Sunday, June 20, 2010

Lost IUD

Yesterday I delivered a baby, and we had been working on it all night-- so I was tired and cranky when I got home after finally having to do a C/Section for failure to progress. It was a mystery why the labor stalled, and I was disappointed, as was the mom, although we were all relieved to have a healthy baby come into the world. I was just starting to eat breakfast, when I got called to the ER. Bummer! There was a lady with a lost IUD who wanted it removed. I had seen her a few days before, and she had been crampy. We had done an ultrasound to show it was centrally placed in the uterus, and the string was visible. So I had told her to keep trying the anti-inflammatories for a few more days and see how it goes. Now she couldn't stand it any more, and the ER doc said the string was no longer visible. So I stopped at the office to get my "little bag of tricks"-- hooks and narrow-tipped graspers, for going fishing in the uterus. I gave her iv fentanyl and toradol, and a paracervical block. She was not febrile and there was no evidence of infection. I used each instrument twice, with a twisting motion. The third time was the right one, and the little hook was able to grasp the t-bar of the IUD and get it out. The string had twisted itself upward and around the long bar, as though it were ivy climbing a tree, up away from the cervix. The tip of the string was poking upward, so it perhaps was the reason for the persistent cramping. The woman was very relieved that we could get it out, without having to go to the OR. And I started thinking about all the crazy things women have to do to be responsible about contraception; and other ways we get tortured to be what we think "women are supposed to be". I have one woman who comes in with the pointiest high heels, and I feel so sorry for her feet! I usually like the Mirena IUDs, as they reduce cramping and bleeding. This is only the second time in my career that a woman needed to have one removed because she couldn't stand the cramping. I thought about this woman, in her early 40's-- going out to feed her horse, getting so nauseated and crampy that she couldn't stand up, and had to come to the ER to get this IUD out. In the afternoon I went to see the movie "Babies". My friend and fellow FMM person, Janet, has a cameo role in the movie as the pediatrician of Hattie. Watching the babies in Africa and Mongolia was a trip. I really thought about contraception, and how the world has changed since the OCPs were developed in the 1960's. I thought about people in Africa and Asia needing the kind of contraception that the Mirena can offer-- but it costs us $600 for each IUD. I want to see all those babies fed and comfortable, and playing with their moms and siblings. I want the dads to arrive and laugh and play, at the end of the work day. I want to see animals around them peacefully playing. I do not want to see starving children in refugee camps, and mothers who have lost their babies to disease listlessly sitting in grief.

Thursday, June 17, 2010

Homes

This morning the Wall Street Journal had a very pious, holier-than-thou article by some financial genius about the problem with Americans having homes without enough equity in them, and the foreclosure and loss to the banks of that lucrative market. The person writing this said that probably people should not be allowed to buy homes they can't afford. The 30 year fixed mortgages are a bad idea because Europe has a much more stable society with shorter mortgage loans. When I think of Europe, I think of families who have lived in towns for hundreds of years, holding on to the family farm, and only having 1 or 2 children, so that they can keep that property. What made me angry, in thinking about this the rest of the day, is how the families I know are struggling to be able to raise children. No longer can people afford even 4 children-- we are down to 2 or maximum 3. College is too expensive, dental work is too expensive. In our area, the gang warfare is rising, as the children of low-income field laborers hit the ceiling after high school, and can't go on to get that diploma which might afford them the WAGES to get a home. Many young people are renting, and the rental neighborhoods are where the crack, meth and cocaine is being bought and sold. Single moms abound. Most of the single moms I know are single because the men were unfaithful or alcoholic, or on drugs. A few are because the woman was unstable or addicted or unfaithful-- but mostly it happens because the women couldn't carry the burden of the family alone, and they couldn't afford to let the man soak up what was needed for having a home and food for the children. Men who are willing to get married, have a 30 year marriage and a 30 year mortgage, and raise kids who can get to college if they apply themselves, are the most precious commodity in our society. I see so few. I know some, from my college years. But around me are so many women who are like birds with broken wings, trying to fly, trying to feed the chicks. And now I know some young men, who also are good fellows, who deserve to make enough so that they can get married and afford a home for their families. It is all tied to the structure of wages and benefits. If the goal of these financiers is to have cheap labor, which always seems to me to be their main goal, they are winning. They have pushed back against the potential for wage increases and benefits, and all the ways which one might be able to use to make a 30 year mortgage possible.
What the article didn't address is the speculators, who are not interested in living in the homes they purchased-- they were just trying to make extra money. This reminds me of the plague of locusts in the Bible. Why was the banking industry allowed to de-regulate, so that those locusts could get those loans-- without any evidence that they were planning to stay in the community and live there, bring up a family there, be contributing members of society there?? Why weren't those questions asked by those brilliant financiers? Most of the young people I know are hitting 30 before they can afford the downpayment on a home, get married or get pregnant. Most of the women are anxious, because even with a husband and a good salary, they need two incomes for that home to be purchased. But what banking morons think that bringing up a child in a rented home is more secure, more stable, more good for the mental and physical health of the child or family? Why would it be better for society? No, it is only so they can have access to cheap labor. Labor which is not paid SUSTAINABLE rates.
God bless the men who are good husbands and fathers, and are working to pay those 30 year mortgages. And may someone inform the bankers about it.