The heritage of the poverty cycle, made worse by public policy

| | Comments (2)

In Turnabout, Infant Deaths Climb in South

One of the big puzzles of modern life is the association between poverty and obesity. One would think that being poor would mean having less food available, and hence being underweight. But one of the 'miracles' of modern intensive factory farming is the availability of cheap sources of calories that do not contribute much to health at all. For example, high fructose corn syrup, found in almost everything.

My maternal grandmother was often poor. But in those days, the kind of food help given to the poor was in the form of actual food. They got beans, canned meat, government cheese, oatmeal, canned fruits and vegetables, etc. It wasn't the world's best, but it provided a base for home cooked food. And the packages had recipes, too. Now we provide food stamps or the equivalent in an electronic benefit card. And so people can make the same sad food choices that the Standard American Diet provides - chicken nuggets, cheap packaged dinners, twinkies and ho-hos, and so on. We have a couple of generations who just don't know how to cook and who eat based on what is cheap, convenient, and loaded with 'taste-good' chemicals.

Another contributor to infant mortality is babies that are born to moms who, though they may really want to do the best by their babies, just don't have the resources. A single teen mom can be a good mom but it is darned hard when the FOB just isn't there. Marriage, even shotgun marriage, used to protect the moms and babies to some extent. But that just isn't happening anymore. And we have so disassociated sexual activity from procreation in our culture that many young girls (and boys, too, for that matter) are just stunned to learn that they are pregnant. Chastity and marriage, it seems to me, might also help decrease the infant mortality rate.

Prenatal care is also important, but there is an interesting qualitative difference between the care given by the average OB and the average midwife (CNM or CPM). Medical training is based on a model of early detection of problems and early intervention via technology. Midwifery training is based on a model of primary prevention of problems through education, nutrition, social support, and referral to the medical model where appropriate. In the 1970s, there was an interesting natural experiment in Madera County CA. The infant mortality rate was higher than it should have been, because moms were not coming in for prenatal care and they were presenting to the hospital with advanced cases of many preventable problems. There were not enough OB physicians in the community to provide all the needed care, at least partially because the rate of reimbursement from the state was not even enough to meet the cost of doing business. So the state brought in some CNMs to provide the care, and the infant mortality rate went down. After a while, the state decided to increase the rates of reimbursement for maternity services, and the docs came back, got rid of the midwives, and guess what! the infant mortality rates went right back up.

I don't think that it would be possible to solve all the problems cited in this NYT report just by bringing in midwives and making them part of the system. But I think that it would be a good starting point. Local clinics with accessible hours, staffed by midwives and nurses, would really make a difference. Too bad the local politics will probably totally block such an intervention.


If you break out your stats by race and age of mother you will achieve enlightenment.

I am a very pro-midwife mom -- but Alicia, there are many midwives who do NOT "refer to the medical model where appropriate" for mothers with hyperemesis gravidarum.

I volunteer for the hyperemesis education and research (HER) Foundation now, and from my experience there, the moms with midwives get the worst treatment for HG, and lots of "crackers" (ie. ignorant advice and treatment.) Trying to get referred to an OB can be a nightmare -- while the woman loses 20-30 lbs, they often hear nothing but chastisement from the midwife and "but you need to EAT for this baby!" Duh -- hard to do when even water is immediately vomited up.

I know you treat HG early and aggresively (God bless you, over and over!) but this is a gaping whole in midwifery care world-wide, from my experience working with HG moms world-wide.

God bless your grandaughter and daughter, by the way!

February 2013

Sun Mon Tue Wed Thu Fri Sat
          1 2
3 4 5 6 7 8 9
10 11 12 13 14 15 16
17 18 19 20 21 22 23
24 25 26 27 28    
The WeatherPixie

About this Entry

This page contains a single entry by alicia published on April 22, 2007 12:15 PM.

rest in peace was the previous entry in this blog.

school shootings,science fiction, and "new age" theology is the next entry in this blog.

Find recent content on the main index or look in the archives to find all content.