March 2006 Archives

More on the cesarean conference

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NPR coverage
I didn't listen to it in real time. Every local station around here is doing fundraising and I can only stand so much gimme gimme. Even if it does help pay my husband's salary.
Oh, and NPR's blog is also starting to heat up. Join the battle here

NIH conference proceeding

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The National Institutes of Health (NIH) Consensus Development Program: >Cesarean Delivery on Maternal Request
I think I'm going to puke.

The pre-existing bias from the panel was incredible. The voices of the public who tried to contribute any alternative point of view were being ignored. About the only thing that was semi-reasonable was that they acknowledged that the risks of repeat cesarean increase with each one - but my cynical side sees this as being a method of bringing those of us who want large families into line with the ZPG crowd.

seen on several fine blogs

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Please pray

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I have a very good on-line friend, a member of the PCOS community, who is very early in pregnancy.
In 1991 she had an uneventful pregnancy, and that baby was later murdered by the baby's dad (my friend's first husband). She has also had at least one ectopic pregnancy.
A few years ago, she had a very preterm birth and the baby only lived a very short time. (Her now-husband is a gem, a wonderful man!)
Since then, she has been trying both to keep healthy (very difficult with PCOS) and to have another baby.
She just found out today that she is pregnant again - she had thought that this was an anovulatory cycle but lo and behold, there it is. She has a good HCG level and is on progesterone for her known luteal phase issues. She is just so scared that she will lose this baby too.
Please pray for her. Her name is Christina.

Yes, there is hope


(Text of the powerpoint presentation follows)
via Argent by the Tiber

119 page pdf file
Happy slogging. I haven't read it yet. I have to finish putting together a presentation I'm giving Saturday on Menopause. Why did I let myself get talked in to that?

NFP in the news

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letter from the FDA


responding to a request to take RU-486 (mifeprex) off the market.

Thank you for your message to the Division of Drug Information in the Center for Drug Evaluation and Research (CDER).

As you know, the Food and Drug Administration has been informed of two
additional deaths following medical abortion with mifepristone (Mifeprex). The Agency received verbal notification of the deaths in the United States from the manufacturer, Danco Laboratories. At this time we are investigating all circumstances associated with these cases and are not able to confirm the causes of death. However, all providers of medical abortion and their patients need to be aware of the specific circumstances and directions for use of this drug and all risks including sepsis when considering treatment.
In particular, physicians and their patients should fully discuss early potential signs and symptoms that may warrant immediate medical evaluation.

As previously provided in our July 19, 2005 Public Health Advisory, updated on November 4, 2005, the Agency is aware of four previous confirmed deaths from sepsis in the United States, from September 2003 to June 2005, in women following medical abortion with mifepristone (Mifeprex) and misoprostol. All four cases of fatal infection tested positive for Clostridium sordellii. All four cases involved the off-label dosing regimen consisting of 200 mg of oral Mifeprex followed by 800 mcg of intra-vaginally placed misoprostol. In
addition, FDA tested drug from manufacturing lots of mifepristone and misoprostol and found no contamination with Clostridium sordellii.

We do not know whether these new deaths were caused by sepsis or, if they were, if they were caused by infection with Clostridium sordellii.

You may read more about this topic at the following site

CDER/Division of Drug Information bmd
Disclaimer: This communication is consistent with 21 CFR 10.85 (k) and constitutes an informal communication that represents our best judgment at this time but does not constitute an advisory opinion, does not necessarily represent the formal position of FDA, and does not bind or otherwise obligate or commit the agency to the views expressed.


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no kidding

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You Should Be a Science Fiction Writer
Your ideas are very strange, and people often wonder what planet you're from. And while you may have some problems being "normal," you'll have no problems writing sci-fi. Whether it's epic films, important novels, or vivid comics... Your own little universe could leave an important mark on the world!

I'm still here

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look for more real content tomorrow.
I was at a continuing education conference today that was somewhat depressing. Basically, one of the things that is fuelling the increased cesarean rate and the idea of patient optional primary cesarean is the idea that women will only have one or two children.
Also, financial pressures in health care make scheduled cesareans more and more appealing to surgeons, administrators, and bean counters. One of the other midwives made a comment about how she was beginning to feel totally obsolete.
There have been other events happening too.
Maybe tomorrow I'll have some concentrated time to write a few things out. and maybe not.
I do respond to email if anyone has any pressing issues.

