ACOG Makes New Recommendations

Holy cow. Is it April 1st? No really, tell me if it is, because this is almost TOO GOOD TO BE TRUE: Approaches to Limit Intervention During Labor and Birth.

Just to have the new recommendations safely in more than one place, here they are, straight from the document:

  • For a woman who is at term in spontaneous labor with a fetus in vertex presentation, labor management may be individualized (depending on maternal and fetal condition and risks) to include techniques such as intermittent auscultation and nonpharmacologic methods of pain relief.
  • Admission to labor and delivery may be delayed for women in the latent phase of labor when their status and their fetuses’ status are reassuring. The women can be offered frequent contact and support, as well as nonpharmacologic pain management measures.
  • When women are observed or admitted for pain or fatigue in latent labor, techniques such as education and support, oral hydration, positions of comfort, and nonpharmacologic pain management techniques such as massage or water immersion may be beneficial.
  • Obstetrician–gynecologists and other obstetric care providers should inform pregnant women with term premature rupture of membrane (PROM [also known as prelabor rupture of membranes]) who are considering a period of expectant care of the potential risks associated with expectant management and the limitations of available data. For informed women, if concordant with their individual preferences and if there are no other maternal or fetal reasons to expedite delivery, the choice of expectant management for a period of time may be appropriately offered and supported. For women who are group B streptococci (GBS) positive, however, administration of antibiotics for GBS prophylaxis should not be delayed while awaiting labor. In such cases, many patients and obstetrician–gynecologists or other obstetric care providers may prefer immediate induction.
  • Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support is associated with improved outcomes for women in labor.
  • For women with normally progressing labor and no evidence of fetal compromise, routine amniotomy need not be undertaken unless required to facilitate monitoring.
  • To facilitate the option of intermittent auscultation, obstetrician–gynecologists and other obstetric care providers and facilities should consider adopting protocols and training staff to use a hand-held Doppler device for low-risk women who desire such monitoring during labor.
  • Use of the coping scale in conjunction with different nonpharmacologic and pharmacologic pain management techniques can help obstetrician–gynecologists and other obstetric care providers tailor interventions to best meet the needs of each woman.
  • Frequent position changes during labor to enhance maternal comfort and promote optimal fetal positioning can be supported as long as adopted positions allow appropriate maternal and fetal monitoring and treatments and are not contraindicated by maternal medical or obstetric complications.
  • When not coached to breathe in a specific way, women push with an open glottis. In consideration of the limited data regarding outcomes of spontaneous versus Valsalva pushing, each woman should be encouraged to use the technique that she prefers and is most effective for her.
  • In the absence of an indication for expeditious delivery, women (particularly those who are nulliparous with epidural analgesia) may be offered a period of rest of 1–2 hours (unless the woman has an urge to bear down sooner) at the onset of the second stage of labor.

Do you have any idea how amazing this is? Women have been fighting for DECADES in this country, to have these very things be standard medical practice for the average woman with an average pregnancy. I spent years training expectant parents how to navigate the American medical system in order to BE LEFT ALONE DURING LABOR, unless something is actually wrong. I taught them how to negotiate with their doctor so the laboring woman could stay out of bed, move as much as she wanted, in whatever position helped her, and to deliver in whatever position helped her. To not be put on an arbitrary time table with the threat of C-section hanging like a club over her head.

And now, out of the blue… it’s here. Have we won the war? Will this actually happen? Will doctors take it to heart and incorporate it into their practice? Will medical schools begin to teach students how natural, intervention-free labor can be? Will they let their students see intervention-free labors during training? Will newly-trained obstetricians actually UNDERSTAND that birth is a natural process?

I’m almost hyperventilating, I’m so excited.

As long as it’s not April 1st.

 

 

 

 

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Keeping Busy and Out of Trouble

I just finished a busy and interesting year as president of my writers club – the Mt. Diablo branch of the California Writers Club. I’ve been with this group for 7 or 8 years, and for the first few, I kept my head down. Not volunteering, not me, nope. I know what happens when you volunteer…

But my lovely and talented critique partners (you know who you are) were all members of the Tri-Valley branch, and they all held positions on the board. At various times one or the another of them was secretary or president, program chair or membership chair, etc. It was interesting listening to stories of their activities and I admit to feeling the odd twinge of guilt now and then. My branch was always asking for volunteers. I was mostly retired. Surely I could do something. 

