Thursday, March 23, 2017

Better Healthcare or Just Inhumanity?

I never expected this blog to be about politics, but I never anticipated the craziness that would come out of our elections and elected leaders over the past year.  I have had to completely stop watching or listening to the news.  I read headlines a couple of times a day, usually from a neutral-ish source like Reuters, and even that is too much.  My friends are caring and passionate people who fill my Facebook feed with politics, so it's hard to get away from any of it, so I spend much less time on Facebook.  Even so, virtually every day includes some jaw-dropping act of dispassion that leaves me churning in frustration and helplessness.

The thing that appalled me almost speechless yesterday was a note that overnight, the Republican ACA replacement was modified to allow states to dump a new mother from her Medicaid benefits if she doesn't find a job within 60 days of giving birth.  Let me try to formulate why this is cruel, anti-child, anti-family and also ridiculous.

First, there is the breast-feeding consideration. If mothers are pushed to start work before even 2 months have passed, babies are much less likely to get the recommended minimum of 6 months of exclusive breast-feeding and all of the benefits that go along with that. It is common knowledge that babies are healthier when breastfed.  This reduces health care costs and employee absenteeism, not to mention improved bonding between mother and baby.  The breastfed baby has better cognitive development, better immunity to all kinds of illnesses, his/her risk of SIDS is cut in half and s/he has a lower lifetime risk of chronic diseases such as Crohn's Disease and diabetes.  Mom has lower risk of breast cancer, ovarian cancer and lower later life risk of osteoporosis.  Despite all of these benefits, though, returning to work early in the postpartum period significantly increases the chance that moms will wean their babies within the first month that they are back at work.  While jobs are legally supposed to support breastfeeding mothers, the reality is that this is much less likely to be the case in low wage jobs and that even in the best of circumstances pumping at work is challenging to establish and maintain through the first weeks of returning to a job.


Second, there is the hypocrisy involved in other policies pursued by mostly the same politicians who have put forth this replacement plan.  The very politicians who think this is a palatable idea are the ones who want to remove mandates for birth control and maternity care to be covered by insurance, the ones who want to keep women and their doctors from being able to make crucial and difficult decisions about whether to continue a pregnancy.  These are the politicians who are taking away education, housing, food and medical dollars in order to pour money into the military. And these are the politicians who oppose raising the federal minimum wage despite the fact that our population has become increasingly top-heavy, with dollars moving toward the upper crust, the middle class shrinking and the poor struggling as always on wages that don't keep pace with the cost of housing, healthcare and other necessities.

Third, let's just look at the financial reality of forcing a single mom in a minimum wage job to return to work despite all of the other arguments:
$7.25/ hour is federal minimum wage (21 states still use this as their minimum wage, while others have raised theirs with the highest being the District of Columbia at $11.50 and Washington and Massachusetts at $11.00)
*2080 which is the standard number of annual hours for a full time worker
= $15,080
Minus $934.96 for Social Security
Minus $218.66 for Medicare
Leaving $13926.38  (I did not count any income taxes, as this individual could adjust their exemptions to prevent any income taxes from being withheld, and would probably get a refund at tax time.  For many low income people, this refund is used to pay off payday loans, license plates, car repairs and other things that they have had to postpone because there just isn't the money to pay for any of it.)
Minus average infant childcare cost (from a nat’l assn of child care referral agencies - and this is assuming you can even find an opening for an infant because those openings are few and far between)
$11,666
leaving
$2260.38 / year
$188.36 / month

In Colorado the minimum wage is $9.30
*2080 hours for full time worker
= $19,344
 minus $1,199.33 for Social Security
 minus $280.49 for Medicare
$17,864.18
Minus Average infant childcare cost in Colorado:
$12,736
=$5,128.18 / year
Leaving
$427.35 / month
+$357 / month Food Stamps (which cannot be spent on anything but food, so no sanitary supplies, diapers, cleaning products, toilet paper, personal care items, etc.)
+$65 / WIC benefits

In my county, there is a constant waiting list for childcare assistance, and a waiting list with no likely openings in the near future for housing (this from our local housing authority, who recently told me that HUD is anticipating $6B in cuts in the new budget), and median cost for a 1 BR apartment in Denver is $1380.

Going back to work for a single parent (without someone they know who can watch their child for free or very cheaply) is not only not financially feasible, it is just plain impossible.  Forcing a new parent to go back to work without supporting the services that would make that possible, or at the very least, supporting a living minimum wage is cruel and inhumane.  You simply cannot claim to hold family values or to be pro-child if these are the things you support.

Selected sources:
https://www.babycenter.com/0_how-much-youll-spend-on-childcare_1199776.bc







Wednesday, January 25, 2017

The Scarlet Letter "A"

The abortion question is connected to everything.  A mother is connected to her child before and after the child's birth, for better or for worse, and abortion is connected to a woman's place in the world for better or for worse.  My opinions about abortion are informed by my experiences and opinions about sexuality.  They are connected to my relationship with my mom and with my children.  They are affected by my experiences with men.  They are influenced by the stories of my friends and loved ones.

