labor nurse has been reborn and shares her experiences as a new nurse-midwife, woman, and blogger

Tuesday, March 25, 2008

More On Being Naive

I'm not singling this comment out because it opposes the majority, but because my response requires more than the space provided in the comments section. And BTW, I like to have good natured debate here on the blog.

Ok. I'll bite. I come from a 3rd world country and have been living in the US for only 4 years so this may come off as being ignorant.But let's start with... how about stop having babies until you can provide a stable environment for your child? I understand the first one. Everyone makes mistakes. But shouldn't one learn from them? When you can't provide/secure a safe and warm place for your 4-year old daughter, then why are you having more kids?It's not like birth control is hard to come by. One can get them for free at planned parenthood or at the public health office. Maybe get some family planning counselling while you're at it. I guess I don't get it. The United States may not be the land of milk and honey as, we 3rd worlders think it is but it sure does provide one with a lot of opportunities to get back on your feet. Or at least not commit the same mistakes over and over and over.

I don't think your opinion has anything to do with being from a third world country, as many of American born and bred feel this exact same way. As a matter of fact, so did I, until I kept talking with these women and learned their stories. People fail to look at details that we, as secure and middle and upper class citizens, couldn't consider only because such details don't exist in our lives.

Specifically regarding the 27 year old in the post below, access to birth control wasn't as easy as one would think. First, she was ineligible for Medicaid in our state. Therefore, she couldn't afford care, even the reduced fee at an area clinic. So, even though Walmart (there is one locally) has two birth control pills on their $4 list of prescriptions, she couldn't afford the visit in which to get the prescription. The closest Planned Parenthood is about 30 miles away in a city where the public transportation in her city did not have routes to. And out public health department does not provide free birth control.

I guess the next logical thought would be to tell her to just not have sex, because there are no other options for her to protect against pregnancy. But, do we really have a right to tell people this? Certainly, as clinicians, we should counsel that abstinance is the only 100% effective method of birth control, and I think most people who have brain cells that rub together know this. Or perhaps she could have used a calender based method (commonly known as the rhthym method) but the most accurate ways require learning differences in cervical mucous, taking your temperature with a basal body thermometer every morning, and graphing your assessments daily. This is harder than it appears and not everyone can do it accurately. Not to mention that many people don't know of any of these methods so they wouldn't even know they could go to the library and read about it for free, let alone pay for an appointment to be counseled by a clinician. And even for those who use calender methods of birth control, the failure rate within the first year is about 25%.

There are so many different unique situations that have aspects that are barriers to these women. We can't start making the assumption that she should "just get on birth control" or "just stop having kids". I look at it the same way I look at women in domestic violence relationships. Many would say "just leave", but its not as easy as that.


Nikki57 said...

Well condoms are always a good option. I know my doctors office has them in the waiting room and anyone can come in and grab handfuls of them even if they can't pay for an appointment, but that's not the point. It is so sad that there are women in this situation and I can't even begin to imagine how hard it must be. I really wish there were more services for women like her that could help her get back on her feet, even if it was as basic as just providing her childcare so she could work.

Anonymous said...

Thank you!! I was really happy to read your first blog on this subject, and I'm even more happy to read this one. Its nice to have someone see the flip side of this situation.

I'm an example. I am pregnant with my 3rd child. Financially, we will have a tough time providing for this baby (along with our other two children) but we WILL make ends meet. I was on birth control pills. I took my pill correctly. The only inconsistency I had was this: I usually take my pills in the morning -- at 9AM -- every day. One day in my 3rd week of pills, I took one pill at 9PM. I thought nothing of it. Lo and behold, I had no period and found out I was pregnant with this baby.

Was this baby planned? No, he wasn't. Was this the best time for us to have another? No, it isn't. Will we love this child and count him as a blessing? Without a doubt! I caught alot of flack for this. I had a *friend* run me over emotionally over this situation. She basically told me that I shouldn't be having sex if I can't afford another child. How do you think I felt after that one?

Anyhow, applause to you, Labor Nurse, for your caring and compassion for others! I hope that when I pursue my nursing career (which I plan to do once my kiddos are older) I can be alot like you!

GuitarGirlRN said...

I'm sorry, but at any drugstore you can get 12 condoms for six dollars. That's fifty cents apiece. Six dollars is a half a day's worth of panhandling.

