Belly Tales

In addition to the moral debate that surrounds giving Gardasil, Merck’s new HPV vaccine, to young girls, the National Vaccine Information Center (NVIC) is also urging against a “universal use” recommendation by the CDC’s Advisory Committee on Immunization Practices (ACIP) on June 29th. The NVIC doesn’t feel that Merck’s clinical trials proved that the HPV vaccine is safe for young girls.

“Merck and the FDA have not been completely honest with the people about the pre-licensure clinical trials,” said NVIC president Barbara Loe Fisher. “Merck’s pre and post-licensure marketing strategy has positioned mass use of this vaccine by pre-teens as a morality play in order to avoid talking about the flawed science they used to get it licensed. This is not just about teenagers having sex, it is also about whether Gardasil has been proven safe and effective for little girls.”

The FDA allowed Merck to use a potentially reactive aluminum containing placebo as a control for most trial participants, rather than a non-reactive saline solution placebo. A reactive placebo can artificially increase the appearance of safety of an experimental drug or vaccine in a clinical trial. Gardasil contains 225 mcg of aluminum and, although aluminum adjuvants have been used in vaccines for decades, they were never tested for safety in clinical trials. Merck and the FDA did not disclose how much aluminum was in the placebo.

Animal and human studies have shown that aluminum adjuvants can cause brain cell death and that vaccine aluminum adjuvants can allow aluminum to enter the brain, as well as cause inflammation at the injection site leading to chronic joint and muscle pain and fatigue. Nearly 90 percent of all Gardasil recipients and 85 percent of aluminum placebo recipients reported one or more adverse events within 15 days of vaccination, particularly at the injection site. Pain and swelling at injection site and fever occurred in approximately 83 percent of Gardasil and 73 percent of aluminum placebo recipients. About 60 percent of those who got Gardasil or the aluminum placebo had systemic adverse events including headache, fever, nausea, dizziness, vomiting, diarrhea, myalgia. Gardasil recipients had more serious adverse events such as headache, gastroenteritis, appendicitis, pelvic inflammatory disease, asthma, bronchospasm and arthritis.

Hmm. This certainly throws a new wrinkle in the story.

You can read the full article over at Red Orbit.

We’re moving! Yay! However, this means that I’ll be offline for a few days…possibly the week (eeegads, a whole week without internet? Can we survive???)…until whenever we can get internet installed in our new place. We’re moving tomorrow, so the internet deprivation begins manana. See you on the flip side.

We’re in the middle of moving from our blah apartment in midtown to our superfly apartment in Brooklyn (trust me, of the two locales, I’m so much more a brooklyn girl than a midtown girl), so this is going to have to be short and sweet, but the controversy sparked by the Department of Health and Human Services’ television ad campaign on breastfeeding has really heated up. Women’s Health News has a great rundown of the issues, as well as faboo links to many of the comments and responses by both the professional media, the blogosphere and individuals which is well worth reading.

Here’s a comment from Feministing’s post on the subject that really stuck with me:

“So how, then, do you all propose explaining to pregnant moms that, from a health perspective, breastfeeding is *by far* the best choice, without making moms who don’t/can’t breastfeed guilty? And on a budget a small fraction of that which the formula companies are using to imply that there really isn’t much difference?

Why aren’t you who can’t breastfeed because of employment ANGRY, instead of guilty, that your baby is deprived of this advantage because of your company’s policies, or your government’s approach to health care and maternity leave?

Women in other countries have significantly longer maternity leave, with at least a percentage of their paycheck during that time, *and* national health services to help them breastfeed to boot. Why aren’t we ANGRY that our babies and their moms don’t have these things?

Moms deserve accurate info about feeding their babies. Some of those moms won’t be able to breastfeed for all kinds of legitimate reasons - that’s a shame, and they are right to feel sad. They and their babies have indeed missed something valuable and special - let’s not minimize that.

We should be working to make the number of moms/babies who can’t breastfeed smaller - but in order to do that, our society as a whole has to understand that such an investment is worth it. How will we get there if the message of the superiority of breastfeeding is watered down to avoid hurting anyone’s feelings?

Moms who are feeling guilty about not breastfeeding should be blaming the patriarchy, not the folks who are trying to improve the health of moms and babies in this country.”