I grew up in the Midwest and attended Catholic schools for most of my childhood and teen years.  In 8th grade, as I remember it, we actually had a semester-long class on abortion.  They taught us about fetal development, the different abortion methods, and the Catholic morality of abortion.  

I wish they had spent even half as much time talking to us about healthy relationships, consent, how our OWN bodies work, and birth control.  Even if they hadn't talked about birth control, knowing and thinking about those other concepts would have been so helpful and could potentially have had as great or greater an effect on our likelihood of ever considering an abortion.  Sex was a topic I would never have brought up with parents or teachers.  I got limited information from friends who were almost as uninformed as I was, and I attempted to fill in my knowledge gaps with books from the public library.  The answers I most needed were not in the books.

I was raised to be polite and nice.  I was raised to not hurt people's feelings.  I was raised to not tell adults 'no.'  I am a rape survivor.  My upbringing played a part in this, which is why I have always told my girls that they have a right to their own bodies.  They have a right to be respected, to say 'no' at any time, and to scream and fight if they need to.  I have told them that I will always back them if they have to hurt someone else in order to defend themselves.  They have voices that are heard when they say 'no', when they say, 'don't kiss me' and when they say 'get the f*&% out of here and leave me alone!"  I was too nice to say these things when I most needed to.  I have been exceedingly lucky in my life to have never been faced with an unwanted pregnancy.  I have always believed that I couldn't consider abortion for myself, but who knows, since I never had to face it?

When my step-daughters were twelve, we watched one of their favorite movies, Dirty Dancing.  They asked why the one dancer was so sick that Jennifer Grey's character has to get her doctor father to help.  I explained that she had an abortion and got an infection from it.  They asked how she got an infection and I dredged up my knowledge of how abortions are performed and explained what I knew as it applied to the movie.  One of them asked, "but isn't that killing a baby?"  I told them that I believed it was, but that other people feel differently and that the girl in the movie felt that she didn't have a choice...if she was pregnant she couldn't make a living and support herself, let alone a baby.

From the time my birth daughters were little, I have had ongoing conversations with them about the things that my own mother was too uncomfortable to discuss with me.  I talked to them about bodies and sex and consent and birth control and abortion.  I talked to them about ethical issues and how I feel about different things.  There was nothing I wouldn't answer if they were old enough to express curiosity.  

Many of my friends have had abortions, a couple of them at very young ages.  One friend was required by her mother to have an abortion against her will at age fourteen.  She has never told her other children about that baby, but still considers herself to be a mother of one more child than most people know she has.  She is a devout born-again Christian who believes that non-Christians like myself will go to hell.

Another friend, a conservative, got pregnant when my youngest daughter was an infant.  She told me she was planning an abortion because she had been having an affair and wasn't sure if the baby was her husband's child or the other man's.  I was the only friend she told because she believed I (a bleeding-heart liberal) was the only friend who wouldn't judge her.  She told her husband about the pregnancy and the affair and he (also a conservative) seemed to support her in her plan to abort.  I offered to adopt the baby if she would have it rather than aborting.  She wouldn't consider it and went ahead with the abortion.

Another friend, also a conservative, has had more than one abortion.  See, she and her husband weren't real consistent about birth control, so abortion filled in when their habits got sloppy.  They campaigned for one of the most conservative candidates ever to run for office in our area, a candidate who was against every program than might help a young desperate pregnant woman.  A candidate who was rabidly anti-gay.  This friend wanted abortion available when it was convenient for her, but wouldn't vote in a way to support either abortion or supportive services for women.

I know a young woman who was pushed into abortion when she was dating a 'man' who didn't like the idea of becoming a dad.  He pushed her toward abortion rather than shoulder his share of the responsibility.  She spent a lot of time afterward studying various spiritual traditions, trying to find answers that... I don't know... would help confirm whether her decision was bad?  Whether she would be punished for it somehow?

I know of another conservative Christian family who, when their teenaged daughter got pregnant, lost no time in kicking her out of the house.  Do you suppose she was more likely to have an abortion if she was welcomed into a loving home or kicked out because of the pregnancy?  I don't know what happened to her.

And one 17-year-old I encountered was completely unmoored when she told her family about her pregnancy.  Not only were her parents giving her only a few weeks to get out of the house, but they were removing her from their health insurance.  Wow.  Nice.

