March 24, 2024

Your Children's Future Health Care

Imagine that you're in your seventh or eighth month of pregnancy and you go into labor. It's frightening, because you know this is too soon.

You rush to the hospital. Fortunately, you don't live in a neglected rural area where there are no hospitals and you're lucky enough to get there on a day when they aren't overcrowded, at a time when the nurses aren't in the middle of a shift change, on a day that's not a holiday. You get seen right away by the best obstetrical team in the region. Your baby is born very prematurely, weighing less than two pounds. She's alive!

Your tiny child is given the best available treatment, and spends many weeks in the NICU. There are several close calls, but the great doctors and nurses are heroic, and your baby survives, despite being very weak and sick. Finally, she's strong enough to come home. You have a long list of special instructions for her care and feeding. Fortunately, there are no major emergencies. The hospital expenses were huge, but you were fortunate to have a good health plan that covered almost everything.

As time goes by, your daughter still has some health issues, but she keeps getting stronger, and by the time she is ten years old, you would never guess she was a preemie. One day when she's 15, she falls off her bike and breaks her leg. This is a fairly normal problem, so you are shocked when your health plan refuses to pay for her treatment, because she had reached her "lifetime limit" by age seven, It's not easy, but you manage to pay the bill.

You start looking around for a new health care plan, but you find out that your daughter can't get coverage because she has "pre-existing conditions."

"Wait a minute," you say, "I thought pre-existing conditions don't matter because of the Affordable Care Act."

The insurance agent replies, "Don't you remember? The ACA was repealed by the Republican majority in Congress back in 2025, after the Supreme Court overruled the election and installed trump as President. We can now exclude anyone who's ever been sick. In fact, we are about to declare that being female is a pre-existing condition. Your daughter will never have health care coverage. Even if she lives to be 75 - the new retirement age - she won't be eligible for Medicare, since it was privatized and operates under our rules. Sorry." He's not sorry.

 

March 14, 2024

What is Contraception?

“Conception,” as it relates to pregnancy, is not a medical term. It has become customary to use this term to refer to fertilization, the coming together of egg and sperm. Some people use “conception” to mean the beginning of a pregnancy.

Fertilization by itself does not constitute pregnancy. For a pregnancy to exist, the fertilized egg must implant itself in the lining of the uterus. It is not unusual for fertilized eggs to pass out of a woman’s body without implanting.

Contraception is any method that is used to prevent pregnancy. Contraception is sometimes referred to as “birth control”. Some well-known contraceptives are condoms and birth control pills.

Barrier methods of contraception prevent the sperm from reaching the egg, so fertilization cannot occur. These include condoms, diaphragms, cervical caps, sponges, and spermicides.

Hormonal methods of contraception use medication to prevent ovulation. That means that they stop eggs from being released. These include pills, injections, patches, and implants.

An intrauterine device (typically called an IUD) is a device that is placed inside the uterus. IUDs use hormones or copper to prevent sperm from fertilizing eggs.

Emergency contraception, sometimes called “the morning after pill”, can be used after unprotected sex has occurred. This is a hormonal method that delays or prevents ovulation: no egg is released. Some people confuse emergency contraception with abortion, but they are not the same. An “abortion pill” is used to end a pregnancy, whereas emergency contraception prevents pregnancy. They are NOT the same medication.

Behavioral methods of birth control include “withdrawal,” whereby the man withdraws his penis from the vagina before ejaculation; and “fertility awareness,” also known as the “rhythm method,” whereby a couple attempts to avoid intercourse during the days the woman is most likely to be fertile.

Sterilization is a permanent form of contraception, that removes a person’s ability to produce a pregnancy. Methods of sterilization include vasectomy for men and tubal ligation (sometimes called “tying the tubes”) for women. In some cases, these methods can be surgically reversed. A woman who has undergone hysterectomy (removal of the uterus) cannot get pregnant. This is not reversible.

Note that there are some additional methods of contraception not mentioned here. See the links at the end for more detailed information.

Abortion is not a method of contraception. Abortion ends an existing pregnancy, whereas contraception prevents pregnancy.

Some people believe that it is wrong for women to engage in sexual intercourse for pleasure or love, but that they should have sex only for the purpose of getting pregnant. These people oppose the use of contraception, and advise women to remain celibate if they don’t want pregnancy. Thousands of years of human history demonstrate that this is an unrealistic idea.

Article from Medical News Today explaining conception: https://www.medicalnewstoday.com/articles/conception

Article from Cleveland Clinic explaining birth control: https://my.clevelandclinic.org/health/articles/11427-birth-control-options

Article from WebMD on the history of contraception: https://www.webmd.com/sex/birth-control/ss/slideshow-birth-control-history

Article from History on reproductive rights in the U.S.: https://www.history.com/news/reproductive-rights-timeline

 

March 12, 2024

Freedom?

