Why I Miss Bill Clinton (and other thoughts):

Ever heard of it? Can you pronounce it?

This is the name of the cancer that my mom has been surviving for the past 4+ years. It's become a regular part of our family vocabulary. Since her initial diagnosis in 2003, she (and the rest of us) have weathered a few recurrences. This time, the stakes are a bit higher with potentially major surgery to remove a significant portion of her liver on the horizon. We'll know more after next Tuesday when she meets again with her oncologist. In the mean time, we're hoping and praying for the best!

To learn more about Leiomyosarcoma, click here. To sign a petition asking the President to make April 26th "National Leiomyosarcoma Awareness Day," click here.

Finally, here's a recent news story of a women's daring surgery to address her own Leiomyosarcoma. Rare coverage for a rare disease...

Breakthrough Cancer Surgery Saves Terminal Patient

By JEFFERY KOFMAN and ROGER FORTUNA
March 25, 2008

Doctors are releasing Zepp from the hospital in Miami today and believe she is now free of cancer.

Posted by Sarah Shannon at 08:55 PM | Permalink | Comments (0)

Within the span of an hour this afternoon, I found myself sitting across two very different tables. The first was at the county jail. I was conducting a follow-up interview for the research project I'm working on. Surrounded by concrete walls with security doors buzzing and slamming in the background, I listened for 45 minutes while a young man described his nine days of freedom in-between lock-ups. As we parted through separate security doors he said, "So I won't ever see you again?" and I said, "No, I don't think so," followed by a reiteration of the study's location within the U should he want to contact us with any questions. We shook hands.

After paying a ridiculous $15 for 45 minutes worth of parking downtown, I whisked myself back to the U for my Friday afternoon seminar on the life course and found myself siting across a very different table from nine other highly educated people surrounded by a great view of the city through large windows. Funny enough, the topic was intra-societal variation in the life course featuring readings about the very social structures and circumstances from whence my research participant hails. Though I'm always at least somewhat aware of the distance between myself and those I "study," the chasm felt especially wide this afternoon. Perhaps the two tables made it all the more clear.

If nothing else, the experience renewed my resolve to always remember the humanity of those I study. They aren't abstract concepts to be operationalized and fitted into regression models. They live and breathe and suffer and rejoice all the while I read and write and do this academic thing and tell myself that maybe what I do might be of some benefit to them...somehow.

Posted by Sarah Shannon at 11:35 PM | Permalink | Comments (0)

Far greater minds than I have blogged recently about the Pew Center's report citing 1 in 100 Americans now in prison, so I hesitate to even approach it. But the hubster forwarded a link today to an editorial in Time (below) by the writers of The Wire, a show we have watched religiously for the past several years. I find two things intriguing about the editorial: 1) the appeal to draw from fictional characters the inspiration to enact social change and 2) jury nullification as a legitimate route for citizens to take action.

The authors put on no airs regarding their lack of authority on the subject, except that they have spun a good tale for TV that takes on real issues of race, crime, law enforcement, education, and general urban decay in perhaps one of the most accurate attempts to date. But they do evoke their characters as muses for average folks who might want to make a difference in the sad state of U.S. carceral affairs. I can't help but wonder if the same viewers the authors hope to inspire spent one hour per week on some of the corners in my neck of the 'hood would find similar sympathy for my less-than-fictional drug dealing neighbors? I don't have to turn my TV on to see "the other America."

At the same time, I resonate with the authors' assertion that politicians are not likely the best targets for citizens who want to effect change when it comes to penal policy. Even our beloved Bill is culpable for a great deal of "get tough on crime" policy in the 90s that has contributed to this trend. Neither Dems nor Republicans are likely to "get soft" anytime soon. In this respect, I'm intrigued by the idea of jury nullification as civil disobedience. It seems like it might have little impact, unless it were to become a widespread practice. How many non-violent drug offenses actually go to trial vs. plea bargaining? Within that number, how many will have juries with willing objectors? For instance, I have yet to serve on a jury for anything, ever, much less a drug trial.

I have no real expertise to speak to the law enforcement side of things, but anecdotally, having lived for 2 years on a block where open-air drug dealing was an unrelenting daily reality, the police didn't seem to be able to do much about it by continually arresting the lil' homies on the corner. Our neighborhood association regularly sends us opportunities to give "community impact" statements on offenders, many of them drug-related, and the sheer number of arrests and/or convictions for many of these individuals is staggering - yet the problem persists.

It's an interesting proposition - if I do get called for jury duty in such a case, I guess I'll have to consult my conscience...

Wednesday, Mar. 05, 2008
The Wire's War on the Drug War
By Ed Burns, Dennis Lehane, George Pelecanos, Richard Price, David Simon

We write a television show. Measured against more thoughtful and meaningful occupations, this is not the best seat from which to argue public policy or social justice. Still, those viewers who followed The Wire — our HBO drama that tried to portray all sides of inner-city collapse, including the drug war, with as much detail and as little judgment as we could muster — tell us they've invested in the fates of our characters. They worry or grieve for Bubbles, Bodie or Wallace, certain that these characters are fictional yet knowing they are rooted in the reality of the other America, the one rarely acknowledged by anything so overt as a TV drama.

These viewers, admittedly a small shard of the TV universe, deluge us with one question: What can we do? If there are two Americas — separate and unequal — and if the drug war has helped produce a psychic chasm between them, how can well-meaning, well-intentioned people begin to bridge those worlds?

And for five seasons, we answered lamely, offering arguments about economic priorities or drug policy, debating theoreticals within our tangled little drama. We were storytellers, not advocates; we ducked the question as best we could.

Yet this war grinds on, flooding our prisons, devouring resources, turning city neighborhoods into free-fire zones. To what end? State and federal prisons are packed with victims of the drug conflict. A new report by the Pew Center shows that 1 of every 100 adults in the U.S. — and 1 in 15 black men over 18 — is currently incarcerated. That's the world's highest rate of imprisonment.

The drug war has ravaged law enforcement too. In cities where police agencies commit the most resources to arresting their way out of their drug problems, the arrest rates for violent crime — murder, rape, aggravated assault — have declined. In Baltimore, where we set The Wire, drug arrests have skyrocketed over the past three decades, yet in that same span, arrest rates for murder have gone from 80% and 90% to half that. Lost in an unwinnable drug war, a new generation of law officers is no longer capable of investigating crime properly, having learned only to make court pay by grabbing cheap, meaningless drug arrests off the nearest corner.