I think this comment raises a lot of valid points, but I also think that this campaign is not the right approach to take with this issue at all (especially when women and mothers in our culture are already beset with way too much guilt on all sides from way too many sources). Why do women feel guilty and internalize the blame, instead of getting angry and looking at the situation we’re surrounded by? Women shouldn’t feel like they’re bad mothers if they have to formula feed their children, for whatever reason, but why is breastfeeding such a challenge for so many women, and such a challeng for our culture? And what can we do to change this???

Thoughts? Comments? Personally, I think that all of Heather W’s suggestions from my previous post would have made much more effective commercials than this current campaign. I still maintain that the focus should be on the barriers in our society that can make breastfeeding so damn hard, rather than on the message that if you don’t breastfeed your baby, you’re taking an unecessary risk. I think that most mothers already know that breastfeeding is the best thing they can do for their baby: GREAT! Now how do we give them the support, strength and courage they need to actually carry this out?

New legislation was introduced last Friday by Senators Menendez (D-NJ) and Durbin (D-IL) which promotes increased research, education and access to screenings for postpartum depression for new mothers. The bill, known as The Mom’s Opportunity To Access Help, Education, Research, and Support for Postpartum Depression (MOTHERS) Act, also proposes grants to health care providers in order to better facilitate the delivery of healthcare to those suffering from postpartum depression. You can read the ACNM’s statement of support for this legislation here, and Senator Menendez’s statement on the proposed bill here. Postpartum depression affects 10-15% of all postpartum women any time from a month to a year after childbirth, and can be incredibly devastating to both the woman and her family, so a bill like this is an encouraging sign, and definitely deserves our support.

The FDA has recently approved Gardasil, Merck’s vaccine that helps prevent cervical cancer caused by Human Papilloma virus (HPV) strains 6, 11, 16 and 18. This is incredibly exciting news, since this is the first vaccine to target cervical cancer, and the first ever vaccine for cancer, period (amazing! a vaccine for cancer!!!). The vaccine has been approved for young women ages 9 to 26, but the recommendation is to give it to girls ages 11 and 12, preferably before they’ve had sex for the first time.

I was listening to a discussion on the radio this morning about Gardasil and the issues that surround its use, and opinions seem to be pretty reasonable on all sides of the debate. Conservative group are not opposing the vaccine itself, but are arguing against making it mandatory. From the NY Times article on the subject:

“Despite rumors to the contrary, our organization doesn’t oppose the vaccine and we have taken no position regarding mandatory laws,” said Wendy Wright, president of Concerned Women of America, a conservative group based in Washington.

Some groups support the vaccine but oppose mandatory vaccinations because cervical cancer is caused by a sexually transmitted virus.

“We can prevent it by the best public health method, and that’s not having sex before marriage,” said Linda Klepacki of Focus on the Family, a Christian advocacy organization based in Colorado Springs.

That’s a very good strategy, but what if the husband you’ve saved yourself for just so happens to have HPV? While not having sex is certainly a sure-fire way to avoid HPV and other sexually transmitted diseases, women can still get HPV on their wedding night from their very first sexual contact. A vaccine doesn’t promote promiscuity, but rather protects you from a very very very very very common STD that many people (men especially) do not even know they have.

Making this vaccine mandatory may help ensure that it’s covered by insurance companies and federal programs which might otherwise choose not to pay for such an expensive drug (a 3-part series over 6 months, costing $120 per shot, so $360 total). From the same Times article above:

A federal program is expected to provide the vaccine to 45 percent of the children in the United States for whom it is recommended. But state programs that cover other children are having trouble buying other expensive vaccines.

North Carolina, for instance, spends $11 million annually to provide every child with seven vaccines. Gardasil alone would probably cost at least another $10 million.

“Increasingly, states are asked to make a Sophie’s choice about which diseases they will allow children to be hospitalized or killed by,” said Dr. Paul Offit, director of infectious diseases at Children’s Hospital of Philadelphia.

It will be interesting to see how all of this unfolds, but for now, it’s enough just to know that this vaccine has finally been approved. As Dr. Sedlis (the guest professor who lectured us on the interpretation of pap smears) jokingly said, if this vaccine becomes widespread, gynecologists are going to be out of a job in 20 years, since pap smears and the mangement of abnormal paps is their bread and butter. This is a vaccine that could possibly someday eliminate the need for routine pap screening for all women, and make cervical cancer, which is already rare in this country, all but obsolete. That’s pretty powerful stuff!

