An intriguing article
from a family practice doc about why many docs refuse to perform abortions. Loads of internal links in the article, as well. Link courtesy of Catholic and Enjoying It aka Mark Shea's blog. Lots of other good stuff there today, as well.
alicia: January 2003 Archives
One of the great things about doing this training has been those with whom I am spending my days. I go to a lot of continuing education events, but this is the first one that included references from Humanae Vitae on the the very first day! Not only that, every one prays before eating at meals. Part of our group is staying at a retreat house rather than a hotel. Two of the physicians are members of St. Luke's Guild, for Catholic physicians. I have heard many stories of how individuals made the decision to stand up against the prevailing culture of death in big and little ways. I have been humbled to hear these stories, and I only hope that I will be gifted with the courage to do likewise.
My friends, please pray for me and for others in the healing professions. It is not easy these days.
A friend sent me this - I thought it very interesting.
Long-Term Physical and Psychological Health Consequences of Induced Abortion: Review of the Evidence
John M. Thorp, Jr.[*], MD, Katherine E. Hartmann, MD,PhD[**], and Elizabeth Shadigian, MD[***],
Induced abortion is a prevalent response to an unintended pregnancy. The long-term health consequences are poorly investigated and conclusions must be drawn from observational studies. Using strict inclusion criteria (study population >100 subjects, follow up >60 days) we reviewed an array of conditions in women's health.
Induced abortion was not associated with changes in the prevalence of subsequent subfertility, spontaneous abortion, or ectopic pregnancy. Previous abortion was a risk factor for placenta previa. Moreover, induced abortion increased the risks for both a subsequent preterm delivery and mood disorders substantial enough to provoke attempts of self-harm.
Preterm delivery and depression are important conditions in women's health and avoidance of induced abortion has potential as a strategy to reduce their prevalence. Only review articles including the single published meta-analysis exploring linkages between abortion and breast cancer were relied upon to draw conclusions. Reviewers were mixed on whether subsequent breast neoplasia can be linked to induced abortion, although the sole meta-analysis found a summary odds ratio of 1.2 [sic; should be 1.3].
Whatever the effect of induced abortion on breast cancer risk, a young woman with an unintended pregnancy clearly sacrifices the protective effect of a term delivery should she decide to abort and delay childbearing. That increase in risk can be quantified using the Gail Model. Thus, we conclude that informed consent before induced abortion should include information about the subsequent risk of preterm delivery and depression. Although it remains uncertain whether elective abortion increases subsequent breast cancer, it is clear that a decision to abort and delay pregnancy culminates in a loss of protection with the net effect being an increased risk. [end of abstract]
To get the full article, send your request to: John M. Thorp, Jr, MD, Department of Epidemiology, School of Public Health, University of North Carolina, Department of Obstetrics and Gynecology, School of Medicine, Chapel Hill, NC 27599.
OBSTETRICAL AND GYNECOLOGICAL SURVEY; 2003;58(1):67-79 by Lippincott Williams & Wilkins, Inc. CME REVIEW ARTICLE 2
I went to a parish I haven't been to before. Something about needing to go early enough to make it down for day 2 of 8 in the training I am doing. I got there a little late, just as Father was starting the homily. I admit I was a little concerned, especially after I looked up the hymns listed on the board. I was blown away by the homily, though. I wish that I had brought a tape recorder or taken notes. Basically, Father talked about the human tendency to think that we can solve problems by either throwing money at them and/or by hiring tons of experts to solve the problems. He went on to say that most of us will only pray when we have tried to fix things ourselves and it doesn't work. Then Father got into the meat of the homily. "What we must do, and do first, is to pray. We are in a war, and we do not battle against people but against powers and principalities. And here is our weapon", at which point he pulled out a Rosary and held it up. "And our other weapon is here in the little house of gold. Eucharistic Adoration, the Rosary, daily prayer - these are our weapons." I was absolutely blown away. Turns out this parish has volunteered to build a space and coordinate stuff so that we can have a 24 hour perpetual (yeah, I know that is redundant!) adoration chapel. What a great start to the day.
