Sleep, makes a very good point in this piece on the measures people take to avoid germs:

"But some of the resulting behavior makes no sense, Mr. Sleeper said. The company’s studies have found bathroom users covering their fingers in toilet paper before flushing and using more tissue to open stall doors, even though there is almost no health reason to do so, because their next stop is the sink to wash their hands with soap and water."

Resource: The CDC's Handwashing Guidelines, just in time for flu season. When's the last time you washed your hands for a full 20 seconds, as the guidelines recommend?

Technorati Tags: germs; handwashing
MeSH Tags: Antisepsis; Fomites; Handwashing

A day late...and a dollar short.

That seems to be the story of my life. It's now November and I'm just now posting Halloween. But that not because we didn't have a great Halloween, we did! The boys LOVED it and the weather wasn't freezing and it wasn't raining or snowing. And in Michigan that's tough to do.

About a week before Halloween we carved our pumpkins. We always go to the pumpking patch and pick our own. But this year it was sleeting and raining for the two weekends prior to Halloween. So Daddy and I said screw it and took the boys to Walmart. Needless to say, they were NOT impressed. Traditions run deep around here even for a 2 and a 4 year old. Next year we are planning on trying our hand at growing our own. We shall see.

Here's the boys' pumpkins. Zachary chose his stencil all by himself. He decided he wanted a spooky alien. So I helped him put it on and we both poke holes in around the stencil. And then against my better judgement, I gave my 4 year old a little pumpkin saw. And he did it himself. (well, minus the fingers. I couldn't even do those right!)

Lucas wasn't too much into it though. He helped pick out the stencil and then sawed on some of the big chunks that daddy took out. Lucas sooo wanted to be a big boy, but just couldn't seem to grasp the concept of it, nor have the patience for it.

Then came Halloween. The boys were ecstatic. We left about 5:45 and it was a bit cold. Not freezing mind you, but enough to turn the boys' cheeks red. Zachary wanted to go home after, oh, about 7 houses. Lucas said "NO! More trick or treating!" So, onward and more candy we went. After a while, it suddenly got warmer. No lie. So we went on. Trick or treating and saying Thank You at every house. But we went about 4 houses too much. Because that's when the 2 year old meltdown occurred. Zachary was such a trooper during it...paying attention to me, staying close by as Lucas threw himself into the middle of an intersection. And when I told him to get up or I would drag him home by the ankle, he stood up and threw his light saber (that Buzz Lightyear HAD to have) down screaming. *sigh* 1 week and I'm already ready for the terrible two's to be over.

Now, we have about 4 buckets of candy and I keep getting yelled at by Chuck to leave the kids' candy alone. Come on, now, that's like telling a cow to not eat the grass she's standing in, isn't it?

Off Topic: Animal Cams

The National Zoo has multiple cameras that you let you view many of the animals from your computer. See the complete list and select the exhibit you'd like to watch; so far, I've been watching pandas and cheetahs and giraffes, oh my! The resolution can be kind of poor, but I happened to catch them feeding a tiger cub. Very cool.

On a related note, check out this recording of a Florida panther from All Things Considered.

Technorati Tags: animals; National Zoo; webcams
MeSH Tags: Animals, Zoo

About Me, My Blog

Since David full on outed me (although you could have put it together, and I do have a picture up), the time has come for an About the Author post.

About Me:
I'm a medical librarian. I have a graduate degree in library and information science (MLIS) from the University of Pittsburgh, where I focused on medical librarianship. I currently work in a prominent academic medical center library, where I was promoted from the paraprofessional ranks and am now a Library Fellow (I worked there while obtaining my degree). I serve as Editorial Assistant for the Journal of the Medical Library Association and handle clinical questions for medical center. I have also worked with our digital library, budget, weeding, our management contract of another medical library, proposal-writing, reference and circulation, web updates, staff training, job candidate screening and interviews, and other projects.

Previously, I worked as Program Assistant and then Communications Coordinator for a non-profit organization focused on promoting renewable energy and energy efficiency. We also worked on mitigating the health effects of dirty power sources. I handled technical problems, website management, database management (10K+ records in a Filemaker Pro database I periodically customized), distribution of emails, faxes, and press releases to donors, members, and activists, politicians, and news outlets, and served as co-editor of the quarterly newsletter. On occassion, I did public outreach at events. See how that ties in to librarianship?

Prior to my graduation from Oberlin College (where I was a geology major), I worked as a Student Assistant and then Student Manager of the Oberlin College Science Library. I received a Metcalf Award for outstanding library service. As a result, I have a lifetime membership to the Friends of the Oberlin College Library. Also while at Oberlin, I took an EXCO course entitled, "Menstrual Health and Politics."

Why Women's Health?:
I like technology, and wanted to play around with blogging. I had (and still have) an interest in women's health, and at the time was taking a course [#326] in Vanderbilt's graduate nursing program on women's health issues. (As a project for this course, two colleagues and I created an online tutorial for nursing students on how to search popular databases for women's health literature.) I knew I needed a focus, and focusing on a health topic is a good continuing education exercise for me. I think a lot of women are underinformed about their bodies, their health, and the policies affecting their health choices, and I hope to use this blog to provide a source of information about those topics.

The Comments Policy:
Comments are expected to be civil. They are also expect not to be spam. If you post a glowing comment about how awesome my blog is, but link to your internet drug site or other venture, it will be deleted. All comments are subject to deletion at my discretion. I don't delete them just because I personally find the argument offensive, but may for any other reason.

Can I Send You My Film, Book, or Other Material to Review?
Please do, but send me an email first so I can give you my address. The item should be women's health, general health, healthcare policy, or otherwise related to the content of this blog. I will not guarantee that the review will be positive, or even posted, and all reviews will mention that the item was provided for review (as opposed to found to be of interest by me independently).

Can I Link to You?:
Yes. Without reservation. I think attempts to prevent links or deep-linking are intellectually dishonest and a hindrance to the benefits of online media.

What's With the Ads?:
Librarianship doesn't pay a lot. The ads pay even less. I do block some advertisers if I have a personal issue with their content or the product or persons they represent. Thus far, I have blocked ads for an infant formula maker, censorware (website blocking technology), a diet pill site, and a conservative book club. I do not vouch for the usefulness or even accuracy of the material presented behind the ad links.

A Final Note:
The opinions expressed here do not represent those of my employer. This blog is my work, independent of my actual paying job, and it is my responsibility alone.

Technorati Tags: about; blogs; librarians; medical librarians; women's health
MeSH Tags: Librarians; Libraries, Medical