Addendum:
Slate Article: very astute break down of many of the issues surrounding the vaccine, including the costs, benefits and risks and moral issues, well worth reading.
Moderately Insane: HPV Insanity: interesting break down the risks v. benefits of the HPV vaccine, in very plain English.
Women’s Health News post on HPV vaccine, full of amazing resources, per usual.

If anyone is in New York in the next two weeks, be sure to check out Until the Violence Stops: NYC, a two week festival organized by playwright Eve Ensler to help educate and promote awareness about violence against women, with events and venues all over the 5 boroughs. Like V-Day, which uses creative events to increase awareness, raise money and revitalise the spirit of existing anti-violence organisations, this festival includes monologues, plays and spoken word performances by artists such as Rosario Dawson, Brittany Murphy, Cynthia Nixon, Isabella Rossellini, Kerry Washington, Selma Hayek, Rosie O’Donnell and more, workshops and forums to discuss the issue and ways to change the alarming statistics, and even a self-defense class. Topics include rape, domestic violence, incest, female genital mutilation (FGM) and sex trafficking, and even a panel discussion with women from global conflict zones. Read more about the festival over at Time Out New York (Antiviolent Femme)

And for those of you who are in town this weekend, come to Friends of the Birth Center’s 3rd Annual “Celebrate Birth” Picnic, which will be in Central Park this Sunday (June 18th). It should be a great afternoon, including birthday cake and lots of entertainment for the kiddies, and the $10 suggested donation goes towards (re-) opening a free-standing birth center in Manhattan after the tragic close of the Elizabeth Seton Childbearing Center. For more information, visit the link above. (Unfortunately, I’m going to be out of the city camping this weekend, but we get back on Sunday, and if we get back in time…I’ll be there).

Have any of you seen the new ads yet that are being run on TV by the Department of Health and Human Services to promote breastfeeding? They’re a bit controversial. I was watching one of them with a co-worker this morning at work who had been unable to breastfeed her daughter, and she was quite incensed, stating that there’s already enough guilt associated with not breastfeeding without the government heaping it on, too, thank you very much. The ad showed two heavily pregnant women competing in a dangerous looking water sport where you basically run in place on a pipe in the water, with one of the women falling off towards the end of the commercial. The tag-line ran something like: you wouldn’t take such risks while you’re pregnant, why will you take such risks by not breastfeeding after the baby is born? Or something along those lines. The New York Times ran an article on this yesterday, and The Gothamist picked this up, too. From the times article: “Dr. Haynes, of the Health and Human Services Department, said, ‘Our message is that breast milk is the gold standard, and anything less than that is inferior.’ Formula ‘is not equivalent,’ she went on, adding, ‘Formula is not the gold standard. It’s so far from it, it’s not even close.’ ” Now, these are words I can 100% throw my weight behind, and I think it’s about time the government and medical community has taken a very firm stance on this! The US has always had low breastfeeding rates when compared to other developed countries, and I feel like much of this is cultural: as the Gothamist points out, our society is still a lot more puritanical than we’d like to think, and there are so many barriers in place which make it very difficult to breastfeed, such as short maternity leaves, very little breastfeeding support (often just those first few days in the hospital), the absence of breastfeeding rooms and support in the workplace, and societal messages which make breastfeeding women feel anything but welcome to breastfeed in public (Birth and Breastfeeding news has a good article on such barriers from the Journal of Pediatrics.) Maybe a strong government campaign like this is just what we need to make it very clear, once and for all, that breastfeeding is not just okay, but DESIRED, something which we won’t just tolerate, but ENCOURAGE….but even so, those are pretty strong commercials. I wonder if there’s a way to promote this message with just a little less guilt. Maybe showing women breastfeeding in the workplace, or standing up to their bosses who are asking them to not pump at work, or telling off someone who’s making it difficult for a woman to breastfeed in the park, or something that takes the pressure off of the mother, and looks a bit more at the environment that mothers must contend with when trying to breastfeed.

