Dear Utah Governor Gary Herbert

I am deeply concerned about HB 12, a bill that has been passed but that you have not signed yet. It is intended to prosecute mothers who try to abort their babies "recklessly," but the language is vague and open for abuse.
If you agree with the bill, I nevertheless request that you send it back so that the wording is changed. Please inform the legislators that their intention is good, but you do not want to leave room for the prosecution of women who disagree with their doctors over care or choose to delay their first prenatal appointment until after the third month, which is quite common.

There are several procedures offered by obstetricians that carry risks of miscarriage, such as amniocentesis and cordocentesis. No one would think to blame the doctor if this occured. However, if a woman chose not to go on bedrest because she had other children at home, or in the case of an Iowan woman charged under a similar law, simply fell down the stairs, that mother could be charged and put in jail. Mothers struggle every day with making tough choices between their care and the care of their children, both born and unborn. We should not frighten them into seeking necessary treatment by creating laws with such dangerous language.
Thank you for your time, and please do not sign HB 12 in its current form.

Navigating the World of Prenatal Tests - Part 1

I finally called an ob/gyn and then immediately broke down and cried. I know I need to give birth in a hospital this time around, but that doesn't make the road there and back any less exasperating.

Has anyone else noticed that the vast majority of prenatal tests have to do with identifying genetic conditions and other problems you can't do anything about unless you plan on ending the pregnancy? And that they're not always accurate? I wonder how many less abortions we would have if doctors weren't telling mothers, hey this blood test means your baby might have problems. Can't guarantee it but IT'S VERY IMPORTANT THAT WE SCARE THE CRAP OUT OF YOU WHILE YOU'RE PREGNANT. Also, we get paid to do tests.

(sigh)

Let's run through the list of common tests and I'll let you know why I'll be turning them down. I'll be using 2 sources, a mainstream one called the American Pregnancy Association, and a natural one called GentleBirth.org.

PREGNANCY TEST
Obviously the first test you will have is your pregnancy test. Hard to make that one controversial. The controversy comes if your doctor wants to do an ultrasound just to confirm the pregnancy and due date. This is not an acceptable use of ultrasound, even according to the American College of Obstetricians and Gynecologists. More on that later.

My own regular physician recommended I get an ultrasound the moment I told her I was pregnant, to confirm the due date. She is very easy going and we have a fantastic rapport, so I told her that since I know the date of conception, it's not a mystery and not necessary. She smiled and said, well that's something I'll discuss with my Ob when I choose one, anyway. Just so you know, the discussion will be "We will have one ultrasound because I have OCD, somewhere around the sixth month, and that's it, unless we have medical cause. The end." Again, more on that later.

URINE TESTS
This is often performed at every visit. Both of my midwives did. The APA lists the following conditions that can be detected with a urine test during pregnancy:

"A urine tests is used to assess bladder or kidney infections, diabetes, dehydration and preeclampsia by screening for high levels of sugars, proteins, ketones and bacteria. High levels of sugars may suggest gestational diabetes, which may develop around the 20th week of pregnancy. Higher levels of protein may suggest a possible urinary tract infection, or kidney disease. Preeclampsia may be a concern if higher levels of protein are found later in pregnancy, combined with high blood pressure."

There's mixed feelings about routine urinalysis in the natural birthing community. Since there are no side effects for mom or baby, it didn't bother me to do this for my midwives. When I had consistently high sugar levels in my urine, my second midwife had me get a glucometer. I tested my own blood and was able to adjust my own diet to keep blood sugar levels low.

I would love to hear if any of my readers have a different opinion, but I myself see no harm in peeing in the cup for a caregiver.

BLOOD TESTS
There are actually several prenatal blood tests.

INITIAL LABWORK
My first midwife sent me to a lab for one blood test at our first meeting. My second midwife didn't. This is what they check for initially, from the APA:

"Blood Type: The blood test will diagnose your blood type. You will either be A, B, AB or O.
Rh Factor: The blood test will also reveal whether you are Rh negative or Rh positive. If you do not have the Rh antigen in your blood, you are Rh negative, if you do have it, then you are Rh positive. This test is important because problems may arise if the mother's blood does not have the Rh factor and the baby's blood does.
Glucose Levels: The blood test is used to measure the body's ability to metabolize sugar and screen for gestational diabetes. If your glucose level is between 130 to 140 milligrams per deciliter of blood, then you healthcare provider will request a glucose tolerance test.
Iron Levels: The blood test will determine if you have iron deficiencies in your blood. If your blood is low in iron, that does not mean that you are anemic, but it does make you more susceptible for anemia. If your levels are low, your healthcare provider may prescribe iron tablets or injections.

