Tag Archives: child health

Maternal Health and the Status of Women

Both globally and domestically, maternal health and the standing of women are inextricably linked. If women do not have the means and access to give birth safely, with trained and educated midwives, physicians and nurses, with appropriate prenatal education and care, it is often indicative of the standing of women in their communities and countries overall. Women’s inequality is also linked to the soaring population growth in developing countries, which will pose a range of new challenges for the next few generations.

Some may point to the United States as an anomaly, citing women’s increasing economic and financial independence, education, and leadership roles in America, while in terms of maternal health rankings, we remain pathetically far down the line for our resources (49 other countries are safer places to give birth than the U.S. – despite us spending more money on healthcare than anywhere else). Of course, the recent and incessant attacks on allowing women to access credible, accurate, up-to-date and comprehensive sexual and reproductive health education and services makes this statistic not entirely…surprising, shall we say.

So, I found the incredibly detailed and visually impressive infographic by the National Post, pulled from spectacular data and research done by Save the Children to be particularly fascinating. What they did was combine information on the health, economic, and education status of women to create overall rankings of the best and worst countries for women, splitting the countries into categories of more developed, less developed, and least developed, and the countries were ranked in relation to the other countries in their category (the divisions were based on the 2008 United Nations Population Division’s World Population Prospects, which most recently no longer classified based on development standing). While these divisions and the rankings can certainly be contentious and may incite some disagreement (nothing unusual there, these kind of rankings usually are), I thought the results were interesting. Some highlights – Norway is first, Somalia is last. The United States was 19th, and Canada was 17th (Estonia fell in between us and the Great White North) in the most developed. Israel is first in the less developed category, and Bhutan is first in the least developed category. The full report with data from Save the Children is also available, if you want to learn more about the information combined to make this image. Take a look:

A Woman’s Place – Courtesy of the National Post

One thing that I thought was particularly great was that the researchers combined women’s health and children’s heath data to create rankings specific to being a mother, when that category is sometimes only assessed based on access to reproductive care.The specific rankings of maternal health highlights largely mimics the overall standing of women, as seen here – Norway is number one, again, and Niger falls into last place:

Mother’s Index, Courtesy of Save the Children

I think these images and graphs are particularly moving given one of the top health stories coming out of the New York Times today, which showed that a recent Johns Hopkins study indicated meeting the contraception needs of women in developing countries could reduce maternal mortality (and thereby increase the standing of women in many of the nations doing poorly in the above ranking) globally by a third. When looking at the countries in the infographic that have low rates of using modern contraception and the correlation between that and their ranking in terms of status of women, it’s not surprising what the JH researchers found. Many of the countries farther down in the rankings have rates below 50%, and for those countries filling the bottom 25 slots, none of them even reach a rate that is a third of the population in terms of contraceptive use – which of course in most cases has to do with availability, not choice. Wonderfully, the Gates Foundation yesterday announced that they would be donating $1 billion to increase the access to contraceptives in developing countries.

Also of note, and in relation to maternal and newborn health, is a new study recently published by Mailman researchers that showed PEPFAR funded programs in sub-Saharan Africa increased access to healthcare facilities for women (particularly important for this region, as 50% of maternal deaths occur there), thereby increasing the number of births occurring in these facilities – reducing the avoidable (and sometimes inevitable) complications from labor and delivery, decreasing the chance of infection and increasing treatment if contracted. This has clear implications for children as well (and why I think this study relates to the National Post infographic and the NY Times article), since newborns are also able to be assessed by trained healthcare workers and potentially life-threatening conditions averted – including HIV, if the newborns have HIV+ mothers and need early anti-retroviral treatment and a relationship with a healthcare worker and system. And it goes without saying that if a new mother is struggling with post-delivery healthcare issues, including abscesses and fistulas, or was dealing with a high-risk pre-labor condition like preeclampsia, the child will have an increasingly difficult early life, perhaps even a motherless one.

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Filed under Child Development and Child Health, Health Education, International, Politics, Public Health, Reproductive and Sexual Health, Women's Health

Child Mortality – What Are the True Biggest Causes?