I’ve been tagged by Melissa over at A Womb of her Own to answer a meme, which is not my usual fare, but hey, what the hell. Anything to lighten the mood. Here are 8 totally random things about me:

1. When I was a young child, I had an imaginary friend named Whaley. I have no idea why he was named that, but I used to insist that we set an extra place for him at the dinner table. My first stuffed animals were also named Alacross, Blueshields and Katarooley (sp?), and my blanket was named Blounrey (pronounced bloon-ray). Hmmmm.

2. There are two pretty prominant dimples just below my back (where the skin seems to connect directly to the posterior, superior iliac spine, without much padding underneath), just like britney spears!

3. Early aspirations included being a veterinarian or an animator for Walt Disney.

4. One of my favorite foods is salsa. Which is also my favorite condiment. In fact, with the possible exception of desserts, I think that a hearty helping of salsa makes just about everything taste better, and I’ve been known to eat it straight from the jar with a spoon, like chunky, spicy gazpacho.

5. I hiccouph approximately once an hour. In fact, my beloved boy has been known to time my hiccups on occassion, and they are, in fact, just about on the hour.

6. My two adoreable cats have been known to show each other a little bit more than just brotherly love from time to time. We’re pretty sure we know which one is the bottom, and which one is the top, too. And the bottom never sounds that happy about it. Given that they’re both neutered, and are actually littermates….does this make them incestuous gay cat lovers? Or is it really just about the alpha cat showing the beta cat who’s boss? I can never tell.

7. I’ve been to London roughly 9 times in the past 2 years, not including living there for 6 months last year. Impressive, eh?

8. One of my favorite brain-candy TV shows is Pimp My Ride, 2nd season especially. But alas, I do not own a TV (which is actually just fine by me), so I haven’t had an opportunity to watch any episodes since I was living in London. I don’t own a car, either. Go figure.

And now, without further adieu, I pass this random meme on to LadyElms over at Midwiffle Seed and K over at Told Not to Blog, should either of them be at all interested in taking up the torch (no pressure!).

I’m delighted to present another edition to the growing library of beautiful birth stories on this site, kindly submitted by RR. Thank you so much for sharing your story with us!

The birth of our son was very eagerly anticipated. Fourteen months before his due date, I had given birth to our first child, a girl, who was stillborn at 24 weeks gestation. I was very medicated during that birth, and didn’’t remember much of it. I was looking forward to not only finally having a healthy child, but to remembering the experience. My birth plan consisted of only two items: 1. Deliver a healthy baby and 2. I would prefer to be conscious and not have any narcotics.

I had been diagnosed with gestational diabetes at about 26 weeks, which was a shocker, considering that I was very fit, trim, and healthy throughout my pregnancy. I was at the gym lifting weights when I was 36 weeks along! The GD was a blessing in disguise, though –I got to have a lot of extra monitoring of my pregnancy, especially in the last six weeks or so. It gave me such peace of mind to go in for my weekly NST’s, and listen to the baby’’s heart thumping away. I had a sizing ultrasound and biophysical profile at 36 weeks, which was incredibly reassuring as well. With my history and the GD, my OB gave me the option of being induced after 38 weeks, or waiting to go into labor on my own up to 40 weeks. I chose the earlier option, and was scheduled for induction at 38 weeks, 4 days.

I went in to the hospital on a Wednesday for cervical ripening. I was about 2-3 cm and having painless contractions when they first hooked me up to the monitors. My NST a week before had shown contractions, but I really didn’’t feel them at all, so it was fascinating to watch the monitor, and figure out what was going on with my body, all the while hearing the baby’’s heart thumping away. After the baseline monitoring was done, I got a dose of cytotec in my cervix. By morning, I was a little more than 3cm, but much more effaced. I got another dose of cytotec, and was still having pretty painless contractions - nothing more than moderate menstrual cramps. The nurses kept asking me if I felt any contractions - apparently, they were pretty strong on the monitor, but I was barely feeling anything at all. At noon, the OB came to check me and I was 4 cm, so he went ahead and ruptured my membranes. The nurse asked if I wanted an epidural so that she could start IV fluids before they started pitocin and page the anesthesiologist. I almost hesitated since my “labor” had been entirely painless to that point. Well, I didn’t need any pitocin. Within a minute of my membranes being ruptured, I was having INTENSE one on top of the other contractions with no breaks in between. It seemed like suddenly the lights were all too bright, and everything was too loud, and just could NOT stand anyone asking me any more questions. I did my best to just concentrate on breathing during the contractions.