And honestly? If you're worried about where you're going to sleep tonight and how you're going to feed your kid, perhaps you don't have time for a hookup. If this woman is prostituting herself in order to have a place to stay for her and her child (believe me, I know this happens), then she needs to take care of herself and her child by not getting an STD or HIV and should be using condoms anyway.

It's not the same as being in a domestic violence relationship. The violence is being forced upon the person, and they are dependent upon the abuser for a place to live.

Unless this woman is getting pregnant from being raped (and if she is, that is truly horrific and of course she should go to the police and get help), she is making a choice to have sex. She knows where babies come from. And she knows how not to have babies.

I completely agree with you that the cycle of poverty this woman is stuck in is terrible and is very difficult to escape. But one way to do that is to take control of the one thing you have control over, and that is your own body.

mommymichael said...

We were using the rhythym method to GET pregnant and watching my mucus. *this was with my first pregnancy* i not only didn't ovulate and conceive when i thought i did, i became pregnant just before my period was due! i was WAY off!

i didn't get a positive pregnancy test until more than a week past my missed period!

i think i just naturally ovulate at the end of my cycle, because same thing happened a second time around.

Anonymous said...

I don't think it's the getting pregnant and having kids that's the issue. Sure, it's tough for a child to be born in a "high risk" environment...but I am one of those kids born to a mother who was 17 and was a drug dealer by the time I was 5. Still, I am glad to be here. I now live with my husband and we have one income and we choose to have children as they come. I have six children, and we're happy to have every one of them. I have been asked about "getting my tubes tied" by my OB and I know she means well, but we love all six of our children. We would love six more just as much. Sometimes, it's not what people think. Yes, we struggle, yes we pinch pennies, but we also know that what some think is poor is not as poor as they think. We do all we can for our children, and they actually may be better off than if they were born into a small family with a lot of money...


Prisca said...

preach it, sista!

Anonymous said...

I don't agree. I think if you have the desire and willpower you can make yourself a better person. I didn't come from a fabulous childhood. Quite frankly I came from a crappy childhood. I was exposed and lived a life of domestic violence till my mother left. Then my mother was the emotionally abusive one. We still have our issues today. I definitely lived on the wrong side of the tracks. BUT,

I worked 40 hours a week starting when I was 16. I paid for my own car, clothes, etc. I did have free medical care through the military till I married my dh at 21. I got into college and paid my way through. I graduated and have my bachelor's degree. There were times when I ate ramon noodles for weeks, but I did it. Before anyone says well you didn't pay living expenses, you are wrong. Many times I paid to keep the electric and stuff on. When I was in college I worked 3 jobs to make ends meet.

When my dh & I got married. We applied for financial aid (didn't qualify because my mother made too much money and I was not a minority. Not sure how that was because she made 30k at the time total). Even though my mother did not support me in any way, I still was not an independent student. Anyway, my dh and I made together 17k a year. I finally qualified for student loans.

Now I live an upper middle class lifestyle. I don't agree with people are too poor to know or anything. They don't have access to services. I didn't have access to services either and made it work. My mother never helped with anything.

The easy way out is to say well I never knew about the good life and the world crapped on me and I didn't have good role models. That's the easy way out. The hard way is to bust your tail like I did for many years and make something of yourself. I didn't have postive role models. In fact, I was the first girl in my family to go to college and graduate with a degree. I knew there was something better. I could fall in with kids in the neighborhood. Or I could bust my tail and do something about it.

Condoms are not expensive. I can understand if BC fails because it happens. However, to say that there is no access is not true.

Hilary said...

Thank you for a wonderful post. I have been pregnant four times, all unplanned, three times using birth control, including those condoms you say are so cheap at the drugstore. Oh, and I am in medical school, studying to be an Ob Gyn. Every failure rate is real women.

I hate to see people being so judgmental toward women. 50% or more of pregnancies in the US are unplanned. Is it only women under a certain income level that the judgmental people have a problem with? I have known poor parents that are great parents, single moms that are great parents, and married rich people who are lousy parents.