What the drugs themselves have not destroyed, the warfare against them has. And what once began, perhaps, as a battle against dangerous substances long ago transformed itself into a venal war on our underclass. Since declaring war on drugs nearly 40 years ago, we've been demonizing our most desperate citizens, isolating and incarcerating them and otherwise denying them a role in the American collective. All to no purpose. The prison population doubles and doubles again; the drugs remain.

Our leaders? There aren't any politicians — Democrat or Republican — willing to speak truth on this. Instead, politicians compete to prove themselves more draconian than thou, to embrace America's most profound and enduring policy failure.

"A long habit of not thinking a thing wrong, gives it a superficial appearance of being right," wrote Thomas Paine when he called for civil disobedience against monarchy — the flawed national policy of his day. In a similar spirit, we offer a small idea that is, perhaps, no small idea. It will not solve the drug problem, nor will it heal all civic wounds. It does not yet address questions of how the resources spent warring with our poor over drug use might be better spent on treatment or education or job training, or anything else that might begin to restore those places in America where the only economic engine remaining is the illegal drug economy. It doesn't resolve the myriad complexities that a retreat from war to sanity will require. All it does is open a range of intricate, paradoxical issues. But this is what we can do — and what we will do.

If asked to serve on a jury deliberating a violation of state or federal drug laws, we will vote to acquit, regardless of the evidence presented. Save for a prosecution in which acts of violence or intended violence are alleged, we will — to borrow Justice Harry Blackmun's manifesto against the death penalty — no longer tinker with the machinery of the drug war. No longer can we collaborate with a government that uses nonviolent drug offenses to fill prisons with its poorest, most damaged and most desperate citizens.

Jury nullification is American dissent, as old and as heralded as the 1735 trial of John Peter Zenger, who was acquitted of seditious libel against the royal governor of New York, and absent a government capable of repairing injustices, it is legitimate protest. If some few episodes of a television entertainment have caused others to reflect on the war zones we have created in our cities and the human beings stranded there, we ask that those people might also consider their conscience. And when the lawyers or the judge or your fellow jurors seek explanation, think for a moment on Bubbles or Bodie or Wallace. And remember that the lives being held in the balance aren't fictional.

The authors are all members of the writing staff of HBO's The Wire, which concludes its five-year run on March 9

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Posted by Sarah Shannon at 11:17 PM | Permalink | Comments (0)

My sis called this morning to tell me about our sad loss of Christopher Bowman (aka "Bowman the Showman"), one of my all-time favorite figure skaters. He was at the height of his amateur career during my adolescent years as a competitive figure skater. While I never aspired to the national, world or Olympic level myself (call me a realist), I certainly admired those who made it there and made it great to watch. Christopher was one of those. My sister and I were recently recalling how we met him backstage in the early '90s, during a tour of skating champions at the Met Center. He was all smiles and flirtation and, of course, there was that tantalizing bad-boy devil tattoo on one bicep.

You'll find pictures online of his more recent years, looking less-than-fit, and hear about his troubles with drugs and the law. But I prefer to remember his as he is pictured at left and as I met him - flashy, flirty, and fast.

Image Source

Posted by Sarah Shannon at 02:14 PM | Permalink | Comments (1)

Until this week, I associated the above phrase with memories of painful visits to department stores with my mother to buy new clothes for the impending school year. My favorite was my junior year of high school, at which point I refused to try on, much less buy, any stitch of clothing that was not black. But this week ,we started looking at potential kindergartens for Micah, who will be five in June. Believe me, we are ready to stop paying for daycare, but I'm also experiencing significant mommy anxiety about my baby going to school!

We're sending Micah to public school for multiple reasons: 1) We can't afford a private school even if we wanted to consider it; 2) No way in heck are either of us homeschooling him; 3) Jerry and I are both products of public school and hey, we're doing pretty well so far; 4) We believe it's a way for us to invest in our neighborhood and community through our involvement in his education there.

We visited two public schools this week, one near the U of M campus and the other in our neighborhood. Micah had two very different reactions to each. The one near the U is larger, both the building and the student population. Micah seemed overwhelmed the whole time and didn't have much to say about it when we asked if he liked it. The second school, in our neighborhood, is smaller and we've been there before for community events. Micah was much more responsive during the tour to the classrooms and the school staff. Afterwards, he said that he liked the school because "they have legos in the classroom" and he likes the big climber outside. I had been leaning toward our neighborhood school anyway, so I was glad that he liked it as well. It's most important to me that Micah feels comfortable at whatever school he attends. Curriculum and other things are a little less important to me at this point. He's got a great foundation from preschool (and maybe some genes?) and the neighborhood school has great test scores (for however much that matters - not much in our opinion, but it's at least one indicator to look at).

Minneapolis Public Schools has it's "School Choice Fair' this Saturday, which we will also attend. I don't know if we'll decide to visit more schools or not. I do know that no matter where Micah goes, I will likely be that crazy mom who drives behind the school bus and watches to make sure he makes it there ok. I think he's too young yet to be embarrassed, and I'm sure I'll get over it....someday.

Image Source

Posted by Sarah Shannon at 09:43 PM | Permalink | Comments (2)

I've blogged before on the much-dissed social work profession in the media. As the hubster and I are rushing to catch up on Season 4 of HBO's The Wire before the 5th (and final) season starts up on January 6th, I was momentarily delighted to see not only social workers but social work researchers portrayed on the show. Note I said momentarily delighted. I thought, "Ha! Finally something different and, dare I hope, positive about social workers on TV!" The premise is that a professor (white guy on the right), purportedly from the University of Maryland School of Social Work, wants to conduct research and pilot a program with severe and persistent juvenile delinquents. Cool, right? Well, that was before the character broke every IRB (Institutional Review Board) protocol known to man and proved to be absolutely inept at interviewing his targeted population - and this from a tenured professor, supposedly an expert in his field! Oh sure, let's just walk into a police station and start interviewing - on tape no less - minor kids without obtaining informed, much less parental, consent! And then let's flinch in fear when the kid utters (okay, shouts) his first "Fuck you!" Yeah, you know what you're doing Mr. Big Expert Professor of Social Work Guy.

Oh well.