The anesthesiologist arrived at 1pm, and I was checked again - I had gone from 4cm to 8cm in just under an hour! At that point, I remember some discussion about whether or not there was even time for an epidural. There was some commotion in the room that I couldn’t figure out, –I was too busy just breathing. The anesthesiologist was able to get the epidural started, however it was working only on my left side - the right side was feeling everything, and I got incredibly nauseated and was vomiting. As painful as the contractions were, the vomiting was the worst part for me. After almost an hour of fiddling with the epi and the dosage, the anesthesiologist took it out and did another one - heaven!! At that point, I looked over to the baby warmer and noticed that everything had been set up for the baby’s arrival, explaining the commotion earlier. Thankfully, the epi slowed my labor a little bit, because the baby had been having some accels and decels in his heart rate that seemed to concern everyone but me. I started pushing at 4:10 pm, when I had just a small lip of cervix left. My epidural was just right: I couldn’t feel intense pain, but I knew when I was having contractions, and had no trouble pushing. The nurse coached me through a few different positions to help move the baby down better. By 4:45, my cervix was completely gone. Near the end of pushing, the baby’s heart rate was accelerating again, so the OB got ready to use the vacuum on him. However, I was able to push him out all on my own, and he was born at 5:56 pm. There were many tears of joy. My husband and I were beyond relieved to have our son safely with us at last. His apgars were 8/8, and he weighed 8 pounds, 5 ounces. Fortunately, I had only one very small tear that required a stitch or two. All in all, this labor was really a breeze, – much easier than I was expecting it to be.

My husband was such a trooper! I had prepared him for a long a boring labor, and we definitely weren’’t expecting it to happen so quickly. We’’d left all our music in the car, thinking that he’d go out and get it during one of the boring parts, but there were no boring parts! Once my labor got going, I really didn’t care what music was or wasn’’t playing. My husband and I were just focused on getting our baby boy into the world. It was so amazing to finally meet the little person we’’d been imagining for so long.

And then people send me beautiful, delicious birth stories like the following, which was written by my friend Miriam, and I am so grateful that births like this exist! Congratulations on your lovely birth, which would have most likely become an emergency c-section if it had occurred in the hospital (since very few doctors know how to deliver breech presentations, and it’s no longer even taught in med school). Three cheers for homebirth! Enjoy:

Nadia Tell was born on Friday, May 19. She was 37 weeks and 2 days gestation, and is healthy and wonderful and loved.

Thursday, May 18, was a gorgeous perfect May day. I walked down to the Chocolate Gecko and spent a good two hours chatting with Lissa, the owner, while she dipped an order of chocolate-covered fruit (and fed me the ones that got marred by being dropped on the counter). She was talking about other young families in the neighborhood and wanting to put us in touch, and generally thrilled to hear all about our plans.

On the way back I stopped in the dollar store and CVS for some final birthing pool-related supplies—sponges, a hand mirror, an inflatable ring. It felt, like much of the rest of our prep, like I was ticking off the ends of a list by a deadline so we could be well-prepared well ahead of time. I wrote a piece for Metroland’s summer guide that wasn’t due until June 1, and sent it in, cleaned the microwave, and sat on the porch enjoying the weather with Mary, knowing from her that the weather report was predicting big storms coming in and rain for days. It felt like it was likely to be one of many similar days to come. I had lots of things to do, but nothing felt urgent, and I was enjoying the calm.

I made dinner since Robin and Rebecca had somewhere to be early evening. We put off our usual Thursday grocery run until Friday. Over dinner we discussed the far-fetched proposition of buying the Chocolate Gecko (Lissa’s selling and was pushing it). It was a fun and fanciful conversation. I was writing something about it in my journal before bed, and sat down on a stool in my bedroom to note down a few last thoughts.

As I leaned forward I felt a tiny movement down low near my cervix, and sudden there was a flood of warm liquid all over the floor. It was hard to believe and yet unmistakable. I stood up, still gushing, and called “Hey guys?” A face popped out of the bathroom and another from their bedroom. “My water just broke.” (Read on …)