kitchen appliances and me

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we replaced the microwave.
then our new stainless steel dishwasher decided to act up.
it was emptied with 2 minutes left in the dry cycle.
it apparently decided that it wasn't going to turn off at the end of the 2 minute period.
the heating element was on for I don't know how long before John smelled something like burning plastic
he opened the dishwasher door to see that the fluid in the rinse agent dispensor was boiling and bubbling over.
he managed to get it to shut off without having to hit the breaker.
After the interior cooled enough to see, we could see that the plastic arm of the bottom water sprayer thingie had melted partially.
John will call the company tomorrow during business hours.
I'm washing dishes by hand until GE decides what to do with their product which is still under warranty.
and we will probably end up filing another report with the Consumer Product's Safety Commission.

quick update

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The allergic reaction that hit me last Sunday took the form of severe swelling around one eye - to the point that the eyelid was swollen almost shut. It also itched like crazy inside my ear canal and I felt like fertilizer. Monday I broke down and went to the doctor who put me on steroids. I made it into work Tuesday and yesterday as well but I am still not quite myself.
I got a reply from NPR about the letter to the editor I sent a couple of weeks ago. Plan to blog it with some more comments when I have the energy. And I still haven't forgotten that I was going to talk about the 'chastity' talk that the confirmation kids got a few weeks ago.
Hope that your Lents have been fruitful. Mine has given me lots of opportunities for prayer that I would not have sought out for myself.

Midwifery at work internationally


prenatal euthanasia, redux

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A Wrongful Birth? - New York Times.
The author of this article seemed to make a heroic effort to present this topic in a balanced manner. However, her biases were revealed halfway through when she admits to having had a second trimester abortion for a potentially severely disabled child.
I think that you all know my views on this topic. However, I think that you need to know that the pressures on those of us who do prenatal care are enormous.
I was recently made aware of a case where a young woman (20-something) gave birth to a baby with Down Syndrome that was not diagnosed prenatally. Her maternal serum screen showed a risk of Down Syndrome that was greater than her age related risk, but not at the cutoff point for recommending genetic counselling or potentially an amniocentesis. This mom was furious that she had not been offered amniocentesis. She states that she probably would have continued the pregnancy, but that she wanted to know what to expect.
The reality is that even with all the testing in the world, we really don't know what to expect. Every baby is a unique individual. Perfection is not only not guaranteed, it is impossible. I have a friend whose baby was born perfectly normal, but was hit by a truck at the age of two. This child is now 26, severely handicapped both physically and mentally - and is in fact fairly similar in physical, mental, and developmental ability much like the child described in this article. Should he have been 'terminated' after his accident? Should the doctors who saved his life been sued for allowing him to continue to live? I don't think so.

And yet, those of us who take care of pregnant ladies, who help them to give birth, who try our hardest to help them to live healthy lives and have good births, are on the line for every single bad outcome - predictable and unpredictable. I'm not saying that true malpractice should go unpunished. I think that the neglectful prenatal care given to that mom was wrong - I can't imagine doing prenatal care without the basics of measuring the baby's growth with my hands! But the reality is that nothing they did or didn't do had any effect on the genetic chaos in that poor child's body.

resource for women's clothing

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catholic dad blog


dad update

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email from my sister:

Dad went home from the hospital Friday night and spent most of Saturday getting re-settled, He’s all settled now and just waiting for Monday for all the specialists to start calling and showing up to provide the supports that were available in the hospital i.e. nursing and physical therapy.

so sorry

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had plans to post some real content today, but have a massive allergic reaction to something
i've taken claritin, benadryl, and Emergen-C and am heading off to bed.
will update when I can

Hyperemesis gravidarum

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This is one of the puzzling complications of pregnancy that can cause otherwise staunchly pro-life women consider abortion. Ashli is an expert on H.G. - having acquired her expertise the very hard way. A friend of my daughter's contacted me years ago for info on the subject - here is the article that he ultimately wrote. Lots of good background information but no real help in understanding the emotional and psychological impact.
I tend to be pretty aggressive at treating nausea and vomiting of early pregnancy. That is because I would like to break the cycle before it can turn into H.G. I use a lot of different therapies. My practice has been blessed that we haven't had a really serious case for a couple of years (and we care for around 240 pregnant women a year). The last really bad one we ended up hospitalizing for a while and putting in a nas0gastric feeding tube - because, paradoxically, the best therapy for this is to have food in the gut.
One thing that is sometimes overlooked is that there can be other reasons for a person to be pukey besides H.G. - and those other causes should be investigated. Infection with h.pylori (the ulcer bug) or giardia can also cause the same symptoms - and intestinal obstruction (a rare complication after abdominal surgeries, including cesareans) needs to be ruled out.
I just learned that one of my regular blog readers is suffering horribly from H.G. - please throw out a prayer for her when you can.
And also pray for her husband and other children, too - because they also suffer when mom is that sick.