The Wire is still far and away one of the best shows every made. Even cops and drug dealers say so. Former commander of our precinct in inner city Minneapolis, inspector Lee Edwards called it one of the most accurate representations of urban policing he's ever seen. I believe him. It's not hard to find parallels in current events in Minneapolis, such as the lawsuit recently filed by five high-ranking black police officers and a botched raid last week of a family home in our neck of the 'hood (Oops! Our typically reliable confidential informant (CI) gave us bad info...). The Wire has it all from the state capitol to the street. Now, if they could just get it right with professors and social workers....

Posted by Sarah Shannon at 05:19 PM | Permalink | Comments (0)

The CDC has released it's preliminary data from 2006 and guess what? The cesarean rate has jumped 3% from 2005! It's all I can do to keep from crying. Too many mothers are being cut and too many mamas and babies are being put at risk, all in the name of "safety" and other obstetric myths.

From ICAN:

Cesarean Rate Hits a New High
Recent Studies Show Cesareans Can Pose Dangers to Mothers and Babies

Release Highlights:

* Cesarean rate at record high in the U.S.
* Cesarean rise coincides with CDC report that maternal death rate rising for the
first time in decades.
* World Health Organization data shows that mothers die at a higher rate in the
U.S. than 40 other countries.
* Consumer Reports includes cesarean on “10 overused tests and treatments”

Redondo Beach, CA, December 5, 2007 – The National Center for Health Statistics has reported that the cesarean rate has hit an all-time high of 31.1 percent.

CDC's Preliminary Data for 2006

“There’s no doubt that cesarean surgery is being overused,” said Pam Udy, president of the International Cesarean Awareness Network. “Unfortunately, despite its reputation as a harmless surgery, many women and babies are paying the high price of complications from this surgery.”

For the second year in a row, ICAN has compiled a list of research from the past year that shows cesarean surgery should be used more judiciously and that VBAC should be used more routinely. (See attached) Currently, more than 300 hospitals across the U.S. ban women from having a VBAC, essentially coercing them into unnecessary surgery and feeding the growing rate of cesarean.

The risks of cesarean were tragically highlighted this year by a rash of deaths related to the surgery, including two schoolteachers and friends from New Jersey, Valerie Scythes and Melissa Farah, who died within two weeks of each other in the spring. Both left behind healthy baby girls.

In August, the Centers for Disease Control released a report showing that, for the first time in decades, the number of women dying in childbirth has increased. http://www.cdc.gov/nchs/data/nvsr/nvsr55/nvsr55_19.pdf Experts note that the increase may be due to better reporting of deaths but that it coincides with dramatically increased use of cesarean. The latest national data on infant mortality rates in the United States also show an increase in 2005 and no improvement since 2000. http://www.cdc.gov/nchs/products/pubs/pubd/hestats/prelimdeaths05/prelimdeaths05.htm

“At a time when maternal and infant mortality rates are decreasing throughout the industrialized world, the United States is in the unique position of having both a rapidly increasing cesarean rate and no improvement in these basic measures of maternal and infant health.” says Eugene Declercq, Ph.D., Professor of Maternal and Child Health at Boston University School of Public Health.

Another report released in October by the World Health Organization, the United Nations Population Fund, the U.N. Children's Fund, the U.N. Population Division and The World Bank, and published in the Lancet shows that the U.S. has a higher maternal death rate than 40 other countries. http://www.thelancet.com/journals/lancet/article/PIIS0140673607615724/fulltext “Women in the U.S. think they’re getting top notch care, but our death rate for mothers shows otherwise,” says Udy. The U.S.’s maternal death rate tied with that of Belarus, and narrowly beat out Bosnia and Herzogovena.

ICAN’s collection of research highlights from 2007 demonstrates the inherent risks of cesarean including a higher risk of dying in childbirth, a higher chance of suffering from potentially fatal placental problems in subsequent pregnancies, and babies having a higher chance of dying in the first year. Research from 2007 also shows that VBAC continues to be a reasonably safe birthing choice for mothers.

“The research continues to reinforce that cesareans should only be used when there is a true threat to the mother or baby,” said Udy. “Casual use of surgery on otherwise healthy women and babies can mean short-term and long-term problems.”

For women who encounter VBAC bans, ICAN has developed a guide to help them understand their rights as patients. The resource discusses the principles of informed consent and the right of every patient to refuse an unwanted medical procedure. The guide can be found at http://www.ican-online.net/resources/white_papers/wp_vbacbanqa.pdf.

Women who are seeking information about how to avoid a cesarean, have a VBAC, or are recovering from a cesarean can visit http://www.ican-online.org for more information. In addition to more than 90 local chapters nationwide, the group hosts an active on-line discussion group that serves as a resource for mothers.

About Cesareans: ICAN recognizes that when a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved. Potential risks to babies include: low birth weight, prematurity, respiratory problems, and lacerations. Potential risks to women include: hemorrhage, infection, hysterectomy, surgical mistakes, re-hospitalization, dangerous placental abnormalities in future pregnancies, unexplained stillbirth in future pregnancies and increased percentage of maternal death. http://www.ican-online.org/resources/white_papers/index.html

Mission statement: ICAN is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean. There are 94 ICAN Chapters across North America, which hold educational and support meetings for people interested in cesarean prevention and recovery.

Posted by Sarah Shannon at 04:02 PM | Permalink | Comments (0)

I have now developed two interesting new habits thanks to prelims:
1) Swearing at hapless file folders. Poor little, unassuming manilla things!
2) Creating new lyrics to children's songs containing references to the material I'm using to answer the prelim questions. Since I can't publicly disclose or discuss the prelim questions, I regret that I cannot post the lyrics, but trust me, they're wildly creative!

We'll have to see what other behavioral changes I undergo between now and Friday at 4:00pm...

Posted by Sarah Shannon at 10:09 AM | Permalink | Comments (0)

It's Day 5. I have now developed one singular goal for myself with regard to prelims: FINISH.

In my former days as an adolescent figure skater, I frequently encountered this scenario: I'm out on the ice skating my routine in front of three judges and a smattering of spectators. I fall on my butt. I hear my coach's voice in my head: Get up and finish! My rear is now cold and wet. The last thing I want to do is finish this routine. Get up. Finish. Get second place. The judges must have admired my perseverance. Maybe next time I'll nail that double sal chow:

Posted by Sarah Shannon at 10:58 AM | Permalink | Comments (0)

That's a Minnesotan's way of saying, "Holy sh*t, the I-35 bridge collapsed!" So far, I'm not aware of any in our circle who were hurt in the collapse, thank God. That bridge is one that my father drove over twice a day to work and back. In fact, he did so yesterday just two hours before the bridge fell. My mother drove across it twice yesterday also, with my four-year-old in the backseat mere hours before the collapse. Yikes! I think many of us who regularly drove that stretch of road feel like we had a close call, even if we were nowhere near it at the time of the tragedy.

