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.

 

 

 

 

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.

 

 

 

 

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.

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?

 

Keith Olbermann “The Crisis of our Lives”

Keith Olbermann is calling it like it is.

Donald Trump is insane. No one is safe.

The Resistance: This Man is Dangerous

 

Pardon My Moment of Despair

I’m awake in the dark night and this time, it’s fear that’s keeping me up. I feel foolish admitting it, but I am sick with worry about our future. The new administration and the extreme politicians that have been given control of our country are wasting no time in implementing their plans to destroy us. We will soon have no good schools for our children, no health care, no way for our daughters to prevent unwanted sex, no way to protect themselves from pregnancy, no way to save themselves when pregnancies go wrong.

Jobs will pay only slave wages, with no protection regarding overwork or unsafe conditions. Our water and air will become dirty and unsafe. Extreme weather, warming and rising oceans, and our newly unregulated industrial pollutants will combine to destroy our societies. Hopelessness will be the spirit of our lives, and we will no longer have a government that represents us, giving us no way to change things.

Most of this will not affect you if you are rich, but “rich” will have to be very rich. Even those of us who are “well off” will not have enough money to live well. Everything – schools, health care, adequate food, public services, government representation –  will be for sale to the highest bidder.

The people doing this are filled with hatred. They blame us for our own struggles and mock us for our despair. They have all the power now, and they want more of both power and money. They will not stop until they have it.

Perhaps I am losing my mind. I am angry and afraid and weak. But I don’t see a way back from this. People think things will be okay, or even better, but they are wrong. The men in power have no care for people, only control. The changes they are implementing will lead to a dark age for this country, and possibly the world.

I know that my despair is not the answer. I don’t plan on just giving up. But I am so afraid.

 

Week 10: Amy Siskind Lists Subtle Changes Toward Tyranny

Here’s your link for the most recent list of subtle changes taking place in our world, right before our eyes.

I am reminded of “Shock and Awe.” Only this time it’s being used against us. These lists are frequent and they are long. We are being lambasted daily, indeed hourly, with changes that in many cases, offer real threat to our existence. It is impossible to remember them all. It is impossible to maintain the outrage each one deserves.

Please don’t mock me by saying I’m a timid old woman afraid of change. People who know me will laugh you out of the room. I agitate for many changes to our lifestyles and politics and economy. So much is wrong, from the laws on the books, to the common practices, to the philosophies behind them.

But I will fight against change that sets up authoritarianism in our country. Yes, I’m afraid of those changes. They will destroy us.

 

So It Begins

The first announcement by the new press secretary begins the official pull-the-wool-over-their-eyes of the new administration: http://www.nbcnews.com/meet-the-press/wh-spokesman-gave-alternative-facts-inauguration-crowd-n710466. It’s pretty sad that it had to be about a silly, unimportant non-issue. The size of the inauguration crowd? That’s your first official lie? Seriously?

Please note: lies are now called “alternative facts.”

From now on, news will be what Trump says it is. Facts are only facts if he approves them. Legitimacy only exists at his say-so. His followers will loudly insist his truth is truly true, and the rest of us only hate and envy him.

Okay.

I do not see how a democratic country can survive this. When truth and lies switch places, and trust no longer exists, there is no recovery.

Perhaps the next generation, or the one after that, will be able to rise above it and bring the country back to sanity. I’m sure people despaired of life ever recovering from the destruction of WWII, yet the following generations worked and scraped and built a better world.

The new world never did come close to perfection, and now we’ve lost much of it, with the rest of it ready to fall to Europe’s new nationalism. But for a while there was real hope and real progress.

We need to tell that to our children and grandchildren. I’ve even got a great-grandchild who needs to know that truth is not what the new language says it is. They need to know that their elders screwed up their world and that if falls to them to fix it.

I don’t mean to say that we elders can just sit back and let the liars hang on to the golden ring. Not at all. We must never stop declaring the facts that are actually facts, and we must prove to our progeny that we will fight alongside them until we are dead.

But it will be up to a new generation to forge trust with each other, at a time when the pain and anger has faded somewhat.

Ours is lost.

 

 

 

  

“This well-executed, ambitious time travel yarn is also an engaging alternate history to the Titanic disaster.”-Publishers Weekly

 “This was just fun. It’s just precisely the sort of gateway drug that got me hooked on scifi as a kid.”-Geoffrey Thorne

 

Reviews

    Worlds Apart
“I’m so glad I took a chance on this new novel as I really enjoyed it. “

“I don’t usually read paranormal books but this one was great”