Hemoglobin Levels: The blood test will identify the level of hemoglobin, which is the oxygen-carrying power of your red blood cells. The expected level is between 12 to 14 grams. A treatment for anemia will be prescribed if your level falls below 10 grams.
Sexually Transmitted Diseases: A blood test is a diagnostic test used to determine whether you have syphilis, hepatitis B, or HIV.
Rubella (German measles): The results of the blood test will determine if you have antibodies for rubella and whether or not you are immune.
Toxoplasmosis: The results of the blood test will determine if you have the toxoplasmosis infection. Toxoplasmosis is harmless to you, but it may cross the placenta and cause harm to the baby."

It just so happens that I had some bloodwork down while I was pregnant but before I knew I was pregnant. My blood sugar is fine but my iron levels were low, so I'm taking iron supplements. I think vitamin/iron levels can be good to know when you are pregnant. I was also extremely low on Vitamin D, and since taking high-level supplements, I have been much less depressed. Vitamin D is also important for baby. So, if and when you get your first bloodwork done, tell them to throw in vitamin levels.

The test results here that would cause some problems is the rubella test. Rubella can be deforming and fatal to your unborn child. The rubella vaccine is a live virus vaccine. It specifically says on the package insert to not give it to pregnant women. If your doctor recommends you get a rubella vaccine while pregnant, fire him and get a new doctor. If he tells you that you should get it immediately after your baby is born, stand firm and say no. For one thing, it's way past the 1st trimester and the danger to your unborn child is over. Secondly, live virus vaccines can pass from mom to child through breastmilk. There is a slim but very real chance you could give your newborn infant rubella. This is all on the package itself, so don't take my word for it.

As for whether or not to turn down the tests, some states mandate that midwives do them. It does not harm your baby, and again, if you ask for vitamin levels to be included, the information you get back could be valuable. On the other hand, I see no harm in turning it down, either, unless you live in one of those crazy states that will pinpoint you as a neglectful parent if you turn down certain tests.

CVS (Chorionic villus sampling)
This test involves either using a long needle to withdraw a sample of cells from your placenta (that would be through your abdomen, ladies) or a catheter inserted through your cervix into your womb for the same purpose. It is used to detect chromosomal or genetic abnormalities, and can also be used to collect DNA for paternity testing.

According to the APA, "Miscarriage is the primary risk related to CVS occurring 1 out of every 100 procedures."

That is not a low number, mamas. Hospitals are pissed that VBACs can cause uterine rupture in 0.5% of women, only a few of those actually being fatal, but doctors can perform a medically unnecessary test that has twice as much chance of killing your unborn baby? That sounds brilliant!

Doctor William Sears says this about the CVS test:
"Even though CVS provides information earlier in pregnancy than amniocentesis, it carries a risk of miscarriage that is 2 to 4 times higher, depending on the expertise of the physician. Vaginal bleeding frequently occurs following CVS. Studies also suggest a possible increased risk of limb deformities, and CVS may cause a decrease in the amniotic fluid production."


TRIPLE SCREEN TEST
This is a second-trimester blood test used to screen for potential fetal abnormalities.

From APA:
"The triple screen is measuring high and low levels of AFP and abnormal levels of hCG and estriol. The results are combined with the mother's age, weight, ethnicity and gestation of pregnancy in order to assess probabilities of potential genetic disorders."

These types of screens do not mean your baby has an abnormality, only that you have risk factors and further testing is required.

These are the reasons that the American Academy of Family Physicians gives for performing these kinds of tests:

"In most cases, the news will be good and may reassure the patient.
Some patients may decide to terminate the pregnancy when faced with a lethal abnormality.
Anomaly detection may allow specialized antenatal treatment and change perinatal treatment.