Eventually I gave in and took over the membership chair position. I found I really enjoyed it, too. I liked being retired and I loved spending days with my husband, but I did miss the challenges and camaraderie of work. It certainly helps that everyone else on the board are nice, interesting, and amusing people. Like any volunteer organization, people come and go, but we all work together very well, I think.

After two or three years of handling the membership work, the board asked if I’d take on the presidency. It was rather abrupt – usually the vice-president steps into that job, but we were short-handed and they promised to babysit me as I learned the ropes. It took some learning, too. I’d never chaired a meeting before, or made an agenda, or facilitated between co-workers. Mostly though, it felt natural to take it all on, including running the general meetings once a month. There’s a bit of me that’s a natural ham, and public speaking is just downright fun.

I trip up now and then, especially on the details. I’m a big picture person and I often need a reminder about the little things to do. Thank goodness for my digital calendar and pop-up notifications! I’m also STILL not any good with faces and names, and being president gives me ample opportunity to embarrass myself and the poor person who’s name I can’t remember. I do recognize all the board members by now, though! In fact, here we are at our recent planning meeting for the next fiscal year:

2017 2018 CWC Board of Directors They are Judith O., Kimberley Ingalls, Lucy H., David G., Andrew B., Elisabeth T., Judith Marshall, Judith Ingram, Danard E., and Al Garrotto. Missing are Lyn R., Jill H., and Ann D. The statue is not on the board!

You probably figured out that I’m president for the upcoming year, too. I blame it all on my critique group.

Why are Progressive Feminist Groups Banning People?

I found this incident at a lesbian march in Chicago to be very disturbing. If you can’t read the article because you don’t subscribe to the NYT, the gist is that organizers of a lesbian march kicked out a couple of women who carried flags with a Star of David. Evidently, the purpose of the march was for lesbians to celebrate their identities. These women identified as Jewish lesbians.

So many of us are more than one thing. In fact, we all are. Part of life is to deal with the struggle to balance the often contradictory aspects of our natures.

The problem, as the organizers saw it, is that the state of Israel is an oppressor of Palestinians. Therefore, a Jewish lesbian who wants to celebrate both parts of her identity is not welcome in progressive feminism. She would have to deny part of her Self (in this case, hide the flag) if she wished to participate.

In this case, the women in question were not advocating for, or even supporting, the political policies of the State of Israel. They were declaring their Jewish-Lesbian identities. I’m pretty sure the Jewish religion does not condone homosexuality, which means that these women, like many of the “Christian” attendees in the march, have had to deal with disapproval and/or rejection from loved ones and religious figures.

Yet, they are Jewish, and happy to be so, despite the shortcomings of the religion. And let’s not forget, that in the case of Jews, the “Jewishness” is an ethnic identity as well as a religious one. It’s as if I were told I could not be Irish or Italian for the purposes of the march.

It’s a strange line to draw, in my opinion.

Imagine instead, a march where Jewish lesbian feminists walked along with Palestinian lesbian feminists. Because the fight in this march was not about government polices of war or aggression. It was about feminism and gay rights and identity. It was about forging bonds with others of similar, but maybe not identical, persuasions. It was about community.

As long as participants were not advocating for the destruction of another group, they should be able to participate. For example, I could see banning skin-head lesbians (if such exist) who deny the right of existence to lesbians of other colors or ethnicities. But Jewish lesbians are not at all represented in that category. Skin-heads choose to be that way. Jews are born. You’d think the gay community would understand the difference. The Left needs to get this stuff figured out, before we turn into the same bullies we are trying to displace.

ON THE ISSUE OF ISRAEL

I have my own opinions about Israel, mostly along the idea that a bunch of men from western nations had no right to carve up the globe to their preference after WWII, and that includes drawing lines in a country none of them lived in, and forcing the inhabitants to pick up and move out, because they were giving the land to other people.

I have no problem with the Jewish people having a state, especially after the horrors of the Holocaust. The world did indeed have to do something. And I completely understand the desire of the world’s Jews to have a place of their own once again. And yes, I know that the area of “Israel” used to be theirs. But after 2,000 years, it wasn’t theirs anymore, and it was the height of western arrogance to give it to them.

It was all wrapped up in that Judeo-Christian thing, where Christians have to admit that the Jewish god is also their god, and that Jews are the “chosen people.” Christians always struggle with the dichotomy of this Chosen-ness, against the idea that the Jews are “Christ-killers.” They really don’t “like” the Jews and would prefer they keep to themselves, but they’re afraid God will be mad if they act on that. So throughout history, Christians mostly tolerated Jews in their midst while practicing mild-to-medium prejudice and segregation.