A great image from Population Services International‘s most recent issue of their magazine, Impact, from the cover article written by Desmond Chavasse, Ph.D, Vice President, Malaria Control & Child Survival, PSI, about causes of child mortality globally.

Causes of Child Mortality – Image courtesy of Population Services International

One of the purposes of the image, of course, is to show the stark contrast between directed funding for treatment and eradication of certain diseases and the number of children afflicted with these illnesses. How does this impact our understanding of global health and of the marketing around certain hot topic health issues and ways in which donors feel as though they are contributing to a decline in preventable deaths?

When I worked in development for HIV/AIDS organizations, it was fascinating to speak with donors about their reasons for giving and their understanding of the prevalence and incidence (and the general audience grasp of the word incidence, which is the measure of risk of contracting a certain illness or disease within a specified time frame) of HIV. Contrast this with the understanding of malaria, TB, diarrhea, deaths due to childbirth complications (for the mother and the infant), and the gap between perception and reality was startling. In no way do I want to deny the importance of consistent development support for all diseases on a global scale, but I do think there is something lacking in terms of the education around these issues for donors and even some advocates.

Solutions? Come chat with me on Twitter.

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Filed under Child Development and Child Health, Health Education, International, Public Health

Body Judgments Begin…Pretty Close to Birth

I know it’s been a while since I’ve written – I took six weeks off to finish my dissertation and prepare for its defense (I passed!), and to take a bit of a breather after all that required writing! But what better way to start a new month than with a new post?

One of the many reasons I went to graduate school to study adolescent female and women’s health was because I wanted to gain a better understanding of why women and girls develop disordered eating behaviors, what makes them worse, and most importantly, how to prevent them. And more and more studies are telling us what many researchers, clinicians, and patients themselves have been telling us for years.

A few recent studies in particular that have been published in the past few weeks highlight these issues well. One new study out of UCLA has again proven that strong self-perception is key to the prevention of risky behaviors in teen girls. The results of this study showed that overweight girls who had high body satisfaction and who were happy with their size and shape were less likely to engage in a range of unhealthy and disordered eating behaviors like fasting, skipping meals, and self-induced vomiting. And more importantly, the study also showed that these girls had lower rates of anxiety and depression, which are so disturbingly common among girls with burgeoning eating disorders.

And the best thing about the study’s results was the discussion that these public health experts, dieticians, and professors had, in which they emphasized that for effective, healthy weight-loss interventions for teens who may need to lose weight for real medical reasons (preventing the onset of diabetes or hypertension and increasing cardiovascular health, for example), these programs need to be rooted in positive self-esteem and the enhancement of self-image. When you feel better about yourself, you want to keep taking care of yourself. You are also more likely to want to share yourself with others, and creating positive social networks increases the likelihood that people will have supporters pushing them to stay healthy as well as a community that makes them feel worthwhile, appreciated, and worth the kind of self-care that diet and exercise changes require.

So why do companies, organizations, media outlets, and other vocal critics keep harping on the idea that shame, insults, and bullying will help people lose weight? To me, the root of this problem lies in the misguided thought that anyone else’s weight is anyone else’s business. It isn’t.

Another recent study has unfortunately shown something I find really upsetting. Preschoolers – remember, that’s ages 2-5 – show negative perceptions of overweight children. The way this study was conducted involved an adult reading four different stories to a group of children, in which one character was ‘nice’ and the other was ‘mean.’ They then showed the children pictures of one overweight figure and one normal weight figure, and asked them to select which one was the ‘nice’ character from the story and which was the ‘mean’ character. Nearly half of all students said that in all four stories, the overweight figure was selected as the ‘mean’ one. Mind you, these figures had no faces. No physical expressions. One was just bigger than the other. And because of that, the children thought they were meaner.

I mean…whoa. Ages 2-5 are in the early developmental stages, when children are absorbing and processing and incredible amount of information – verbally, visually, and physically – and learning how to reason. We do not need judgments about others’ weight getting ingrained at this age, creating perceptions that are very difficult to change. Of course, this one study bears repeating, and should incorporate additional measures of exploring these outcomes; nonetheless, these results are troubling.