In some countries, we see low abortion rates and low teen pregnancy rates.  In the Netherlands, the country that has the lowest verifiable rates, sex education, open discussion of sexuality and low barrier access to family planning services are credited for the low numbers. https://www.ncbi.nlm.nih.gov/pubmed/7971545  A comprehensive study of abortion rates and legality across the globe concluded that rates are comparable regardless of legality, indicating that laws against abortion do not deter the practice.  In addition, abortions are generally safe in the countries where abortion is legal, and generally unsafe in countries where it is illegal. http://www.nytimes.com/2007/10/12/world/12abortion.html

In Afghanistan, abortion is extremely restricted, but birth control is also difficult to access. Women are not valued and have little education and few rights. https://www.pri.org/stories/2012-09-06/afghan-women-largely-lack-healthcare-education Women's healthcare is almost non-existent and the top cause of death among women of child-bearing age is childbirth. Violence toward women is commonplace, and infanticide is not uncommon.  Even in educated families, little or no information is available on biology, human sexuality or human reproduction.  Girls grow up believing that all sex is rape, with no understanding of how their own bodies work or that women can enjoy sex, too.  The whole climate toward women in these countries shapes the issue.  Rates of clinical depression for women are extremely high.

Historically in many times, places and cultures, life was not considered to begin at conception or at birth.  In some places and times, abortion was legal and accepted until the "quickening", when the mom was first able to feel the baby's movement.  Until then, the baby wasn't considered a separate, live person.  In other cultures, life began not at birth, but after birth... when the baby was a week old, or when it first cried, or when it was a month old or when it was named. http://www.bbc.co.uk/ethics/abortion/legal/history_1.shtml These beliefs are stymying.  

Beliefs about infanticide are almost equally inconsistent throughout time and place.  http://www.encyclopedia.com/social-sciences-and-law/anthropology-and-archaeology/customs-and-artifacts/infanticide  Like abortion, laws about infanticide throughout history have attempted to control women, punishing them differently and generally much more harshly for the crime than men are punished for the same crime.  Infanticide is horrendous and yet, is infuriatingly full of historic double standards.  The most extreme example I saw in this evening's research was ancient Rome, where a father had the full right to kill his child at will, but a mother would be put to death for doing the very same thing.

In early Christianity, a number of writers condemn abortion, but others offer penance or suggest that no crime is committed before certain points in gestation.  http://www.religioustolerance.org/abo_hist.htm

I've even read an article http://www.politico.com/magazine/story/2014/05/religious-right-real-origins-107133_Page3.html#.WIlw0VMrLIU that proposes that Christian conservatives coalesced into a political agenda not around abortion, but around racism.  I don't have enough historical context (or brain space, after the rest of this essay) to think critically about whether I agree with this, but it's interesting to think that abortion might have been a more morally palatable, marketable cause than the racism that was (in this proposition) the real unifier for conservatives.

This may seem like a string of barely connected paragraphs but for me the connections are strong.  All of these facts and stories and relationships have contributed to my beliefs about abortion.  So, here are my beliefs:
1.  Abortion is both a human rights issue for the women involved, and a morality issue with regard to the fetus.
2. Until we can agree on #1 we will never be able to bring the two sides of the abortion debate together, because in no other circumstance is one life (yes, I realize there are those who argue that it is not a life yet -- which the morality/ethics piece of the puzzle) completely dependent on another life for its very being.
3.  Women would be absolutely unstoppable in the world if they could come together on this one crucial gut issue.  And this is possibly the most crucial issue to women on both sides of the debate, because it is one of the only issues that applies only to women.
4.  Abortion should be rare, legal, and safe so that women's lives are not valued less than the fetuses they carry.
5. I believe that life is magic.  I don't know for sure when it begins, but it might begin at conception. But since I believe in reincarnation, I fully believe every creature goes on to something else after this life, and that lessons are learned along the way.  I don't claim to know exactly how all of that works, but I fully believe that we get to keep coming back until we learn everything we need to know.  In some lifetimes, someone else has to do most of the learning and in some lifetimes we have to do most of the learning.  
6. I believe in a loving God/dess (bigger and more inexplicable than gender), and any deity worth worshiping wouldn't give us just one chance to get it right.  Just because we don't understand the plan doesn't mean there isn't one.
7.  It's not my job to tell you what to do with your body.  It's certainly shouldn't be the job of a bunch of white male politicians to tell women what they can do with their bodies.
8. If we believe that abortion is not a good thing, then we can not ignore causative factors and...
9. ... we are morally obligated to provide those things which prevent unwanted pregnancies and which support pregnant women and families with young children.  This includes comprehensive sex education for boys AND girls (including discussion of consent, healthy relationships, reproductive biology and birth control information), free easy access to birth control, affordable high quality childcare, free high-quality medical care including comprehensive prenatal and postnatal care, and education programs for young parents including parenting education and job training.
10. Abortion does not exist in a vacuum... it exists in a human context where sexual assault is rarely and inconsistently punished, where women are still treated as 'less than', and where economic factors such as health care, child care and housing are out of the reach of many.  In no major city in the US can an individual afford decent housing on a full-time minimum wage job.  THIS is one of the many factors that affects abortion decisions.

I used to believe that if I could just find the perfect set of words that I could bring anybody together on any issue.  I'm no longer so naive.  I have just spent five hours writing this and I still don't feel like I said anything clearly.  The bigger the issue is, the more of a jumble it ends up, even after hours of thinking and writing and research.  I would love to hear your comments as long as they are kind.