Many times the prejudice boiled over and pogroms were enacted. Mostly these were ignored by the rest of the world. Hitler just went too far, while also trying to take over the world. This could not be ignored. And the extremeness of his actions required the rest of the world to make restitution to the Jews.

No argument from me. But again, it wasn’t our place to give them Palestine. Maybe we should have given the Jews Eastern Germany instead of letting Stalin have it. It would have been payment the Germans in particular owed to the Jews, and the Jews would have done a much better job of running the place.

 

 

 

 

A Cooking Post: Socca

I’ve found a new food that meets a lot of my criteria for Good Stuff to Eat.

Meet Socca, a crepe-like bread from Nice, France. The link I’m sharing is only one version of many on the web, and I’m not making any recommendations one way or another. Have fun and figure out your own favorite.

Here is my go-to version:

20170610_070639

This was my breakfast. Yes, I know you’re jealous.

As I said, there are many variations for this bread and some of them can require real effort, such as folding in beaten egg whites or investing in a brick oven. All worth it, I’m sure. But it doesn’t get any easier than my version:

1/2 cup garbanzo bean flour
1/2 cup water

That’s it. Wisk it up and pour 1/4 cup of batter into a heated and greased small, iron skillet. Rotate the skillet a bit to spread the batter out, let it brown, then flip to brown on the other side.

This recipe makes three small crepes. For today, I spread mashed banana on them, then filled with the cut-up fruit you see above: 1 apricot, 3 small strawberries, 1/2 peach, and a small handful of blueberries.

That’s a lot of fruit, but it’s summer and my CSA box is full of the lovely, fresh, organic stuff, and I take advantage.

Disclosure Note: if you want to sign up with my CSA, Farm Fresh to You, you can use my code, MARL2337, and get $15 off your first delivery. Yes, I get a bonus, too…

I also like to use these crepes to hold a salad of any vegetables I feel like tossing together, along with a shot of Sriracha Sauce or a squeeze of lemon and salt and pepper. Garbanzo flour is high in protein and fiber: 21 grams of protein and 10 grams of fiber in 1/2 cup. This recipe is low in calories too: 180 calories, not counting the calories in the butter used to grease the pan.

So that’s pretty much a full meal up there folks. For today, I just need to add veggies!

Try it and let me know what you think.

What’s one of your favorite go-to foods?

 

 

 

 

From Marion Nestle: What Fruits and Vegetables do Americans Eat?

I almost linked this post straight to Facebook. I’ve been doing that too much lately, bypassing my own blog.

It’s either lack of sleep or plain laziness.

So here’s the link to Dr. Nestle’s post: http://www.foodpolitics.com/2017/05/what-fruits-and-vegetables-do-americans-eat-more-charts-from-usda/.

It’s an eye-opener. People, there are far more vegetables than tomatoes, corn, and potatoes. Oranges, apples, and bananas are NOT the only fruit in the world. For your own health… please branch out!

Pet peeve: potatoes should not even be listed as a vegetable, and juice is not fruit. Use potatoes as a healthy starch (they ARE good for you as long as you don’t fry them), and juice is just candy. EAT the fruit!

What do you eat most weeks?
What are your reasons?
Have you ever tried to branch out into the huge variety of fresh fruits and vegetables available?
What is NOT available where you live?

 

 

 

Charles M. Blow: War as Political Weapon

From the NY Times: https://nyti.ms/2oQuaL8

Like everyone else, I reacted with rage and horror at another chemical attack in Syria. I felt desperate for action – this has got to stop. We need to do something.

I still feel that way. Part of me cheers the American attack. The rest of me is deeply suspicious of DT’s motives. He doesn’t give a damn about those “beautiful babies,” but this was great for distraction from serious investigations and for propping up ratings. And an even better excuse to increase the war budget.

What I really wish the world would do, is put an end to idea of “sovereign nation.” It is always used as an excuse to let violent men destroy innocent people. “Oh my, no… we CAN’T interfere. It’s THEIR country!”

Bull-shit.

We need hard-and-fast rules that all countries and all monarchs and all politicians must adhere to, and that are enforceable by a strong central body made up with representatives from all countries.

Sort of like the U.N.