Of course, the real focus now is on the families and friends of those who were hurt or killed. Thanks to those of you who have inquired after us...we're fine.

Posted by Sarah Shannon at 06:58 PM | Permalink | Comments (1)

All I wanted were a few martingale residuals!!! Now, is that too much to ask? Apparently, as I finally have them after 2+ hours typing commands, having Stata freeze, restarting the program, reloading my data, etc etc ad nauseam. This in addition to spending all week trying to figure out the code to properly format my data for EHA analysis. My gracious prof and some other folks have patiently assisted in the process, but GOD (and I have talked to HIM a few times about this too, FYI).

In other stat-related news, I got my first paper back on Thursday and got a stinkin' "A"! Yeah, holy sh*t, huh?!? The prof even called it "outstanding." You can bet your a** that's going up on the fridge.

Posted by Sarah Shannon at 01:24 PM | Permalink | Comments (2)

It feels like springtime up here in the Northland. And you know what spring brings - that's right, Open Toe Sandal Season (OTSS).*

I love sandals. I love wearing sandals. I even paint my toenails (badly) when the weather warms in anticipation of OTSS, which flies in the face of my general beauty ethic. My general beauty ethic is this: do what is necessary to look passable (so as not to be received as immediately ugly) but anything beyond this standard takes more time, energy, and money than I am able or willing to put forth.

As much as I am a fan of OTSS, I do have one thing to say on the matter and that is, while there is no general law or moral precept against any particular individuals wearing Open Toe Sandals, there are some who should seriously, out of love of neighbor, consider forgoing them altogether. You know what I'm talking about. I feel this principle as deeply as I do that young men should be seriously counseled, in the home, about the proper use of cologne prior to being released upon the rest of civil society. But that is another blog. By all means, flex your toes, air out your paws, but please, consider the rest of us before donning those sandals without socks...

*At the School of Social Work, of course, this means that those who have wintered in their Birkenstocks with wool socks can now "free the feet!"

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Posted by Sarah Shannon at 09:35 PM | Permalink | Comments (0)

Word came via email yesterday that the kind editors at Families in Society will in fact publish my very first academic journal article ever. My revisions were accepted and the article goes to press immediately for the April-June issue. While I can intellectually acknowledge that this is cause for celebration, emotionally I find myself in a sudden state of panic. Here are a few questions rumbling through my mind:

What if what I wrote was crap? (one would think the scrutiny of a co-author, two peer reviewers and an editor would quell this fear, but no).

What if I misrepresented something in the literature? (I don't think so...but what if someone I cite reads the article and says, "that's not what I said!" Unlikely?)

Did I get the story straight?

Did I do something wrong?

Oh my God!

Are they really going to print this?

Will anyone read it? (Irrationally, I find myself hoping not).

I'm thinking this is normal...is it?

Posted by Sarah Shannon at 10:35 AM | Permalink | Comments (4)

I've blogged before about my disdain for correctional programs that have insulting titles. Well, I've found another winner. In the course of investigating what programs exist in state prisons for fathers, I came across Cage Your Rage, an anger management program for incarcerated offenders.

Now, don't get me wrong. I'm quite sure that a good number of criminal offenders have anger issues. Not a doubt in my mind. But for real, cage your rage? Need I comment further???

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Posted by Sarah Shannon at 09:17 PM | Permalink | Comments (4)

Just in case you thought criminals packed up their chunkies for the winter, think again. A couple weeks ago, during the Minnesota deep freeze, the hubster and I heard seven rounds fired within a block of our house. If we had a nickel for every time we've called the Minneapolis Police Department over the past four years for "shots fired," we could put a little dent in my student loans.

What's frustrating is that, try as they might, the cops really can't do much with, "We heard seven shots really, really close by.....no, we didn't see anything....ok, thanks."

But, sound the trumpet! An email from our neighborhood association informs us that Shotspotter is on the way! And when you blow your horn, don't worry, 'cuz Shotspotter can tell if it's a gunshot or a firecracker or a fart.

Now, don't think I'm being too smartass about Shotspotter. Reports of Shotspotter's success in South Minneapolis over the first month in operation are intriguing. According to news reports, "In the first month, police responded to 69 Shot Spotter calls, made three felony arrests, three misdemeanor arrests, and recovered two guns and a stolen car." Not bad. We shall see. For now, we must keep in mind that this Wednesday night between 10pm and 12midnight, the shots we will hear are but friendly fire from our men/women in blue giving Shotspotter a try.

Posted by Sarah Shannon at 09:41 PM | Permalink | Comments (0)

As you may ascertain via Exhibit A (right), my son is quite vivacious. So a fall at daycare yesterday wouldn't have been a big deal except it knocked him unconscious. As a parent, I doubt there's anything quite as harrowing as a call from daycare/school that something has happened to your child. Two and a half hours at the ER and a CT scan later and Micah is fine. But the emotional impact of the event is only sinking in today.

There are a lot of things about parenting that I'm not so sure about (e.g. what was I thinking?), but one thing I am: I love my child with a kind of ferocity that often takes me by surprise. It's all too easy to lose sight of amidst the whining and the complaining and the demanding and the potty training. But my kid is really, really, really awesome.

Posted by Sarah Shannon at 02:30 PM | Permalink | Comments (4)

I should not be sharing this publically.

But, I can't stop myself. I was instructed by the office manager at my internship site to use one of those compressed air sprayers to clean my keyboard out. Well, I did so dutifully and was so disgusted by all the crumbs and debris that came flying out that I have now vowed not to eat at my cubicle anymore (this vow would help me with some other resolutions as I am typically eating one of the following: 1) chips, 2) popcorn, or 3) candy). Seriously, it was like tipping the toaster upside down! No wonder I have mice at home. I don't think my cat could save me even if she wanted to.