I grew up in a region known for being politically and socially conservative. The churches displayed American flags inside the sanctuary. We pledged allegiance in school every morning. People talked a lot about patriotism and freedom, especially freedom as in, "America, land of the free." Freedom meant that we could choose any religion (or no religion), that we could read (or write) any books we wanted, that we could listen to (or perform) the music we liked, and enjoy (or create) whatever artworks we chose. It meant we were free to choose where to live, whether or not to marry, how many children to have (including none), what kind of career to pursue, what clothes to wear, what food to eat, etc.

A saying that was popular in that time and place was, "Your freedom to swing your fist ends where my nose begins," meaning that we were free to do what we wanted, as long as we didn't interfere with someone else's freedom to do what they wanted. We were taught to "tolerate" the existence of other religions and people whose way of thinking or way of living was different from ours. "Freedom" was a concept that applied to everyone.

Today, those ideas seem to have changed within the "conservative" community. Many people now define freedom as not tolerating those who are different They seem to believe that the existence of someone whose beliefs or choices are different is an affront to their own beliefs and choices. They want to swing their not-always-metaphorical fists squarely into the noses of those whose very being offends them. They will not feel free until everyone else complies.

 

March 2, 2024

Abortion, Miscarriage, Birth: Don't Be Confused

"Abortion" is a word used to indicate the expulsion or removal of the contents of the uterus in early pregnancy. Historically, "spontaneous abortion" was the term used when this happened naturally or due to a medical condition, and "induced abortion" referred to performing an abortion intentionally. At some time during the 20th century, it became customary to call a spontaneous abortion a miscarriage, and to refer to an induced abortion simply as an abortion. No matter what terminology is used, this is a situation in which a pregnancy ends without a birth.

Birth is the process by which an infant is expelled from the uterus. This may occur when a pregnant woman undergoes "labor", a series of contractions that enable her to push the infant out. It may also occur surgically, in a process called "Caesarian section", typically shortened to "C-section", during which the surgeon cuts open the uterus and extracts the infant. In some cases, doctors may determine that it is necessary to induce labor medically rather than wait for it to occur naturally. Once a birth occurs, the pregnancy is over.

In recent times, some people have invented the term "post birth abortion" to refer to something that is physically impossible. Abortion ends a pregnancy, as does birth. Once a pregnancy has ended, there cannot be an abortion, just as there cannot be an additional birth.

A typical pregnancy is expected to last about 280 days (40 weeks). An infant born at 39-40 weeks is "full term". An infant born earlier than 37 weeks is considered "premature" or "preterm". Babies born very prematurely are likely to have health problems. The earlier the birth, the greater the risk of severe problems or death. At 28 weeks, a birth is extremely preterm. Successful birth before 28 weeks is not viable; this will be considered a miscarriage.

We now know that more than 30% of pregnancies end in miscarriage, most so early that the woman may not even realize she was pregnant. In some cases of miscarriage, the contents of the uterus are not fully expelled. To avoid infection or other health risks, medical treatment is needed to remove all the tissue. This may involved a procedure called dilation and curettage (D&C) or dilation and extraction (D&E). Sometimes medication is used. Occasionally, some people get confused and think that the treatment following a miscarriage is the same as an abortion. It is not. A miscarriage ends the pregnancy; at that point an abortion is impossible.

Click this link to see the March of Dimes explanation of miscarriage.

Click this link to see the Britannica explanation of birth.

Click this link to see an NIH discussion of termnology.

 

March 1, 2024

Blah blah blah

donald trump barking gibberish
Some people wonder why trump's followers accept his incoherent, nonsensical speeches. It's because they can't distinguish between intelligent speech and the ravings of a lunatic.

Perhaps you've had the experience of trying to explain something of moderate complexity to a person like that. They tend to just stare dully or else they snap, "Speak English!" because they don't know the words you are using. To them, complex sentences and words of three or more syllables are impossible to understand. So they don't expect to be able to make sense of a leader's speeches.

When trump's speeches veer off into word salad, they can't tell the difference, since, for them, most English discourse is like a secret code. All he has to do is use occasional baby talk, make smug faces, and throw in a few buzzwords -- border, babies, Christian, communists, Democrats, unfair, veterans -- and they think he's on their side. They really can't tell when he is incoherent. And even when he speaks in complete sentences that follow each other, they don't notice how ridiculous his claims are, because they lack critical thinking skills and don't have the broader knowledge needed to evaluate such statements.