If the patient chooses not to terminate the pregnancy, she might still find it reasonable to avoid a cesarean delivery for fetal distress in a child with a lethal anomaly.
It is much gentler to the parents to learn of anomalies early rather than during the stressful, usually happy time of labor and delivery.
The parents have time to prepare emotionally and financially.
The family can educate themselves about the anomaly."

I would never terminate a pregnancy because my baby might have Down's Syndrome or some other condition, but overall I do not think I can judge parents who might want to know in advance in order to prepare for a child that may have special needs. Even if my child has a fatal abnormality, I want to try and give birth to it and be a part of its life as long as possible. Someone else might not feel that brave, and even the LDS Church accepts that abortion may be acceptable if the baby is not expected to live beyond birth.

I think this is really up to you and your partner. I myself would never overcome accidentally aborting a perfectly normal baby.

QUAD SCREEN
Same as the Triple Screen, but it looks for 4 substances instead of three.

AMNIOCENTESIS
CORDOCENTESIS, or Percutaneous Umbilical Cord Blood Sampling (PUBS)
Amniocentesis and Cordocentesis start the same - a needle is inserted through your abdomen. Amniocentsis extracts a sample of amniotic fluid. Cordocentesis extracts a sample of the baby's blood through the umbilical cord. Both tests are used to detect fetal abnormailities.

For the Amnio, the APA says the following:
"Miscarriage is the primary risk related to amniocentesis. The risk of miscarriage ranges from 1 in 400 to 1 in 200. In facilities where amniocentesis is performed regularly, the rates are closer to 1 in 400. Miscarriages can occur because of infection in the uterus, the water breaks or labor is induced prematurely."

For the Coordo, the APA says the following:
"Miscarriage is the primary risk related to cordocentesis occurring between 1 to 2 times out of every 100 procedures.

Other potential side effects include:
Blood loss from the puncture site

Infection

Drop in fetal heart rate

Premature rupture of membranes"
 
I will not be taking these tests and do not think mothers should take a test that risks terminating their pregnancy.
 

To be continued...

Not Allowed to Multiply, And Other First Grade Pleasures

A Montessori teacher I follow wrote the following poignant blog post about her follow-up with a former student who now attends the first grade. The student who loves science and used to study it at her whim now only does science on Wednesdays. She can multiply and divide but they only add and subtract and she's not allowed to do multiplication or division. READ THE POST HERE

It reminds me of my own niece who got in trouble when she was younger for not wanting to read the class books because she was way ahead of them and reading chapter books.

It reminds Bryan of To Kill a Mocking Bird, where Scout gets berated by her teacher for knowing how to read already.

     "...[Miss Caroline] discovered that I was literate and looked at me with more than faint distaste. Miss Caroline told me to tell my father not to teach me anymore, it would interfere with my reading...
     '...Now you tell your father not to teach you any more. It's best to begin reading with a fresh mind. You tell him I'll take over from here and try to undo the damage - '
     'Ma'am?'
     'Your father does not know how to teach.'
   "...Miss Caroline caught me writing and told me to tell my father to stop teaching me. 'Besides,' she said. 'We don't write in the first grade, we print. You won't learn to write until you're in the third grade.'"
(Lee, Harper. To Kill a Mockingbird. New York: Warner Books, 1982. 17-18)

Why Grow Vegetables That You Can Buy Cheap?

No one wonders why the most popular home-grown vegetable is the tomato; it's expensive in stores, even in season; it's relatively easy to grow; homegrown tastes 1000% times better because you can pick it fresh. Red peppers make sense because those are usually $2.99 a pound. Leeks? Only for special occasions. If you like them, it makes sense to grow your own.

But why on earth would someone grow their own potatoes? Russets are 3 pounds for $1.00 in my store. I've seen garlic as low as 25 cents each. Yellow onions, carrots, iceberg lettuce - with all the effort you put into them to grow them yourself, why bother?

Because, there are almost 4,000 (no, there aren't extra zeros there) varieties of potato. Garlic, leeks and onions make up a group that has over 400 varieties. Mexico alone boasts 300 varieties of corn. Carrots come in purple, red, yellow and white.