Posted by Sarah Shannon at 10:39 AM | Permalink | Comments (4)

This morning we discovered hard evidence of a rodent presence in our kitchen. This is a profoundly disturbing revelation. Don't get me wrong, I'm not a jump-up-on-the-chair kind of chick, but a mouse in my house is not acceptable. What I'm wondering is, what in the hell is my cat for? Albeit we did have her front claws removed, but c'mon! It's in her nature to catch mice. I would expect a little more evolutionary adaptation here. So, she's fired and in light of her poor performance I have sent the hubster out for traps. Yeesh.

Posted by Sarah Shannon at 11:43 AM | Permalink | Comments (3)

I've lately been reading a quadruple literary/spiritual biography of Dorothy Day, Thomas Merton, Flannery O'Connor, and Walker Percy. I originally heard the book's author on NPR's Speaking of Faith and subsequently borrowed the book from a friend. It's a great read and fascinates on multiple levels regarding American history, literature, and spirituality. I am not a Catholic, but find much to admire in the tradition - particularly in the realm of social justice theology and practice- as well as in the individuals studied in the book. I admit I find myself most drawn to Dorothy Day and Flannery O'Connor, perhaps not only for our shared gender but also because I have never considered becoming a monk (Merton) or a philosopher-writer (Percy) but have on occasion flirted with a radical life among the poor (Day) and, well, I just love O'Connor's writing and the fact that she also spent an exile in Iowa City.

What I find most engaging about the book is its attention to how each of these individuals made their way as believers and sought to communicate with their contemporaries - those of faith and not - about their experience. This was often fraught with misunderstanding, frustration, and occasional epiphany. I find this true to life myself. Through the book I'm finding some good comradeship and a fair share of wit and wisdom along the way.

Of particular note is the following quote from Flannery O'Connor's correspondence. I will be holding fast to this one as particular individuals and churches do their best to make the Christian faith seem indefensible to the world. Brooklyn Park's Mac Hammond provides a current example. My husband and I have recently spent time clucking our tongues, composing potential letters to the editor, and citing as many Biblical passages as possible that might heap burning coals upon Hammond's head (ok, perhaps a little humility is in order). While reading the book last night, I found this from Flannery and will take heed as we move on:

"It seems to be a fact that you have to suffer as much from the Church as for it, but if you believe in the divinity of Christ you have to cherish the world at the same time that you struggle to endure it."

Posted by Sarah Shannon at 10:39 AM | Permalink | Comments (0)

It's going to be a nail-biter, people.

On Tuesday I began my latest odyssey as a graduate student: Advanced Social Statistics. Yes, that's right! Time to start the betting pool - how long will Sarah go before the meltdown this time? Week 2? Week 7? All the way to 15? We'll see.

I've heard glowing reports about the prof and was impressed that I pretty much understood everything he was saying on Tuesday. Of course, he was only reviewing bivariate regression so it would be a really bad sign if I were lost already. He did say, however, that the course covers what is probably an "ureasonable" amount of material, but that he feels this is necessary to "expose" us to the methods we will need to know about. I'm down with this on the conceptual level, but we'll see just how unreasonable reality gets...

He also said some very blessed words, to which I will cling for the remainder of the semester: "we'll let the software do the work for us" when it comes to calculations. Hallelujah! STATA, here I come!!!

Posted by Sarah Shannon at 09:50 PM | Permalink | Comments (2)

A fellow member of an online support group for recovering c-section moms (and concerned others) posted this today. I'm going to keep this in my back pocket in case I need the precedent for a future birth experience!

A Plaintiff's Verdict: Meador v. Stahler and Gheridian

The $1.5 million award to a Massachusetts woman and her family in Meador v. Stahler and Gheridian made news as a rare instance of a malpractice judgment based on an allegedly unwanted and unnecessary cesarean section rather than a failure to perform such an operation.

The plaintiff, Mary Meador, did not claim that the procedure was negligently performed or that the rare and disabling physical complications that resulted from it (which left her largely bedridden and unable to work or meet her family responsibilities for several years) were foreseeable. Instead, she claimed that the defendant obstetricians had misrepresented the risks of the alternative procedure (vaginal birth after prior cesarean) and ignored her persistent pleas for this alternative. Moreover, she alleged, they compelled her passive assent to the surgery in an emotionally coercive manner while she was progressing normally in labor, despite their having previously agreed to such a trial of labor.

Because the consequences of the cesarean were unforeseeable, and because Meador had signed a consent form for the surgery (to be used in case of emergency), this case did not meet the technical requirements specified under Massachusetts law for an action based on informed consent. Instead, the case was brought on the theory that the physicians' failure to obtain the patient's informed consent constituted substandard, negligent medical care. The forensic psychiatrist's expert testimony emphasized that the pro forma signing of a consent form did not constitute true informed consent, especially in light of the physicians' alleged disregard of the patient's expressed wishes and their inaccurate representation of the risks and benefits of the approach she preferred.

The psychiatrist also explained to the jury how Meador's life history left her vulnerable to experiencing the denial of informed consent as a highly traumatic event. Having coped since childhood with serious illnesses in her family, Meador had viewed doctors and nurses as nurturing figures who helped her gain control of potentially tragic situations. She had learned that choice was still possible even amidst illness and death. She had even been inspired to become a nurse herself and to teach this discipline to others. Thus, when she experienced a sudden loss of choice and control during childbirth, she reacted with intense fear and horror and felt she had been betrayed by health professionals, whom she now feared and mistrusted. In this way she lost her accustomed strategy for coping with life. Moreover, having helped hold her original family together in the face of tragic illness, Meador saw the family she had created torn apart by her sudden and devastating loss of control in a medical situation. The jury's recognition of the importance of the emotional facts of the case was highlighted by its awarding almost one-third of the total damages for loss of consortium.

Thus, it was not simply the physically disabling consequences of the surgery, but the loss of personal decision-making power concerning her body, her health, and the birth of her child, that caused Meador to suffer from Post-Traumatic Stress Disorder. Similarly, her husband's experience of loss of consortium was exacerbated by the physicians' failure to consult him to interpret his wife's wishes during labor. Instead of having participated in a true informed-consent process, he was left to feel powerless and helpless. In this way, forensic psychiatric testimony established a persuasive causal link between the lack of informed consent and the physical and emotional damages suffered by the patient and her family.

Source: http://www.forensic-psych.com/

Posted by Sarah Shannon at 03:49 PM | Permalink | Comments (0)

I be knowin' a lot of pregnant women these days, at least four of whom are due in January/February. As a burgeoning birth advocate (another one of my mini-missions), I offer this article written by Henci Goer, a well-respected expert in the field.