Just a brief note about where I spent all day. It was great to be with a bunch of health professionals with similar values. There were 2 pediatricians, and a pair of family practice docs (married to each other) as well as several other moms etc. This was educational phase one training in the Creighton Model. When done, we will all be Fertility Care Practitioners of some kind.
Lots of great stories mixed in with the in-depth information. We start again tomorrow morning at 1030. I guess I end up going to early Mass!
Something I love about the internet is that I am not tied to my home computer. Right now I am sitting in the call room of a major community hospital, waiting to see if my pager will go off. Because I live 44 miles from the hospital where I catch babies, I routinely spend the night here even if there is nothing much going on. It is pretty great because the hospital cable TV has EWTN on 24/7, unlike my cable at home which randomly is switched to some Benny Hinn spouting christian station. (I actually have this image of shifts changing at the cable company, and the officer of the day changing the station to his or her christian/inspirational station).
What follows is a composite of actions that makes up a 'typical day'. I see between 14 -18 patients in the office, ranging from a 17 y/o having her first baby in for a first prenatal visit, to a 60 y/o in for an annual exam. There is also a sprinkling of random 'female complaints'. About 1/3 of my patients spoke spanish only. Most have no insurance. The legal residents that are pregnant usually will get medicaid. But we see them all, regardless of insurance or none. I just wish that the Catholic Hospital down the road would do likewise.
After the clinic ends, I head over to the hospital. Some days it is crazy, others pretty dull. There will usually be several in and out visits by women with various issues. Am I in labor checks, back pain, I didn't go to school today and now my probation officer needs a doctor's note or he'll throw me in jail, gall bladder attacks, baby not moving, baby won't stop moving, I haven't slept for 3 weeks, acute asthma (usually in smokers!), I fell down, I got beaten up - we see it all. If the woman is pregnant, the ER usually doesn't even ask what the problem is - they just send them up.
On a good night I will have one mom in labor who will birth around 3 am and be happy. On a bad night I will have nothing but in and outs and not get any sleep, or I will have 2 or more moms in labor that both need me all the time, and I will be wondering how far apart their babies will come and if I can do them justice. On a really bad night, I will have in and outs, moms in labor, and one or more who end up needing a cesarean for some reason.
But the thing that makes it all worthwhile is to look into a newborn's eyes and realize that I have been privileged to be part of a miracle. I mean, how many people get a chance to earn their living sharing in miracles on a daily basis?
How to share the truth of the humanity of the unborn? Science for Unborn Human Life is a beautiful resource. Thanks to Bill Cork at Ut Unum Sint for the link.
Next week, I will be taking an 8 day intensive course in the principles of Natural Family Planning and gynecological problem solving. I will probably not be blogging a lot between 1/24 and 2/1, as I study and learn. This course is being offered only 1 hours drive from my home (yeah!). I hope to gain some new knowledge and skills. Many of you may not realize it, but the practice of contraception and the use of birth control pills for gynecological conditions is very tightly woven into our health care system. Learning to do without is in many ways similar to giving up an addiction.
My 14 year old daughter and I have been having some heart to heart talks lately, now that she has become an only child. (The perils of being the youngest of 6!). She is in 9th grade at the public high school. She is trying to figure out how one of her best friends can justify being both a vegan (on ethical grounds) and pro-choice. Reminds me of the clashing bumper stickers - "Save the whales" and "If you oppose abortion, don't have one". This car also stated "I'm pro-choice and I pray" and "Stop animal cruelty". How can people be so incongruous?
Davey's Mommy asks me what my take is on the concept of abortion to save the life of the mother. I am reminded of the bumper sticker Abortion: One Dead, One Wounded. We got into the whole abortion debacle with the idea of 'Therapeutic' abortion, abortion intended to save (initially) the life of the mother. Then it became health, and then health was expanded to include mental health, and so on.