Look in your grocery store, and at most you probably see 4 types of potatoes, 3 types of onion, and 1 type of carrot. My organic food coop had 4 varieties of garlic. That's still more than the standard white soft neck kind one usually finds, but still limited.

We've developed such a monoculture of food, with our one white cauliflower and 3 red tomatoes (roma tomato, cherry tomato, and large slicing variety) that we're completely unaware of an entire universe of tastes.

Vegetables bound for the supermarket are chosen for their uniform, recognizable shapes and long shelf life, at the expense of flavor and often nutrition. That tomato, orange or melon is picked before it is ripe so that it can travel thousands of miles to your store and wait in your produce aisle. Corn starts to lose sugars and hence flavor the moment it leaves the stalk. If you've never liked corn, this is probably why.

You also now have genetically-modified foods cross-pollinating with heirloom varieties. Mexico has banned GMO corn but found it cropping up and breeding with heirloom corn fields, anyway. The more people demand that one orange carrot or one soybean resistant to Roundup, the more we start to lose our fruit and vegetable heritage. Yellow cauliflower, pink tomatoes, purple beans - all of these with their own tastes, storage qualities and growing habits, almost impossible to find in a regular store, all threatened by the spread of GM crops, and a ubiquitious indifference from a population accustomed to a limited selection of perfectly symmetrical, mild-flavored fruits and vegetables.

Yesterday I visited a friend to swap seeds. She showed me purple corn seeds she had no intention of sharing (which was fine; I'm growing popcorn this year, anyway). She attended the annual Bellingham Seed Swap and met a gentleman who brought exactly one ear of this rare corn variety and shared a few kernals on a first come/first come basis. Save some seeds from your harvest each year, he instructed. This variety is going extinct.

So here is my garden, and my choice of what to grow. If I had a large plot of land, growing my own food would make economic sense, with enough tomatoes to can my own tomato sauce and enough strawberries to make my own jam. Instead, I have just under 60 square feet of space, which is smaller than it sounds.

Do I pick the foods we can readily buy at the store? They will certainly taste better grown at home, without any pesticides, herbicides or artificial fertilizers. If I am going to dig and mulch and sow and harvest, I might as well grow something spectacular; flavorful, colorful, and not likely to show up anywhere except possibly the farmer's market.

Starting Seeds and Preparing The Garden Bed

Despite how discouraged I have felt lately, I feel compelled to return to the blogging world after only a short hiatus because it is GARDENING TIME. Aaaaah, yeah.

I've had friends asking me about seed starting and planting so I figure pictures and explanations are in order, especially since home gardening brings me almost only happiness (with a little bit of frustration thrown in with regards to the general use of chemicals and unethical seed companies). Today I will concentrate on the happiness.

This photo is our garden plot in a community garden maintained by our apartment complex here in Bellingham, Garden Zone 7. It's not quite 5 feet by 12 feet, as you can see by the narrow strip down the middle. We have marked out squares 2 feet by 2 feet with sticks and black yarn.

Over the winter, I grew cover crops on the soil. These act as "green manure," adding nitrogen and other nutrients back to the soil. I recently used a shovel to dig them up and turn them over, but as you can see by scattered bits of green, the kids have been practicing the kid-friendly art of raking.

The green things in the top right corner there are my sprouting garlic.

To learn more about using cover crops, CLICK HERE.

If you haven't planted garlic yet, you still can.

This is my humble seed starting station, on our kitchen hutch which has become our entryway shelving system, complete with keys hanging where mugs used to hang, and a patootie picture of my nieces and nephew that my kids wanted up. I put screws in the top to hold up the grow light, which I bought at Lowes a year ago. I bought the seed tray at a local feed store for $1.69. Peet pellets are my personal preferred way to grow seeds. It might not be as cheap as other methods, but it's more kid friendly. They like watching them pop up in the water, and it's easy for them to hold them and help plant them in the ground when the time comes.

Those seedlings are all yellow storage onions. Yes, I have started them already. I can put them in the ground here in the middle/end of March. I will also be starting my broccoli and pok choi very soon. Hurray for mild winters!

The biggest disadvantage to growing seedlings on a shelf is that they will grow weak without a little daily agitation. I know some people recommend putting a small fan on them during the day, but Bryan and I just brush the palms of our hands over them whenever we pass them.