It is way too easy to stand in judgment of people we don't know (and we dehumanize), but the beauty of the original post the comment was on was that if you get to KNOW women, it is a lot easier to sympathize with their situation. Oh, and to respect their right to have sex and reproduce in the matter that they see fit, or simply find themselves in. I would never want to stand in judgment of ever sexual decision that commenters on blogs make, and I doubt they would want to open up their personal lives in that way.

Eliza said...

I'm not going to say it's as simple as not getting pregnant or using birth control, because clearly it isn't (though please be more specific - sympto-thermal charting is NOT a calendar method, and frankly many more women could do it if they were taught properly). Yes, condoms don't cost much, yes abstinence would be the best solution.

I feel for this woman and her struggles. Surely it is a terrible thing to worry about where you sleep and where your next meal could possible come from. It is not easy to make it out.

However, I've known many women to make it through and by, scraping and clawing. She is fortunate that she had a boyfriend standing by to bring in some money.

But there are a ton of programs out there that could have helped her - lots of counties and states have daycare assistance available, and there are a number of jobs that offer daycare assistance. WIC can help with groceries and it is possible to eat well on a very small budget with creative planning. I do not see why, if in fact her boyfriend was around, she would be unable to work a part time job on second or third shift to bring in more money. No, it's not desirable, but certainly it could be done to keep a rood over my child's head.

There are also a number of options for women who stay at home to bring in additional money. Drop in babysitting, for instance, pet walking, envelope stuffing and telemarketing from home even. I know not everyone is aware of these options, but they are out there.

I have even heard of program (though they tend to be in larger, more liberal cities) that match women who trade off watching each other's children while they work part-time, so that she would be responsible for 2 children without compensation, but in return would know her child was safe while she pursued part-time employment.

It is a frustrating and sad situation, certainly. And the reminder that we shouldn't make judgements without the facts before us (or even then, because we none of us are perfect) is an excellent point. But I cannot agree that it is impossible to find a way - I know too many women who have done it.

Labor Nurse said...

I certainly don't think it's impossible for these women to get out of these situations. But given many circumstances, it's extremely difficult, and if the woman does not know of available support or have contacts that could hook her up with available services. I'd imagine depression plays a large role in these situations, and depression can certainly play a role in motivation and further feelings of despair.

I also think there are women who really don't want to better themselves, think it may be easier to live "off the system", but I don't think its as often as people think. Rather, I think most women want to better themselves and their families but find the mountain in front of them is almost impossible to scale.

Labor Nurse said...
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Labor Nurse said...
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Labor Nurse said...

I certainly don't think it's impossible for these women to get out of these situations. But given many circumstances, it's extremely difficult, and if the woman does not know of available support or have contacts that could hook her up with available services. I'd imagine depression plays a large role in these situations, and depression can certainly play a role in motivation and further feelings of despair.

I also think there are women who really don't want to better themselves, think it may be easier to live "off the system", but I don't think its as often as people think. Rather, I think most women want to better themselves and their families but find the mountain in front of them is almost impossible to scale.

Scherza said...

How sad to think that people would say to or about a woman who chose to give birth to her child that she shouldn't have done so if she couldn't "afford" to do it. This is a child -- a human being -- not an expensive car on which she can't afford maintenance in her situation.

But it's also a bit disheartening to hear a medical professional lump well-researched, accurate, and reliable methods of natural family planning that involve charting and observing fertility signs in with outdated and inaccurate methods like the rhythm/calendar method. Many couples successfully use one of the methods like FAM, NFP, or the Billings or Creighton methods in order to achieve/avoid pregnancy with a far lower failure rate than 25%. When used perfectly, NFP's published failure rate is under 2%, which is comparable to the failure rate with perfect usage of many synthetic methods of birth control.

But in this situation...if the woman couldn't even get to the doctor because she was so caught up in just trying to survive, I doubt that any method of birth control was high on her list of priorities. I don't think some compassion comes amiss here -- it certainly isn't as though women in terrible circumstances are having babies to make their lives easier!

Labor Nurse said...

scherza, in regards to "lumping" NFP methods together and calling it a calender method, etc, is for simplicity sake. Most people don't know the methods in which you mention. Also, many people do not fall into the "perfect use" category, and so I lean to looking at the "typical use" statistics (I do this with all methods). For the fertility awareness methods/NFP, the failure rate in the first year ranges from 12-25% depending on the specific method being used.

And you make an excellent point, these women don't have babies to make their lives easier!