How Childbirth Went Industrial: A Deconstruction
By Henci Goer

Henci Goer, author of *The Thinking Woman's Guide to a Better Birth*, skewers a recent, ripe-for-the-deconstructing article in the New Yorker on the rise of cesarean sections. If you read Atul Gawande's article with mounting dismay, this brilliant, research-based riposte will leave you thoroughly restored.

Gawande's history of obstetrics begins with the premise that childbirth is a complicated, dangerous business where, "At almost every step . . . the process can go wrong." In particular, "obstruction of labor" poses a threat. To illustrate this, Gawande recounts the story of the English Princess Charlotte, who in 1817 gave birth to a stillborn boy after 50 hours of labor and then succumbed to a postpartum hemorrhage. The parallel with Rourke's labor is surely intentional.

According to Gawande, yesterday's tragedies can now be averted thanks to the development of new and improved obstetric procedures, drugs, and instruments. "By the early twentieth century," he says, "the problems of human birth seemed to have been largely solved." In the next paragraph, however, he retracts this statement. A 1933 report, he writes, found that most maternal deaths were attributable to medical mismanagement and that women were "better off delivering at home" with midwives who avoided using those same procedures, drugs, and instruments.

Faced with this "shocking" fact, the experts of that time concluded that the solution was not to study what midwives were doing right but to "standardize childbirth," that is, to set rules for how to manage labors and deliveries. Standardization meant applying obstetric interventions to everyone, needed or not, and, according to Gawande, in our day has resulted in the vast majority of women having electronic fetal monitoring (EFM), IV fluids, and an epidural or spinal analgesia; half having Pitocin to speed up labor; and nearly 1 in 3 women delivering their babies via major abdominal surgery.

Gawande makes no case that these interventions improved outcomes. In fact, he notes that EFM has not been shown to benefit babies while increasing the likelihood of cesarean, and cesarean section carries the risks attendant on any major surgery plus the future reproductive risks of a scarred uterus. Despite this, Gawande has no quarrel with the increased use of cesarean surgery on the grounds that it is:

easy to teach,
is a "reliable" but not a better option,
is "comfortable" for obstetricians,
can be performed with "consistency,"
is a "simpler, more predictable way to intervene," and
is believed by obstetricians to be less risky than "natural childbirth."
This, of course, is not the same thing as actually being so.

Unfazed by his own statements on the hazards of inappropriate obstetric intervention, Gawande next claims, "The package [of obstetric interventions] as a whole has made child delivery demonstrably safer." He then goes on to say, "In the next decade or so the industrial revolution in obstetrics could make Cesarean delivery consistently safer than the birth process evolutiongave us," and follows this with a leap to the conclusion that that time has already arrived. He asserts that scheduled cesarean surgery may have lower maternal mortality rates than vaginal birth, and there is "speculation" that it might lead to fewer problems in later life with incontinence and uterine prolapse.

Gawande applauds doctors for trying whatever appeals to them without "wait[ing] for research trials to tell them if it was all right." It is sufficient that obstetric innovators "looked to see if results improved,"although how they would know this without a controlled evaluation of safety and effectiveness, he does not say. Neither does he bring up the obstetric disasters that have followed in the wake of this approach. DES, thalidomide, retrolental fibroplasia (blindness in premature newborns), and misoprostol (Cytotec) inductions come to mind as well as the damage caused by episiotomy (cutting the vaginal opening to enlarge it for birth).

The take-home messages of "How Childbirth Went Industrial" seem to be:

Women can have an easy, safe cesarean surgery or they can undergo difficult, dangerous labors and then have cesarean surgery.

Modern obstetric management is the key to healthy babies and mothers. One hardly knows where to begin to correct the illogic, erroneous information, fallacies, self-contradictions, prejudicial language, and false dichotomies, but perhaps by deconstructing these messages we can highlight many of these along the way.

Continue reading "The industrialization of birth" »

Posted by Sarah Shannon at 11:21 AM | Permalink | Comments (0)

One of my mini-missions in life is to contribute toward and increase social work research, education, and practitioner skill in navigating the criminal justice system. This is not one of the hallmark social work arenas, such as the public welfare and child welfare spheres, although, historically, social workers were instrumental in the creation of the juvenile justice system, including probation and the courts. So, when I go to conferences, such as the American Society of Criminology meetings, I get asked questions like, "So, you're in social work, why are you here?" Well, figures recently released are at least part of the reason why. Seven million people in the United States were under the supervision of the criminal justice system by the end of 2005 - this includes those in prison, jail, on parole or probation. That's 1 in 32 adults. Do you know 32 people? Well, most social workers, regardless of their primary area of practice, work with at least that many on a caseload. Chances are, given that social workers often work with populations at greater risk for criminal justice intervention (the poor, minorities), a great many more than 1 in 32 of those individuals are likely affected by this increasingly powerful system. And the effects of this system go way beyond "time served" either while incarcerated or "on paper," as my illustrious boss and others have demonstrated. "Collateral consequences" of involvement in the criminal justice system are sweeping, affecting an individual's civic rights, parental status, employment prospects, housing, and other "life chances." Not to mention that the lives of families and children of those involved in the system are also deeply altered, both practically and psychologically.

Social workers ought to be in on this mess, and not just those few of us who are directly involved in the criminal justice system, but all of us. Because the lives of our clients are undoubtedly touched, directly or indirectly, by this far-reaching system, we ought to be looking critically at how this system works or doesn't, how it affects our clients' (whether individuals or communities) lives, and what we can do to promote change and greater social well-being - even for those who have "done wrong" but who have "done their time."

Posted by Sarah Shannon at 12:28 PM | Permalink | Comments (0)

About a year ago this time, a doctor diagnosed me with "probable early pneumonia." At that time, the chest x-rays I had were not conlcusive, but the doc thought my lungs sounded "suspicious."

Well, after 5 days of terrible fever, chills, sweats, and a cough, I went to urgent care this morning. Lo and behold, chest x-rays definitively show pneumonia in my right lung. Oh joy.

I'm just glad for some drugs that give me hope that I might feel a bit better in a day or two. Assuming that I have bacterial and not viral pneumonia, I should be. Let's hope so! Lots of end-of-semester projects and obligations in the next few weeks...

