Tuesday, July 30, 2013

Okay, she's probably too old.

Jimmy Fallon and his wife just welcomed a baby girl!

Felicitations to them!

Seriously, they are in for some really fun times as new parents. 

By the way, Fallon's wife, Nancy Juvoven, is 46. News articles don't really make reference to whether Juvoven gave birth to the girl, although Wikipedia does use that phrase. And it really doesn't matter except for one thing that, since going through infertility treatments from ages 37 to 39, really bugs me. 

Over-forty celebrity women seem more fecund than the general population. My reproductive endocrinologists (yes, plural) all indicated, either explicitly or implicitly, that if you see a 45+ pregnant woman, she is probably using donor eggs, eggs donated to her for the purpose of in vitro fertilization so the 45+ woman can carry the child and give birth. And donor egg procedures are expensive.

I just wish that just one of these famous ladies would say, "Yes, I used donor eggs, so what?"  I mean, sure, it's none of our business whether they did or didn't.

But I think the over-aged high-profile pregnancies without explanation lead the rest of us normal people to think that over-40 healthy pregnancies are easy and not that rare. While not outside the realm of possibilities, they are not easy or common. Bringing a healthy baby to full term using middle aged eggs is, in fact, quite rare.  Statistics show that women over 45 have a less than 1% chance of getting pregnant with their own   eggs. Google it. The statistic is everywhere. 

Infertility is painful.  The treatments are arduous, the results uncertain and subject as much to chance as to science. I would applaud a celebrity who acknowledged those facts to the public.  I think it would help a lot of suffering people to have it acknowledged by a public figure.

That being said, maybe Nancy Juvoven's and Jimmy Fallon's girl is one of those fluky rare over-40 pregnancies that is the result of no medical intervention. In any event, no matter how she got here, the baby's darned cute and kudos to her soon-to-be-exhausted parents.  I'll climb down off of my pet peeve, now, and just gaze at the cute baby pictures. :-)

Saturday, July 13, 2013

She's not too old.

The New York Times recently reported that certain of the Republican cognoscenti have decided to float, ever so subtly, the idea that Hillary Clinton is past it. "The 2016 election may be far off, but one theme is becoming clear: Republican strategists and presidential hopefuls, in ways subtle and overt, are eager to focus a spotlight on Mrs. Clinton’s age." They want to say, in other words that, Mrs. Clinton, who will be 69 when November 2016 rolls around, will be too old to hold the office of President. As Rush Limbaugh so eloquently put it in 2008, they want you to think this:  Do I "want to vote for somebody, a woman, and actually watch a woman get older before their eyes on a daily basis?"  Yeah, because that would be so much worse than watching a man grow older before our eyes on a daily basis, which we've done for, I don't know, the entire history of the United States of America. Pbbt.

First, such an argument is hypocritical when one considers the GOP's most revered modern day President, Ronald Reagan. When Mr. Reagan was first elected in 1980, he was older then than Mrs. Clinton will be in November 2016. And do you really want her to highlight this hypocrisy by quoting Reagan's fantastic "youth and inexperience" line back to you? No, no you don't.

But here's really why it's a colossally bad idea:

If you make the argument that Mrs. Clinton is ill-suited to high office because she is old, you are, essentially, telling every woman of a certain age that she is also past it, worth less than she was at a younger age. And these ladies are reliable voters. (P.S. You're also telling a fair number of men the same thing. For Senator Mitch McConnell has already described the Democratic field -- Mrs. Clinton and Joe Biden, who will be 70 in 2016 -- as "a rerun of the Golden Girls." Yes, you're indeed worthless if you're older, to Mr. McConnell, no spring chicken himself at age 71. Nice going. Beside, the Golden Girls was a great show!)

And, by the way, when I say "of a certain age," I do not merely mean over 65. I mean even folks as young as 45 or 46. There are a lot of voters out there who are seniors or soon-to-be seniors. Tacitly telling those folks that their services, skills, knowledge and talents are not as valuable now merely because the body is more than four or five decades old, and a little wrinkled and saggy, is not a good move.

Age is as weak a criticism of Mrs. Clinton as the criticism that Sarah Palin endured for being a vice presidential candidate who was also a mother of five children, one of whom was a special needs child.  Nope, no other vice president had ever had young/youngish kids before, so I can see why Mrs. Palin was criticized for that . . . . Oh wait. Yeah, there were many things to criticize about Sarah Palin.  Her status as the parent of young children was not fair game.  I dare say that if her name were Sam Palin and she were the father, no one would have batted an eye.

So, similarly, yes, there's a trove criticisms to lob at Hillary Clinton after so many years in the public spotlight. Have at it, GOP! But, age is not one of them.

She's not too old.  Find a different way.

Friday, July 12, 2013

I don't like what's going on with women's and children's healthcare in Texas.

So.  Yeah.  This may be a bit incoherent, because every discussion about abortion inevitably becomes incoherent.  With that caveat, here we go:

I doubt that there are many people who read this blog who are unaware that I live in Texas.  But just in case someone doesn't know that, I do.  I live in Texas.

You, friends and readers, may have heard or read about State Senator Wendy Davis's filibuster of a bill that would, in effect, close many women's clinics that provide abortions by requiring that they conform to the standards of ambulatory surgery centers.