As we come closer to the tragic anniversary of Roe vs.Wade, I think we are all thinking deeply about this topic. Over at Atheist to a theist, Jeff Miller has a great item about the position of various religious groups on abortion.
And Then has a link to an item about the Polish government's efforts to remain pro-life despite political and economic pressures from the European Union. Earlier today I heard a program on EWTN about the pro-life battle in Ireland. There is a lot of good stuff out there especially this week. Check around. I also have a number of pro-life sites on my blogroll.
The National Catholic Bioethics Center has a confidential consultation available via email. Although there are very clear guidelines for Catholic hospitals and health care organization, they are often not honored or the exceptions become the rule. Alas, one can not even rely on most 'catholic' physicians (any more that on 'catholic' politicians).
There are really very few situations grave enough that without intentional abortion, the mother will die. I actually can't think of any where the treatment (which may be dangerous to the baby) can't be justified under the principle of the double effect. We do have a responsibility to take ordinary means to preserve health, but we are not required to try to live forever or at the expense of another. I cannot demand that a relative give me their heart or liver if mine have failed - I cannot protect my life at the expense of another. If my unborn child truly presents such a risk to my life, I still have an obligation to protect both my life and that of my unborn to the highest degree possible. At the point where the baby has a fighting chance to survive if born, induction of labor (or cesarean) is an option.
I recently cared for a woman whose baby was diagnosed prenatally with a lethal defect. Part of the skull had not formed, and the brain tissue was exposed and floating in the amniotic fluid. This woman and her family elected (against great pressure) to continue the pregnancy. She birthed the baby 4 weeks before her due date (similar to her other children) and held her daughter until the baby died, about 1 1/2 hours later. I baptized the baby as soon as she was born. One of the pressures this mom faced was the argument that there was no need for her to stress her body with pregnancy for a baby that was just going to die, and didn't she just want to get it over with? Her response (which I shall treasure forever) was "This is all the time I will have with this child. Leave us alone!"
If any of you have a specific medical condition that you are concerned about, please let me know. I will be glad to research it.
Read the comments attached to the post about the "R-rated" conversation. Sometimes posts take on a life of their own. Hard cases make bad law, I have been told. Hard cases held up before the public eye have all too often been the first step down the famous slippery slope. Hard cases became the incentive for the infamous Lambeth declaration, in which the Church of England reversed centuries of opposition to artificial birth control. Hard cases became the reason behind intentional sterilization, behind abortion, behind divorce. Anyone reading Humanae vitae can see how prescient it was. What started as a difficult, thoughtful, anguished decision eventually became commonplace and even expected.
I have been involved in the care of pregnant and birthing women for nearly 20 years, the last 7 as a certified nurse-midwife. I started my professional career as an RN on the High-Risk OB unit of Los Angeles County's biggest hospital. I saw women who were pregnant and had medical conditions that I had not seen before (or since). By far, the vast majority of these women went on to have pregnancies and births from which they and their babies emerged in reasonable shape. Some of them had miserable pregnancies, some had very scary births, but most did OK.
There are in reality very few medical or obstetrical conditions that make a pregnancy (first or repeat) truly life threatening. In many medical conditions that make pregnancy unwise, God also makes the woman infertile (for example untreated insulin-requiring diabetes). I have been trying to bring to mind the permanent or not easily treatable conditions that might make pregnancy life threatening to the mother. I can only name a few - there are probably some others, but here are the few I can think of.
Cardiomyopathy: This is a heart condition that sometimes strikes during or just after pregnancy. The heart muscle is weakened. If there is a spontaneous recovery with no residual damage, repeat pregnancy still carries an increased risk which cannot be quantified.
Severe diabetes: diabetes which is under control carries added risk to both mother and baby. Diabetes accompanied by heart, kidney, or nerve damage can cause pregnancy to be a life and health threatening event to the mother, and babies born to moms with severe diabetes have a higher than normal rate of several birth defects.
Prior organ transplant: this is variable. There have been successful pregnancies with little or no damage to mother or baby, but the care during and after pregnancy is intensive for both mother and baby.