Posted by Sarah Shannon at 05:45 PM | Permalink | Comments (2)

To enter a family's home and remove a child is to enter highly contested territory. Despite the State's mandate to protect children, no parent or family ever welcomes a social worker, acting in "the child's best interest," with open arms. As the story below illustrates, this work is not without great risk. While this indicent is no doubt extreme, I have heard many a social worker describe (understandably) hostile reactions by recipients of child protective services. This is a sober reminder that, while we can't assume that all of our clients will be violent, social workers must always be aware of their environment and its potential dangers.

Couple held in slain social worker case
By SOPHIA TAREEN, Associated Press Writer
Fri Oct 20, 11:55 AM ET

CHICAGO - After four days on the run, a Kentucky woman and her boyfriend are in police custody in Illinois, accused of kidnapping her 9-month-old son from a social worker, later found dead, who had taken the child to visit the mother.

The infant was examined by a doctor and found in good condition, FBI agent John Stafford said at a news conference Thursday at the Alton Law Enforcement Center, where the couple were being held.

FBI agents arrested Renee Terrell and her boyfriend, Christopher Wayne Luttrell, about 8:30 p.m. Thursday in a rural area near Godfrey, about 35 miles north of St. Louis, Stafford said. The baby, Saige, was with them.

Stafford could not say when Terrell and Luttrell would appear in court for an extradition hearing for their return to Kentucky.

Sgt. John Nevels of the Henderson, Ky., police department said the couple were caught hiding in a camper where they had sought shelter after their car apparently broke down and got stuck in mud.

"They were getting pretty desperate and had run out of money and food," Nevels said. "They started reaching out to people to try and help them."

Nevels said he didn't know why Terrell, 33, and Luttrell, 23, had fled to Illinois, but authorities had been searching the area for them after contacting the couple's friends and family.

Earlier Thursday, the FBI had issued warrants for the couple for unlawful flight to avoid prosecution on state kidnapping charges, according to Tracy Reinhold, an FBI agent in Kentucky.

The baby had been removed from Terrell's custody when he was 13 days old because of neglect, according to police. On Monday, social worker Boni Frederick, 67, took the boy to his mother's home in Henderson for a visit.

Frederick was found beaten to death at the house later that day, and the baby, his mother and Frederick's station wagon were gone, authorities said.

Frederick's purse was found near Mount Vernon, Ill., about 100 miles southeast of Godfrey, said Henderson police Detective Ron Adams.

A neighbor, Jean Davis, told The Courier-Journal that Terrell learned last week that the boy was to be put up for adoption. Terrell told friends on Saturday she planned to take the boy and run away to New Mexico, Davis said.

"She loved her baby," Davis told the newspaper in a story published Wednesday. "She talked about how she was going to get her baby and everything back. She was buying clothes. She had a baby bed and a high chair and everything. ... I guess it made her snap."

Posted by Sarah Shannon at 02:46 PM | Permalink | Comments (0)

On Monday, I made my first official submission of a paper for publication review to a social work journal. It felt a bit anticlimatic at the time, but seems to be increasing in significance mentally as the week goes on. I co-authored the paper with my previous advisor, now a facuty member at another university, who graciously lent me her data and gave me reign over the analysis and authorship. The review process can take months, so I'm not expecting results anytime soon. Most likely, there will be comments and revisions before full acceptance, assuming it is not outright rejected. In any case, this is a brand-new experience, but one I hope will become more familiar in the next couple of years. Wish me luck!

Oh, and the paper is a qualitative analysis of 22 interviews with seven incarcerated teen fathers regarding their perspectives and experiences of parenting in relation to their potential for future offending. I'll keep you posted...

Posted by Sarah Shannon at 07:44 PM | Permalink | Comments (4)

This one definitely has me beat (my son was fully four pounds lighter!), but elements of this experience sound remarkably and disturbingly familiar...

Conn. mom breaks record for biggest baby
AP

Oh baby! Marie Michel's fifth child was one for the record books. Michel gave birth to a 14-pound, 13-ounce boy Tuesday at William W. Backus Hospital.

Backus officials said the newborn — Stephon Hendrix Louis-Jean — broke the 18-year record for the biggest baby ever born at the hospital by 1 pound, 13 ounces. He was nearly 23 inches long.

"He's built like a linebacker," said Dr. David Kalla, who delivered the baby by Caesarean section.

After nine months of carrying Stephon, 36-year-old Michel said she was more tired and happy to have given birth than all the attention her baby was receiving.

"I was miserable," Michel said. "I couldn't sleep at night. My 13-year-old son had to help me get in and out bed."

The baby's size came as no surprise to his mom. Michel's oldest son weighed 9 pounds at birth, her 8-year-old twin sons each weighed 8 1/2 pounds and her youngest son, age 3, was nearly 12 pounds.

Michel's husband, Vijens Louis-Jean, a truck driver, was coming from Florida to see his son.

Less than 24 hours old, the baby was fitting into clothes for a 6-month-old and was too big for newborn diapers.

"I have baby clothes but I don't think they will be able to fit," Michel said. "I think I will have to return them."

Posted by Sarah Shannon at 01:50 PM | Permalink | Comments (4)

Yesterday Sarah Shannon felt excited just thinking about the new semester about to begin at the University of Minnesota next Tuesday. Today, however, the tide has turned.

"I saw the faculty on campus for their fall retreat. I was happy to see several of them. But the wave of nausea I felt when I realized that I would once again be subject to coursework and deadlines was overpowering," said Ms. Shannon.

She is not alone. All over the country, thousands of graduate students will be resuming their posts on the lower rungs of academic hierarchies during the next several weeks. Some have already been back in the books for a week.

"The worst part is the fear," states Ms. Shannon. "When you think about what might actually happen if the veil is ever lifted and the people around you (professors, students) realize that you're really not that smart, it's paralyzing."

A memo, recently released from the files of a former graduate student, further highlights the challenges faced by many graduate students across the nation.

As for Ms. Shannon: "I'm going to try to take it all in stride. Never mind that I'm a mother, a spouse, and citizen of the world. Taking five classes for thirteen credits isn't that bad. As my high school teachers were wont to remind us kids, it's better than flippin' burgers!"

Or is it?????