Of course, this study begs the revisiting of one of my most pressing points on this blog. Weight, just like food, is not a characteristic that is inherent in measures of good versus evil. That’s very dangerous territory to traverse – once one allows weight to dictate the assessment of whether or not someone is not only of value and worth (societally speaking, this already happens, when overweight people are ignored, more easily dismissed, not taken as seriously), but whether or not they are actually truly ‘bad’ or ‘mean’ or capable of certain sins because they are overweight, one’s morality becomes game for critics. I also always remain shocked at some critics’ short-sightedness in this relam – if you yourself gain weight in the future – something which may happen for a variety of reasons – are you readily willing to take on the label of weakness, ‘meanness’, gluttony? The impassioned rhetoric around the blaming and shaming of overweight people is so starkly in need of an infusion of compassion.

What this shows is that children are inundated with messages, both direct and indirect, from so many different sources at such a young age, that the idea of being overweight is coded as bad in so many ways, that it seems nearly inescapable. To me, this means we have to keep making intense efforts to combat these messages, because we are climbing one steep hill.

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Filed under Child Development and Child Health, Disordered Eating, Health Education, Mental Health

This Fight is Literally Never-Ending

The Center for Disease Control’s Division of Adolescent and School Health (DASH) will lose $10 million in funding if the Fiscal Year 2012 Omnibus Appropriations bill, which sailed through the House of Reps, comes to be. And to kick the prevention specialists at DASH while they’re down, the funding for absitence-only “sex education” will make an unwelcome return.

The DASH has proven time and again that the CDC, as well as state health agencies, are capable of creating health education initiatives that teach students and adolescents the best ways to stay healthy and prevent both chronic and infectious diseases. They have worked with school districts as well as other governmental organizations to not only create effective STI-prevention and teen pregnancy prevention initiatives, but also do an incredible job of monitoring the risky behaviors that teens are currently engaging in across the United States – including substance use and abuse, sexual behavior, drunk driving, physical violence, and depression and suicide, as well as tracking the rates of victimization that teens experience in the form of sexual assault and dating violence. Understanding how common these behaviors are, knowing in what areas and regions they seem to erupt more intensely, and determining what demographics on a national level are at greatest risk for some of these behaviors is essential for targeted education and prevention initiatives.

Without these prevention strategies, and without the ability to track the rates of risky behaviors to know how to develop such strategies, we will be left to treat the consequences (STI care, HIV treatement and care, babies born to teen moms), which are of course ultimately far more expensive. The CDC has (or had) the resources as well as the expertise with its impressive body of scientists and researchers, to do so. And lest we forget, abstinence only education? Doesn’t do teens any favors, and in fact leaves them woefully misinformed in how they should protect themselves when they do ultimately engage in sexual activity.

RH Reality Check details this upsetting news here. On the heels of Sebelius’ decision, this has been a pretty devastating month for adolescents.

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Filed under Child Development and Child Health, Education, Epidemiology and Population Health, Health Education, Politics, Public Health, Sexism, Women's Health

The Girl Effect Impact

I’m lucky – I have conscientious friends. People who are invested in their communities both immediate and global; people who care deeply about education, human rights, and child development; individuals who believe firmly in these principles. I’m grateful for that, and grateful that they remain open to hearing about violations of these principles and what can be done to work towards eradicating circumstances that allow these inequities to thrive. Which is what I’m doing here.

By now, many of you have likely heard of The Girl Effect. The Novo and Nike foundations, partnering with the Coalition for Adolescent Girls and the UN Foundation, started the Girl Effect a few years ago, and since the movement started they’ve garnered a healthy following on Twitter, Facebook, and via non-profits and educational institutions. One of the organization’s most essential functions is raising awareness – they do this through their profiles of young girls around the world, their easy to understand presentation of facts and country profiles, and the way they create a storyline of cause-and-effect that shows us how the subjugation of girls is multi-faceted and interconnected.

Statistics can be powerful. If there’s one thing I’ve learned working in both public health and education, it’s that statistics can redirect money and help gain political endorsements; they can garner media attention and can heave weight behind opinions. But they can also leave people cold, and can create some emotional distance between the problem and one’s understanding and relation to it. This is where I think the real impact and power of the Girl Effect comes in.