The bill would also provide for, I think, a far less controversial (though still objectionable to many people) 20 week limitation on abortions in Texas.  (The current limit, as of the writing of this post, is 24 weeks.)  The bill has been reintroduced in a special session of the legislature, and it will pass.  People predict with some level of certainty that the passage of this bill will close down all but five abortion clinics in the state (one in Dallas, one in Austin, one in San Antonio, and two in Houston).

Texas women are already required to have a sonogram and wait 24 hours before an abortion procedure may be performed.

So here's the problem:  availability of abortions will, probably, be vastly diminished for vast swaths of lower income and rural women in the state.

And here's my fear:  that's not going to stop these women wanting to terminate their pregnancies.  They will seek other means that are far less safe than the non-ambulatory surgical centers that they currently visit today.

This is scary.

My personal feelings on the subject shouldn't matter that much, but for the sake of clarity, I return to former President Bill Clinton's comment that abortion should be "safe, legal and rare."  That is and always has been my position. (Also, I should note a fact:  I have been inside a Texas abortion clinic.  For the sake of the privacy of all parties concerned, I am not going to describe the circumstances of the visit.  But I want to say this:  It was fine.  It was not a happy place.  The protestors did not help and, were, in fact, ineffective.  People do not merrily skip up to a clinic to end a pregnancy.  People do this in great anxiety and sobriety.)

But back to the bill.  I said that abortions should be "safe."

So, yes, the bill is aimed, at some level, at safety, but I fear that the safety measures sought to be imposed are attempting to force the "rare" part of Mr. Clinton's equation by making abortions harder to get.  Making them harder to get does not mean that they won't happen.  It means that there will be far less safe abortions performed in the shadows.  They just will be.  Deal with it.  And women will be harmed; some may die.

So let's talk about how to make abortions more rare:  prevent the pregnancies from happening in the first place.  This means:  (a) better sex education for the people of Texas (including adults, through their doctors) and (b) more widely available contraceptives.  But Texas doesn't want to do that either.  (By the way, the sex education that I think should be provided really ought to contain a component of what pregnancy is and its awesome life-altering-ness.  Honestly, I never knew until I was 39 years old and pregnant for the first time.  That's awfully late in life to learn a fundamental fact about my sexuality.  Maybe the only way to learn it is to go through it, but I think maybe we could do a little better in trying to get that message across prior to the actual pregnancy.)

But I mentioned children's healthcare too in my title.  Right.  What did I mean?

I meant that Texas does not want to provide adequate healthcare for the children of poverty.  Indeed, the sponsor of the Texas House of Representatives version of the bill, Jodie Laubenberg, cannot maintain a coherent position on the status of that entity that grows in a woman's womb.

For the purposes of her present abortion restrictions bill, that entity is a human child deserving of protection.  For the purposes of funding prenatal care for expectant mothers under Texas's version of the CHIP program, Ms. Laubenberg argued that the mothers of in utero humans were undeserving of economic support for prenatal and perinatal care in the first three months of pregnancy under CHIP because their children "were not born yet."

So for the purposes of the abortion bill, these pre-born humans are deserving of utmost protection, but for the purposes of the CHIP program, they're not deserving of vital healthcare until the fourth month.  All of our Ob/Gyns tell us that we need to be getting prenatal care ASAP as it ensures the best outcomes for the pregnancy and the child it will produce.  So why deny it until the fourth month?  It's bizarre.

But it's not, if you think about how most people view abortion, which is through the lens of viability.  Most people hold their nose and turn the other way when you're talking about an abortion in the first three months of pregnancy.  Ms. Laubenberg was just betraying her own prejudices in that regard when she made that statement that they "were not born yet."  She holds her nose and turns the other way too in the first trimester.

And that's because we all understand at least that part of the science:  no embryo or fetus is viable at twelve weeks gestation.  At twelve weeks gestation or earlier, pregnancies are still potential.  But at 24 weeks?  Well, I know of at least two babies born that early who have lived.  So, yeah, at 24 weeks we're talking about at least a fighting chance at life outside the womb.

So, indeed, the 20 weeks limit proposed in the bill, while perhaps not based in sound science, is based in the sort of hunch we all have:  that somewhere between 12 and 24 weeks, potential becomes probability.  For me, it was when I felt my baby move for the first time -- 17 to 18 weeks -- that's when I began to see the future with a real baby.  But that, I admit, is purely arbitrary and should not be utilized as a standard by which one should pass a law.  (Still, it informs my opinions and personal prejudices.)

But the fundamental hypocrisy of wanting to prevent abortions, but not wanting to provide prenatal healthcare for the pregnant women, or provide contraceptive and gynecological services to the poor persists.

So to end my little tirade here's my prescription for a compromise:

  1. Safe, legal, and rare abortions.
  2. Adequate healthcare for the indigent women and children, including in utero children, of the State of Texas.
  3. Comprehensive sex education for the people of Texas.
  4. Affordable contraception so as to prevent unwanted pregnancies.
And what I do not want, but fear I may see in the near future:  Women being injured or, God forbid, dying in "back alley" clinics in poor and rural areas of Texas.  Babies being born into a system that will not ensure that they and their mothers have adequate healthcare and support.  It's not enough to prevent the abortion.  If you prevent the abortion and a child is born, we must ensure not just that she lives, but that she has the opportunity to thrive.

I think Texas is smart enough, I think Texas is good enough, to do that.