For most purposes, there’s no reason for interference in any country’s operations. But when violence is happening, when people are fleeing their homes to escape imprisonment, torture, death…, that is the time for interference. No regime, in any country anywhere, has the right to create such a situation within its borders. If they do, the world steps in, with unity and force. Such a ruler must be deposed immediately. We can’t leave a vacuum – new leaders must be established with constant supervision. A clear method must be in place for the people of that country to replace the temporary government with one they establish. And it has to be the government the PEOPLE choose, which may not be the one we would prefer. It just cannot be another government that will incite new violence.

I know this is vague and idealistic. If humans ever decide they want real peace and prosperity, I’ll be happy to help work out the details.

Views from My Hotel Window

John Scalzi frequently posts photos of the view from his various hotel windows, and it’s one of my favorite categories of his blog. Travel is often about the highlights of a given place, but hotel windows do not always look out on the best a city has to offer. It’s like the difference between watching a high-end runway fashion show, and people-watching at the local mall. You see all kinds of things.

My recent trip involves a different kind of “hotel” and features views with a mix of the local mall-type spots, tourist spots, and the best of nature. We were on a cruise through the Panama Canal. My hotel window is the view from our balcony. We didn’t have internet on the ship, so you’re getting all of it at once – a selection of the best. I’ll come back in another post with more photos of the trip.

Starting at the beginning: Leaving Ft. Lauderdale.

View from HW - PCC Ft. Lauderdale.jpg

Below is a day at sea – I think we’re in the Caribbean by now. A few whitecaps show things were a little bouncy, which usually means good sleeping for me.

View from HW - PCC Mar 2 at sea

The next two photos are the port in Aruba, which is kind of touristy AND local mall-ish. Of course, ports are working places for the movement of cargo and people. Aesthetics is not the primary purpose.

View from HW - PCC Mar 3 Aruba

View from HW - PCC Mar 3 Aruba 2

Below are a couple pictures showing our approach to Cartegana, Columbia. The city and bay are stunning as you come in.

View from HW - PCC Mar 4 CarteganaView from HW - PCC Mar 4 Cartegana 2

This is a picture of Lake Gatun, at the top of the Panama Canal. I have LOTS of pictures of the canal, but not many from our stateroom. We spent most of the day out on deck watching our passage through the locks. It was beyond fascinating. Lake Gatun is the middle passage – after the first locks have raised the ship, we sail across the lake to the locks that will lower the ship down to the Pacific. The city in the distance is Panama City.

View from HW - PCC Mar 6 Lake Gatun

A sunset picture. We were lucky to be on the port side of the ship and were facing west as we sailed up the coast of Central America. The sunsets were spectacular.

View from HW - PCC Mar 7

View from HW - PCC March 12View from HW - PCC March 11

I missed getting pictures of Costa Rica and Nicaragua. We sailed into Costa Rica before I was awake and it was dark, anyway. The captain canceled our stop in Nicaragua due to rough seas at the port.

Our next port was Cabo San Lucas. I took this as we approached – a picture of the famous Arch Rock. You might have to expand the photo to see the arch.

View from HW - PCC Mar 12 Cabo And finally, our return home. Another working port, but a great view on a foggy morning. Time to get the jackets back out!

View from HW - PC cruise

A Guest Post: #Voice for the Voiceless, 1

For this post, I’m starting something different. There is someone I know whose life is a testament to struggle, bad choices, and pain. It is not pretty. It is not easy. But I want to give her a voice. So as often as she can write something, I’m going to post it here. These posts will always appear under the heading you see above: #Voice for the Voiceless.

I will not edit the posts unless she asks me to. This is her life and I don’t want my edits to add or detract from that. For her safety – and frankly, for mine, too – she will remain anonymous.

There is no order or reason to the posts. These are her thoughts. Her life. My blog is simply a vehicle.