I’d encourage my readers to do two things. First, check out the basic information the organization offers – the nuts and bolts, the facts and outlines. Then head over to the videos page and pick a profile of any one of the girls. Watch it a few times, to see if the second or third time you catch something you missed the first time. Instead of focusing on the fact that girls who do not attend secondary school in India are nearly 70% more likely to be married as children, focus on Anita or Sanchita and what they’re actually saying to you. The fact that in Chad, Guinea, Mali, and Niger half of all adolescent give birth before 18 – and that girls who give birth before age 15 are fives times more likely to die in childbirth – is a frightening statistic – one big enough to think that the problem is too overwhelming, too all encompassing, too massive and systemic to be solved or challenged. So instead, watch the interviews with Kidan, Shumi and Addis. Hear them describe the internal changes they went thorough when they pushed against the status quo, the familial and community influences they have had as they developed despite monumental odds stacked against them.

Lastly, I’d invite you to check out the connect/mobilize page – see what small contribution you can make, while keeping in mind the profile of the girl you just watched. Focus on the element you found most meaningful. The seconds you felt most connected to her, the point at which you most admired her. Think about that moment when you feel overwhelmed by the statistics, think of that emotional response if you feel overwhelmed by the task at hand. Move to change one step at a time, with that feeling as your guide.

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Filed under Child Development and Child Health, Education, Feminism, Public Health, Sexism

Bill O’Reilly, You So Crazy

Oh, Bill. I never cease to be amazed by some of the things you teach me. For example, how the brutal and horrifying rampage in Norway was not committed by a Christian (despite the rambling Christianity-soaked manifesto, and your O’Reilly-esque insistence that all terrorist attacks are carried out by Muslims regardless of any indication of their Islamic faith), simply because you don’t think a Christian would do that. Or like how your three visits to Africa assured you that you just can’t “bring Western reasoning into the culture.” Oh, and that the ACLU is second only to Al-Qaeda in how dangerous and threatening it is. And that poverty is a result being lazy and irresponsible, and if you just work hard and go to school, then, you know, you’ll make bags and bags of money and be just fine regardless of anything else or circumstance. Which sounds totally on point, since you also taught me that conservatives “see things in black and white, and liberals see gray.” Which sounds like nuance, and uh-oh, you’ve made me see that nuance makes things complicated…

And this past week, O’Reilly taught me this: “Many women who get pregnant are blasted out of their minds when they have sex and [are] not going to use birth control anyway.”

(First of all, if the women O’Reilly and the men he knows are having sex with are blasted out of their mind, I’d be interested in hearing how that consent discussion went. Perhaps his definition of consent is a little hazy. Recall – if she’s too drunk to consent, it’s not consensual sex.) 

But back to what he’s taught me. With this latest statement, I’ve learned that women – regardless of their sobriety level – are exclusively the ones who need to be concerned with contraception and infection (and that, in fact, they do a terrible job of this). Only one person in a two-person sexual encounter is responsible for ensuring the woman doesn’t get pregnant (hint – it is not the man). He’s also informed me that contraception is something only considered the exact moment before a sexual encounter occurs – not hours or days or months before – just in that whisper of a moment before the magic happens. If O’Reilly had actually engaged in sexual activity with the woman he harassed, maybe he would have just crossed his fingers that she was both sober and using birth control and not have give it a second passing thought or considered it his concern. So let’s all just do the same moving forward.

More seriously now – it’s unconscionable that someone supposes men should be able to have sex with a woman (a drunk or sober one) whenever they want and also not have to worry about or share the burden of responsibility to avoid pregnancy. We need to utilize as many tools as we can to prevent pregnancy, and that prevention should be shared equally between the two partners engaging in sexual activity. It would be great if health insurance took the lead and incorporated 50% (or 100%, if they were so inclined) of the cost of a partner’s contraception of choice into a man’s health insurance plan. I think that would be even more of a fighting point than co-pays being covered under plans.

Nancy Northrup, CEO of the Center for Reproductive Rights, did a great job and broke it down over at CBS News about why the hysteria over insurers now eliminating co-pays for women with contraceptive prescriptions that is bubbling over is not actually all that hysterical. In fact, it’s something that 28 states require to be covered by health insurance, something already covered (with those pesky co-pays) by government health insurance, and something that 99% of all women have used, regardless of religious affiliation.