Active cancer: again, there is a lot of variation. I have been involved in the care of pregnant women with cancer. It is a challenge, but not impossible. It would be preferable to delay pregnancy until the cancer is in remission and shows no signs of recurrence, but this is not always possible.
AIDS - Being HIV positive is not an absolute contraindication to pregnancy, but pregnancy is probably unwise from several points of view. Active AIDS - a pregnancy would probably shorten mom's lifespan, by how much is unknown.
Recurrent hyperemesis of pregnancy - this is a difficult call, because so little is known about this condition.
Things that do NOT necessarily mandate no further childbearing are such complications as post-partum hemorrhage, eclampsia or pre-eclampsia, gestational diabetes, prior cesarean delivery (even prior uterine rupture is not an absolute contraindication), chronic hypertension, advanced maternal age. Each of these does carry a certain level of risk, but then so does getting out of bed in the morning or riding in a car at any time.
I plead with anyone who is contemplating sterilization or other irreversable decision, please get all the facts. Get your records and review them with an expert or two. A book I highly recommend is Life Giving Love by Kimberly Hahn. There is sage advice about many hard cases, from a profoundly pro-life and Catholic point of view. and, first, last and always, pray.
Madeleine L'Engle, a writer I greatly respect even when I disagree with her, has this to say:
"One of the most pusillanimous things we of the female sex have done throughout the centuries is to have allowed the male sex to assume that mankind is masculine. In The Irrational Season she goes on to insist," It is not. It takes both male and female to make the image of God."
I heartily concur. See Genesis 1:27.
In Penguins and Golden Calves: Icons and Idols L'Engle goes on to say:
"...our attempts at inclusive language (which thus far) have been inconclusive and unsuccessful...In language, as in life, male and female need to love each other...We need more poets, more artists who understand how to express in metaphor and icon that which cannot be expressed in finite words."
Totally ignoring (for now) the very real theological errors brought in by the inclusive language movement, far too many of the changes it has wrought have been downright ugly. Asexual language is bleak and deprived.
An interesting opinion on the Novus Ordo mass from a student at Franciscan. Thanks to Jeff at El Camino Real for the link. Jeff also comments further at Caritas Unitas et Veritas.
Pete Vere from Envoy Encore (and other sites!) asks us to look at CIEL-Canada and I also suggest CIEL-UK.
Does anyone know if there is a similar group based in the USA? I am very frustrated by the way in which the ICEL has butchered the translations of liturgy. I have a lengthy rant to make some day about the idiocy of so-called 'inclusive language'.
This has been a hot topic around St. Blog's lately, and seems to get almost as much air time as the death penalty and the rad-trad/neo-con debate. Over on Caritate Dei , Ad Orientem, Victor Lams, and even Exceptional Marriages one can find good natured debate and hair-pulling angst. Michelle at And Then had something to say about applause during Mass. All this was percolating in my brain during Mass this morning.
When I got home from work this morning, things were running late, and we couldn't make the 1030 at our usual parish (the one where we are in the choir). So we attended 1100 Mass at the big parish in town, the one with the regional Catholic elementary school. Many of our daughter's High School friends and teachers attend, so she is always bugging us to go there. I've been to Mass a few times in this Parish before. Daily Mass is usually OK and pretty well attended because it is at noon. I have winced my way through Sunday Mass there a few times, but today I really was upset.