NEJM -- The Supreme Court and the Purposes of Medicine

I am not fond of the New England Journal. Too often (in my opinion) they let politically correct but scientifically suspect ideas prevail, both in the selection of articles and on the editorial page. I also happen to think that organized medicine takes to itself a deference that it is not willing to grant to other professions - including those with which medicine works in an uneasy alliance (nursing, physical therapy, midwifery, pharmacy, psychology, to name but a few). This editorial has some rather eye opening statements on that behalf.
Predictably, 'medical ethicist' Dr. Annas also has an editorial in this issue. His focuses on the 'assisted suicide' aspects of the the current court fights. He also argues in favor of self-regulation of the medical industry. It's an argument I would find more defensible were it applied by that industry to its competitors.

The idiocy continues

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Why mothers should be offered (elective) caesareans
This editorial conveniently ignores the very real increased risk of death and disability following cesareans (especially many and repeated cesareans). I think that one would need to be sure that the benefits outweigh the risks before having major surgery. However, I get the feeling that I am in a distinct minority to have that opinion.
Placenta previa, for example, is a good reason to endure the risks and added pain of recovering from a cesarean. Convenience or anxiety probably isn't.
Our culture worships at the altar of choice, radical autonomy. It shows up in all kinds of seemingly unrelated ways. I've recently seen a virtual epidemic of young women who had breast reduction surgery done during their high school years. Not having known these women before their surgeries, I can't even begin to understand their motives. But I do have to wonder if a 15 y/o could truly give informed consent or if her parents could really understand the life-long consequences of such surgery.

teaching tonight


I will be doing a large group teaching for Confirmation One tonight. Some will be my personal testimony, some will be didactic. The subject is "The Catholic Church.

What follows here is my didactic teaching from my notes. I will be handing out to the kids a sheet with the actual bible quotations on it. I looked in the CCC but it wasn't organized in such a manner that I thought I could make it comprehensible.

apropos my blog art

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Boston Catholic Women's conference

Made a last minute decision to go once I learned that a local parish is running a bus!

What do you think?

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Prisons Often Shackle Pregnant Inmates in Labor
(Registration may be required - see bugmenot in R column)

me and kitchen appliances

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I don't know what it is lately. First the dishwasher saga. Then, a few weeks ago, the icemaker in the fridge popped a hose and flooded the freezer, with drips down the back into the main part of the fridge. Once again, it was just as we were getting ready for bed that we discovered the mess - had to remove everything from the freezer, throw away that which was not salvagable, and move what we could salvage to the deep freeze - then clean and clean and clean.
Last night, I put a cup of tea in the microwave. Having given up sweetening my tea for Lent I at least wanted it to be hot. 20 seconds into the cycle, I heard a snap/crackle and looking over saw arcing around the edge of the appliance. Hit the off button, unplugged it, retrieved my still cold tea. That lovely smell of burning insulation........ John is of the opinion that the transformer blew and now the microwave (which is of the same vintage as the dishwasher - and was also purchased at Best Buy) is nothing more than a boat anchor.
Lord - can't you let me pick my own mortifications? Living without a microwave wasn't anywhere near my list!

Seeking Book Donations


A friend emailed this to me and asked that I post it.
The New Orleans Public Library
(New Orleans LA)
The New Orleans Public Library is asking for any and all hardcover and paperback books for people of all ages in an effort to restock the shelves after Katrina. The staff will assess which titles will be designated for its collections. The rest will be distributed to destitute families or sold for library fundraising. Please send your books to:

Rica A. Trigs, Public Relations
New Orleans Public Library
219 Loyola Avenue
New Orleans, LA 70112

If you tell the post office that they are for the library in New Orleans, they will give you the library rate which is slightly less than the book rate.
This is my personal advice from my days working in a library in the cataloguing department:
If you are seeking a tax deduction, please enclose in each box 2 copies of an itemized list of the contents. Also enclose a stamped self-addressed envelope. Ask that the library stamp or sign one copy and mail it back to you - this will be your receipt for tax purposes. The itemization should be sufficient for you to be able to assign a reasonable cash value to your donation. The IRS has some good guidelines on how to value charitable donations in kind. Or consult your tax program or accountant. I think that your shipping costs are also deductable - but double check, as my knowledge of tax regulations are limited to what I have learned by filing them for decades.
I was getting ready to clean out some space now that our nest is emptying, and this will give me a great excuse to pack and mail some books!

In yesterday's Spero Forum


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About this Archive

This page is an archive of entries from March 2006 listed from newest to oldest.

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