Additionally, under the Affordable Care Act, virtually all of us will be required to have or purchase health insurance (a contentious point, still, largely among Republicans, but others as well). With what will be an added cost to the personal budget of many Americans, let’s take a snapshot of what the cost of birth control is: the pill is up to $50 a month (over $500/year), the NuvaRing is up to $70 a month (over $800/year) $500 – $1,000 for an IUD; even the morning after pill, used if other birth control methods failed or were forgotten, costs up to $70.  If you are currently one of the millions without healthcare and one of the millions without a job and an income, these costs are likely to be the first that are cut as you struggle to keep you and your family afloat. However. Pre-natal care costs, the cost of delivery, well visits for a newborn – and, you know, the food and clothing needs of a baby – are not going to be cheaper than the contraception options. Bottom line – prevention can be costly, and beneficial to all. Absence of prevention is even more costly, and frequently puts a lot of burden on all parties involved.

Remember how in O’Reilly’s world everyone is super wasted when they’re having sex – too wasted to worry about a condom? All these methods – the IUD, the birth control pill, the NuvaRing – can be taken or inserted well before sex. Some don’t ever come out, some devices like the NuvaRing are changed monthly. This is why these are called preventive measures. You are utilizing them well before you engage in sexual activity, so when you’re in O’Reilly’s alcohol-soaked sex fiesta and about to engage in consensual sexual activity, pregnancy is already well on the way of being stopped in its tracks. (Not STIs, let’s not forget. None of these protect against sexually transmitted diseases.) His excuse that they aren’t thinking about using contraception holds no water in the argument of preventive techniques like these that take the worry about pregnancy prevention out of the immediate sexual encounter (not 100%, though – no method is 100% effective, and I actually recommend using one of these birth control methods as well as condoms). I’d also add here that many women when drunk are still concerned with pregnancy prevention, so that weasle-y move of trying to make intoxicated women look like reckless players shooting for a fertilized egg is also inaccurate.

Bill’s “black and white” take on the issue of contraception seems to boil down to: women need to pay for their birth control, they need to pay for their pre-natal care costs and gynecological exams, they need to pay for the cost of having the baby. But the fetus was not put there by her alone. The desire to not get pregnant is not hers alone. Communicative partnerships and cost coverage in these areas leading to happy, healthy mothers and children would benefit everyone.

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Filed under Defining Gender, Feminism, Health Education, Media, Politics, Pop Culture, Public Health, Sexism, Women's Health

“Top Girl” Doesn’t Actually Help Girls Get Anywhere

I’m always on the lookout for games, books, toys, and stories that an aid in the education, emboldening, social-awareness, and positive development of children and young adults. And as someone who usually finds it impossible to not look at things through a gendered lens, I am frequently concerned with the discrepancy between what I see actually advertised to young girls and boys and what I think is actually appropriate for young girls and boys.

A new game has just been released by CrowdStar, called “Top Girl.” This is how TechCrunch described the game:

“Top Girl is a mobile role-playing game that allows players to create a fashionable avatar and then climb up the fashion social ladder, collecting money by doing modeling jobs, buying new outfits, and going to clubs.

The core gameplay is around the modeling job, where as you work more, you earn coins and cash and are able to buy better clothes.”

Here’s the advert image:

Photo via TechCrunch

I mean, I started cringing before I even finished reading the first sentence. We just recently discussed how the repitition of images and gaming constructs can impact the development of children and their self-perceptions, and we are now confronted with another representation of not only a strict, but a damaging gender role  being touted as “female-focused.”

Why does “female-focused” mean fashion and social-climbing to these developers? Why is clubbing, the latest trends, social hierarchy, and physical appearance being touted as what it means to be definitively female even in virtual worlds? It isn’t enough that mere media imagery feeds girls the idea of a limited definition of beauty and implies that others’ perceptions of them will be based on how closely they align with this definition? We have to take it further, with the “female-focused” game we offer them telling them that the best way to get attention (and affection) is by booking modeling gigs that can push you into what they present as the only relevant social world – one of wealth and fame – which will give you money to buy the hottest outfits, which will also allow you entry into the latest clubs, where hopefully your latest fashions will be admired by all, garnering you more modeling gigs, which will make you more money, pushing you up even higher on the social ladder until you reach the pinnacle of success?