We got there late (getting teenagers out the door can be brutal), just in time for the first reading. We couldn't get into a pew - there were spaces but they were behind the pillars and no one would move over. OK, it's our fault anyhow for being late. Standing through Mass is penance for running late - that's fair. There was no choir at this mass, just a cantor and a keyboardist. The responsorial song was nearly unsingable even for us, I couldn't hear anyone in the congregation joining in at the response. IT was from the back of the OCP Music Issue. I don't really understand how anyone can take the Psalms and uglify them to that degree. The celebrant kept emphasizing every third word or so, and I didn't recognize the Eucharistic prayer he used. I found myself listening closely to be sure that he didn't omit important stuff in the consecration. It was so 'politically correct' - instead of disciples he said 'friends' and the like. The mass parts were decently sung, and the communion song was "Shepherd Me O God", which I happen to like. I am not sure how appropriate it was to communion, though. I see it more as a responsorial psalm, as the verses are pretty tricky for the average congregation to sing. What really got to me happened right after communion. When everyone was back in the pews, the cantor launched into a solo piece of music, not even a particularly beautiful hymn or one that had really meaningful text (actually, all I remember was the repetition of Allelulia) and sang 4 verses with refrain. At the end, the congregation applauded. My husband had to physically restrain me. I was sick at heart and disgusted. The celebrant then launched into an amusing anecdote, the announcements, and the closing prayer. Only obedience kept me from storming out of the building when the applause started.
Why is it that so few people seem to realize that Mass is NOT performance art?
cool - now I, too, can do quizzes and post results.
You're thunder! You can be very loud but very quick. You probably like to talk on the phone, because you are VERY talkative.
What element are you?
On January 12, 1973, I was received into the Holy Catholic Church. My sacraments were administered by Fr. Randall Roche, S.J., in the Huesmann chapel on the campus of Loyola Marymount University, El Pueblo de Nuestra Senora Reina de los Angeles (better known as L.A.). It was my 18th birthday.
My parents met in the choir of a Protestant Episcopal church in San Diego CA. They married, young, in that same church. I was born 46 minutes after the end of my mother's 17th birthday. Happy birthday, mom, and thanks for choosing life for me and for my brothers and sisters. I was baptised at an Episcopal church in the SF Bay area when I was a few months old. My dear godmother (with whom I still keep in touch) is Russian Orthodox. I lived in England from age 3 to age 6, attended Episcopalian day schools until I was 10 years old, and was confirmed and communicated as an Anglican. I was very happy as an Anglican, and I still miss the liturgy and the small church community feeling. I also miss the music and the chant. I visited other churches (notably Lutheran and Methodist) as a child, and even attended a few Latin Masses with friends (which I found very disappointing).
So how did I end up Catholic?
My family was posted to France when I was 10. We left our Anglican parish behind. We were living out in the country as the only English speaking family in the small village of Premontre. I should mention that this village is home to an Abbey that I later found was founded by St. Norbert .
If we wanted to go to church on Sunday, we had 3 choices. The generic protestant service at the military base, Mass at the base, or Mass in the village. My parents stopped going to church entirely. I was scared to go to the local mass (still in Latin) so I quit going to church, too. I was angry that MY church seemingly didn't exist. What was it with these Catholics? Everywhere THEY went, they had the comfort and familiarity of their specific liturgy, but I could only get mine if and when a liturgically minded Protestant pastor came to base. It just wasn't fair.
Back in the states, my parents continued not to go to church, and I continued to go to various churches on occasion. The various Protestant churches of my friends had great youth groups and lots of fun activities. I went on a camping trip with some Baptist friends. They were miffed that I wouldn't answer the altar call. I told them that I was saved when I was baptised as a baby. I also refused to hand out tracts to the other campers.
By the age of 14, I was really seriously confused by this whole religion thing. I met my first serious boyfriend at a school dance. I was a freshman at the public school, he was a junior at a Jesuit high school. He believed and lived his faith. We went out for 6 months, and then my family uprooted again and I ended up 3000 miles away. At the same time I was dating this young man, I was also regularly babysitting an Orthodox Jewish family's children. I threw myself into learning about religion and history.
My next boyfriend was Anglican but his parents had sent him to Lutheran schools. That didn't make a lot of sense to me. I continued to study but didn't reach any conclusions. My third boyfriend was raised Catholic, and I went to Mass with him and his family at least partly to impress his family. But it all started to make sense, then, all the studying I had done. At the age of 16, I decided that the only two religions that made any sense at all were Orthodox Judaism and Roman Catholicism. Since I had accepted Jesus as my Messiah and saviour, that left me no alternative.