_______________________________________________________

#Voice for the Voiceless, 1

Thank you for the listings. I contacted them myself, as well as many others. Also, the woman has done this as well and is on many waiting lists.  As she puts it, the funding is there but the actual services never come through. In fact Alameda County has a homeless information system they us to streamline homeless services and homeless clients. If they contact one program, they contact them all. Yet the agencies are simply not meeting the needs. In Berkeley alone there are over 300 homeless Families. Not singles. Families. Yet Berkeley has shut down almost all of its family shelters. I believe as of January there is only one shelter that accepts mothers and children. And they only have room for 4 of that family type. Berkeley recieved more bulk grants and funds than any other city in Alameda County. For families.
The numbers in Oakland are even higher. Sadly, the few places that take children do not take both parents as well. None take fathers and children. Or thebshelters are in communities where you might as well give up living unless you have a car a job a house and retirement package. So if you get blessed with a shelter spot, and you have a whole family unit, that unit either separates or stays on the streets.
According to the Federal government, Alameda County failed to disperse services to homeless that YOUR TAX DOLLARS paid for. Quite simply, those funds went to alameda county paychecks instead of where they were supposed to. As of January 2017 our county was ORDERED TO CORRECTLY DISTRIBUTE THOSE FUNDS TO THOSE IN NEED. They were told to literally go find the homeless and give them exactly what they shouldve already recieved. Real help.
This woman in particular has been severely traumatized, both physically and emotionally. She was assaulted in our city of Oakland, and then left to survive on the streets with her baby. Not one of the city, county, state or federally ran services aided her. I asked for evidence of this and she gave it to me. That homeless information system, has her listed as an automatic denial for services. Her and 800 other homeless people. Automatically denied aid. No reason. Services get the tax money, and pay themselves or put in “trust funds for the future”. What right do they have, not spending the money on the exact things its given to them for, at the exact time its given to them?
Honestly I believe that this woman was so severely wronged by society, that, we her society owe her an apology, among other things. Not every homeless person on the steeets is choosing to be there. Not all of them are junkies and indigents. In reality there are hundreds that quietly hide in the shadows and try to blend in with us, hoping to one day return to being, us. She is one of the few I have found that does not hide and is not quietly hiding from our eyes.
Her sign says it and when her child is out there with her, you hear it even more loudly. Alameda County, Oakland, Berkeley, if we dont like the homeless problem, we need to start fixing it now. She doesntbneed shelter information. She needs a home. A stable solid building that her son can believe he belongs in. Studio apartments, small single level homes with a yard. Not expensive. Not hard to build. Easily self maintained by the tenant. Lived by the family in it.thats what my hometown streets should look like. My tax dollars got used up by somebodys greedy budget. Now my streets have a partially blind mother with a very young little child, living among the needles and trash of all the others that were ignored. If each of us takes a small personal stance and a bigger public stance to help her and others like her, things might someday calm down. Ignore her and read her or her childs obituary someday soon. Or worse step over that pile of trash and realize its not trash. It might end up being them.
I hope that when you read this, you dont take offense. Just understand that reality isnt what it seems. Its more sick and sad and almost always, the chaos is caused by greed.
At least acknowledge her with gentleness.

 

Healthcare: How to Get There from Here

This article, We all Want Healthcare to Cost Much Less – But We are Asking the Wrong Questions, by Joe Flower, is just about perfect in its analysis of the problem. I encourage everyone to read it.

I have always believed that we need health CARE, as opposed to health INSURANCE. This has led me to advocate for a single-payer system that does away with insurance companies. Mr. Flowers does not quite go there in his argument, but it’s not really his point, anyway. He goes a step further: how to go from a profit-driven and highly wasteful, inefficient system, to one that promotes the best health of each individual? What are the steps we take? What happens in the transition?

In short: what do we pay for?

Therein lies the rub, folks.

Comments? What do you think?

 

Oh My, Look at the Time

I’m on the third night of Very Poor Sleep. I’ve been awake since 2:00, just like last night. Yes, I tried meditating, counting my slow, deep breaths, muscle relaxation, and pretty much anything else they claim is useful. I don’t drink coffee after 10:00 a.m. and I almost never drink alcohol anymore. I don’t/can’t nap during the day. I stay off of electronic devices after dinner and do gentle stretches and relaxation poses before bed. There is no TV in my bedroom. Yet in the middle of the night, adrenaline courses through my veins no matter what I do, and now I’m up talking to you.

This is my Normal. It has been for almost 20 years, so no, this is not a result of recent stresses. It would be nice if I were one of those people who happily function on 4 hours of sleep a night. In a way, I do function all right – I always get through the day, usually get a few things done, and feel mostly okay. But years of this are taking a toll. My memory is much worse. I can’t write fiction anymore and you’ve probably noticed the scarcity of blog posts over the last year. It has become a challenge to organize my thoughts and write something coherent. Often I start a post and give up in frustration because I’m not making sense even to myself.

Maybe I should resort to Twitter.

There’s no real point to all of this. Consider it a case a weary mumbling and go on with your day.

How did y’all sleep last night?

 

Science Fiction and Fantasy Author

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