Money is what matters in this virtual world, and the best way to get it is not through intellectual prowess, dedication to a sport, writing a book, finding a cure, coming up with an innovative tech idea. It’s through pictures of your face and body. The girls aren’t engaging in the creative process of designing clothing, which would make the game more innovative and actually push these girls to have a unique style of their own – what if they did this instead? Bought virtual fabrics and textiles, and created a design empire? Because otherwise, I’m not sure I want to know what the “winner” of this social game looks like, do you?

Perhaps the silver lining is that this game might teach girls about managing money and understand a budget. You think? And how about you follow me on Twitter so you can see what else I’m dishing.

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Filed under Child Development and Child Health, Defining Gender, Feminism, Media, Pop Culture

Abortion Isn’t That Simple, Mr. Douthat

Ross Douthat, one of the NY Times conservative columnists whose pieces I occasionally force myself to read, wrote an article yesterday about sex-selective abortion. In short, he claimed that the reason 160 million women were “missing” (that is, the reason they were so outnumbered in many countries like India and China, as well as other nations in the Balkans and Central Asia) was because they were “killed” via sex-selective abortion. In his words, the women weren’t “missing,” they were “dead.” (He also claims that the author of the book he cites, Mara Hvistendahl of the book “Unnatural Selection: Choosing Boys Over Girls, and the Consequences of a World Full of Men,” appropriates the issue to one of patriarchy, of greater social issues and inequities – which I agree with. He then says that “the sense of outrage that pervades her story seems to have been inspired by the missing girls themselves, not the consequences of their absence,” saying that she is more upset by the idea of abortion itself than she is about the issues surrounding abortion. Don’t you think that’s for her to decide? And doesn’t it seem she’s already decided what she thinks based on her book?)

Douthat, however, manages to contradict the crux of his argument near the start of his column.

He begins by saying “female empowerment often seems to have led to more sex selection, not less.” He then quotes Hvistendahl as saying “women use their increased autonomy to select for sons,” because male offspring bring higher social status. In countries like India, sex selection began in “the urban, well-educated stratum of society,” before spreading down the income ladder.

If this were the case – if in fact women had become truly empowered in their respective lands – culturally, politically, economically – then why would they be aborting based on the opposite – that men in their communities are still holding the cards? Are they imagining that men still hold positions of power and wealth in their countries, or are they living the ramifications of that painful reality everyday? Women do have some increased autonomy in many of these regions. But guess what? This autonomy has likely served to highlight the still very real inequities and disparities that exist in their communities, which contributes to the rates of sex-selective abortion. If women see which sex has the higher status, and one of the few autonomous decisions they can make is to choose the sex of their baby – they are likely going to choose the one with more status. This upsetting power dynamic shows just how far away true empowerment is for many of these women and their communities. If they felt their children would have the same opportunities if they were female than if they were male, the sex selection abortion Douthat decries would actually decrease. It is not the responsibility of the female fetus to ensure she is treated with the same respect and equality as the male fetus. Douthat seems to really care about female fetuses – but seems less interested in addressing the massive social, political, and economic issues that create so many difficulties for them once born. (His colleagues Paul Krugman and Nick Kristof seem to have handles on that. Too bad they were off yesterday.)

It seems that Douthat wants to push for the feelings of regret and remorse about abortion itself, separate from the issues surrounding it. Does sex-selection abortion sadden me? Yes. Does aborting a fetus that indicates it will have Down Syndrome sadden me? Yes. You know what else makes me sad? That a woman cannot afford a baby because she is single and has no familial or community support; because she has an abusive partner (homicide is the number one cause of death for pregnant women); because she has a low-wage hourly job that offers no maternity leave which could help her stay well while carrying the baby if needed; because she has no health insurance meaning she can’t access quality pre-natal care to make sure her baby would be healthy since we are systematically closing down those facilities that offer services for women who are uninsured (and also help provide birth control to prevent pregnancy!); because she has no way to pay for day care and she may have to quit her low-wage job to care for her baby; because she would then have no money for all the supplies, food, and developmental tools her baby would need to thrive which can lead to malnutrition, behavioral problems, child depression; because she could then become part of the 29.9% of families in poverty that are headed by single women, and her child could become part of the 35% of those in poverty who are under 18 years of age - the poverty rate for households headed by single women is significantly higher than the overall poverty rate.