On my own, I signed up for the 'Inquiry' classes at my boyfriend's parish. I went through the process, and wanted to enter the church at Easter, but my parents threw a fit. They told me I didn't need to leave the Anglican church, they trotted out the branch theory, and they finally forbade me to enter the Roman Catholic church. I frankly was surprised, since they had left church to the point where they hadn't even baptised my baby sister. I took the issue up with the pastor. He told me that the I was to honor my parents, and that while I was legally a minor, I could not join the Church. The only exception would be if I were in danger of death. Sadly, I agreed.
I broke up with that boyfriend around the time we both started college. I chose to go to a Catholic school, and my parents didn't object because it was close to home. The moment I hit campus, I sought out a chaplain and explained my situation. We were able to get the needed permissions from the Diocese and so, the day I turned 18, I was in!
The last 30 years have been a bumpy road. Becoming Catholic and learning what it means to be Catholic are very different things. I have not always been obedient to the church, I am certainly a sinner and I am so grateful that Purgatory is an option! As I age, I am becoming more appreciative of the sacrament of Penance. God has been generous to me. Shortly after my reception into the church, He sent me the wonderful man to whom I am married, and as fruits of that marriage, 6 wonderful children. I was able to celebrate the Sacrament of Matrimony with the assistance of the same priest who heard my first Confession, Confirmed me in the faith, heard my profession of faith, and gave me my first Holy Communion.
I will close this longish memory with a quote that certainly applies to me. "To be deep in history is to cease to be a Protestant."
One last note - my husband's birthday is the Feast Day of Saint Norbert. God has a strange sense of humor!
This link should take you to a top ten list of Catholic Periodicals. Let me know what you think! Gift subscriptions gratefully accepted.
I am a compulsive reader. As a child, I read my way through dictionaries, encyclopedias, textbooks, and the Book of Common Prayer. I love to get new things to read, especially in the snail mail. There is something about the feel of paper and the smell of ink that no screen, even with the greatest pictures and video, can easily replace.
I currently subscribe to around 20 journals and magazines. The selection is fairly eclectic - Midwifery Today, Magnificat, Ladies Home Journal, Reader's Digest, Journal of Ob/Gyn (the green journal), Envoy, Today's Liturgy, Asimov's Science Fiction, Women's Health in Primary Care, Catholic Digest, Cooking Lite, and a few others. I am trying to control my addiction, but there are still periodicals that I lust after.
I worry about the decreasing literacy of the next generations. My children are all readers, voracious readers. I tried to have a plentiful supply of quality words around for them to read. I think that it is fair to say that I read my way into the church, and as I continue to read I learn more about my adopted faith. I have found the writings of those who have gone before me to be valuable. I find audio and video tape apostolates to be valuable. Still, I maintain that there is nothing like a book or pamphlet to stir up discussion and spur critical thinking. I have not forbidden television, radio, or movies to myself or my children. I was concerned about the 'forbidden fruit seeming sweeter' phenomenon. There is good to be found in all media, as well as filth and garbage. An advantage to printed media is that it is processed a little more slowly, and that it requires the use of the imagination to a degree that is not true of other media.
So here is a thanks to all the writers, past, present and future. May they all continue to write and to be read.
The customer support at enetation has been helpful. It turns out that I needed to put two blocks of code in the template - which I just did. Let's see if this works to get the commenter up. The next thing I need to figure out is how to put my email address into the 'mail me' slot, and then to work on putting up links. Who told me this was a simple 'turnkey' operation? I have news for you......
OK, I am trying to get a commenter up and running. Most of the free services aren't taking new customers. My personal tech support (22 y/o son) is 3000 miles away. I couldn't figure out how to get a blog linked to my personal web page, so I've gone to blogspot for now at least. I am not an idiot, but it seems to me that the various services assume a basic level of knowledge that I just don't have. Very frustrating! I've been on the internet since 1994. Why is this so hard? The message gets lost in the medium. There is probably a metaphysical message there that I am too ticked off to see.