We’ve cut child welfare services that aid women by the tens of millions in the past few years. Georgia alone cut over $10 million in Child Welfare Services. We’ve also cut subsidies that support adoption agencies – the organizations that help women find families that may be able to care for her baby were she to carry it to term – and who make sure these families are actually fit to do so! TANF (Temporary Assistance for Needy Families) provides women and families with aid so that children can be raised in their own homes or with relatives, instead of being placed in foster care and becoming wards of the state. How much have we cut from TANF? 17 of the poorest states, with some of the highest poverty rates in the nation, have already stopped receiving funds.

Birth control, one might say? Sure – birth control is expensive, so if she doesn’t have health insurance, she isn’t likely to be able to afford birth control (hey, Planned Parenthood can help with that, too! Seeing a pattern?) And if her partner refuses to wear a condom? If she is in an abusive relationship, if she fears leaving her partner, if she relies on her partner for added economic security – she’s much less likely to argue with him about the condom use. Or even feel that she has the agency to begin a negotiation discussion at all.

These facts make me sad. And all of these facts might lead a woman to decide she can’t have a baby. And many things not listed here may lead a woman to decide that she will not have a baby. And that she will have an abortion. Is it my decision? No. It’s not. It’s not yours or Ross Douthat’s, either. Again, Douthat represents the contingent of pro-lifers who want to make it seem like pro-choicers are cheering the performing of abortions right and left. What we are cheering is the right for women and respect of women to make their own decision based on their very specific personal circumstances. And given the fact that the medical establishment has not agreed with the pro-life camp in claiming that fetuses before a month into the third trimester can feel pain (reacting to stimuli does not equal pain, to reiterate, and pain without a cerebral cortex is seen by physicians as not possible), which has most recently become the pro-life camp’s wildly off-base rationale for preventing a woman’s right to choose, and given the fetus’ place of residence in the woman’s uterus as a part of her body, not as a human, these issues that Douthat sees as “sideline” are actually very much at the center of the argument. Bottom line – it’s the woman’s body. It’s the woman’s choice. She will be the one carrying it, she will be the one birthing it. No one else. So why should anyone else decide?

Additionally, it is not a crime for a woman to not want children. Since she is able to give birth, it is her decision as to when and how that will happen. Everything about her life and future will change once she has a baby. So she needs to be sure she is ready for that. How can one disagree with that? Douthat may not like it, but “the sense of outrage that pervades his story” (see what I did there? ;) ) seems to me more rooted in his anger and frustration with his opinion not being considered by women in these decisions and not being able to control what a woman decides to do about what is going on in her body.

All of the things I listed – the job issues, the healthcare issues, the family and community issues, the issues that arise when a child doesn’t have access to food, clothing, and developmentally appropriate stimulation – are the causes. So why don’t we start figuring out how we can mitigate those facts and issues instead of attacking the effect – the abortion – which is a decision women come to after weighing all of those facts and issues just discussed. Douthat’s fear tactics of talking about female fetuses strewn across Indian hospitals is scary imagery. So is this:

Photo thanks to ehow.com

And this:

Photo via Captain Hope's Kids Blog

And this:

Photo property of streetkidnews.blogsome.com

Want less abortions? How about providing health insurance, that covers both birth control and pre-post natal care? How about equal pay for equal work, so women are more financially and economically secure, providing them with the resources to stay out of poverty and keep their children out of it, too? How about child care in work environments, helping women who cannot afford day care can stay in their jobs and remain a part of the economy? While we’re at it, how about great public schools and clean community centers, so women know their children are being intellectually fed and socially stimulated in safe environments that help keep them out of more dangerous and potentially life-threatening social circles? How about comprehensive sex education so men and women know how to protect themselves not only from pregnancies but from diseases that can endanger a fetus and create complications during birth and cause health issues for them and their children – creating more expense, particularly if one has no health insurance.

Let’s talk then. And how about you follow me on Twitter?

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