Posted by Sarah Shannon at 01:41 PM | Permalink | Comments (10)

It's not every day that one can say, "I almost died" and mean it. Yesterday, on my way home from class, as I was driving down the cloverleaf from Snelling Ave to Hwy 36-West, the ball-bearing on my left front tire broke off. I managed to steer the car mostly off the ramp, but was still hanging slightly onto the ramp, which other cars continued to zoom around. After a tearful phone call to 911, a worker from MinDOT came to my rescue, with flashing lights and an arrow signaling to other drivers, "hey, go around this pitiful scene." I wish it also had a sign reading, "Gawk on penalty of death." Several minutes later, a state trooper joined the party. Finally, after about 30 minutes, a tow truck arrived to take my purple death-trap away.

The worker from MinDOT was very reassuring and helpful. She helped put things in perspective by letting me know that if I had been any further down the ramp or going any faster, I probably would have flipped the car in the middle of a lane of speeding traffic. I started thinking about that, and the fact that I had driven to and from Minnetonka earlier in the day, at freeway speeds, and realized that I had fared pretty well, all things considered. Still, it's more than a little unnerving to contemplate the "what ifs" in such a situation. Perhaps Someone thinks my continued presence on this earth is a good thing...

Posted by Sarah Shannon at 09:23 AM | Permalink | Comments (5)

I realize the 4th has come and gone; guess I'm just a little behind. As a prepared myself to greet the day last Tuesday, I heard a special patriotic message on my favorite radio station. It sung the praises of all the great Americans who have made our country great - the founding fathers, immigrants, veterans. The usual. But as I listened, I realized that someone important was missing on that roll call: the slaves*. I sort of wish our country could be just a little more honest about itself sometimes. Slavery certainly wasn't a bright spot, but we wouldn't be who we are without it. So, in honor of our darker side, here's a little somethin' from one of my favorite masters of versification:

I, too, sing America.

I am the darker brother.
They send me to eat in the kitchen
When company comes,
But I laugh,
And eat well,
And grow strong.

Tomorrow,
I'll be at the table
When company comes.
Nobody'll dare
Say to me,
"Eat in the kitchen,"
Then.

Besides,
They'll see how beautiful I am
And be ashamed--

I, too, am America.

~Langston Hughes, 1925

*nota bene: Native Americans were not mentioned either - that's another post someday.

Posted by Sarah Shannon at 10:52 AM | Permalink | Comments (0)

Obstetrics & Gynecology 2006;107:771-778
© 2006 by The American College of Obstetricians and Gynecologists

ORIGINAL RESEARCH

Previous Cesarean Delivery and Risks of Placenta Previa and Placental Abruption

Darios Getahun, MD, MPH1, Yinka Oyelese, MD2, Hamisu M. Salihu, MD, PhD1 and Cande V. Ananth, PhD, MPH1

From the 1 Division of Epidemiology and Biostatistics and 2 Division of Maternal–Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey.

OBJECTIVE: To examine the association between cesarean delivery and previa and abruption in subsequent pregnancies.

METHODS: A retrospective cohort study of first 2 (n = 156,475) and first 3 (n = 31,102) consecutive singleton pregnancies using the 1989–1997 Missouri longitudinally linked data were performed. Relative risk (RR) was used to quantify the associations between cesarean delivery and risks of previa and abruption in subsequent pregnancies, after adjusting for several confounders.

RESULTS: Rates of previa and abruption were 4.4 (n = 694) and 7.9 (n = 1,243) per 1,000 births, respectively. The pregnancy after a cesarean delivery was associated with increased risk of previa (0.63%) compared with a vaginal delivery (0.38%, RR 1.5, 95% confidence interval [CI] 1.3–1.8). Cesarean delivery in the first and second births conferred a two-fold increased risk of previa in the third pregnancy (RR 2.0, 95% CI 1.3–3.0) compared with first two vaginal deliveries. Women with a cesarean first birth were more likely to have an abruption in the second pregnancy (0.95%) compared with women who had a vaginal first birth (0.74%, RR 1.3, 95% CI 1.2–1.5). Two consecutive cesarean deliveries were associated with a 30% increased risk of abruption in the third pregnancy (RR 1.3, 95% CI 1.0–1.8). A second pregnancy within a year after a cesarean delivery was associated with increased risks of previa (RR 1.7, 95% CI 0.9–3.1) and abruption (RR 1.5, 95% CI 1.1–2.3).

CONCLUSION: A cesarean first birth is associated with increased risks of previa and abruption in the second pregnancy. There is a dose–response pattern in the risk of previa, with increasing number of prior cesarean deliveries. A short interpregnancy interval is associated with increased risks of previa and abruption.

url here

Posted by Sarah Shannon at 09:51 PM | Permalink | Comments (2)

It's springtime and friends and acquaintences alike are reporting pregnancies. Babies are so wonderful, but sometimes birth is not. Beyond the "it hurts" of labor is something far more insidious: a growing movement in the medical community to make birth a surgical, rather than a natural, experience. Unfortunately, many women are, wittingly or unwittingly, complicit in this movement. As a woman, this is far more concerning to me than any potential threat to Roe v. Wade. What we have going on in the US is an all-out attack on the right of every woman to do something that is, in the opinion and experience of many including this author, the very essence of womanhood - to birth our babies from our vaginas. Sorry to be so blunt, but here are a few facts:

*The cesarean section rate remains at an alarmingly higher rate in many industrialized countries than the 10-15% average recommended by the World Health Organization, causing unnecessary risk to both mother and baby. [17] Healthy People 2010 recommends a reduction in cesarean births in the US to 15% by 2010. [18]. The current c-section rate in the US is 29.1% - nearly one-third of all babies born in the US!

*When a cesarean is necessary, it can be a lifesaving procedure for both mother and baby.[1] However, psychological outcomes such as negative feelings, fear, guilt, anger and postpartum depression are common consequences of both emergent and elective cesarean sections.[2] [3][4] A cesarean section is only indicated when: Complete placenta previa at term; Transverse lie at complete dilation; Prolapsed cord; Abrupted Placenta o Eclampsia or HELLP with failed induction of labor; Large uterine tumor that blocks the cervix at complete dilation. Almost all fibroids will move upwards as the cervix opens, moving it out of babys path. True fetal distress confirmed with a fetal scalp sampling or biophysical profile; True cephalopelvic disproportion or CPD (baby too large for pelvis). This is extremely rare and only associated with a pelvic deformity (or an incorrectly healed pelvic break). Fetal positioning during labour and maternal positioning during second stage, most notably when women are in a semi-sitting position, cause most CPD diagnosed in current obstetrics. [5]; Initial outbreak of active herpes at the onset of labor; Uterine rupture.

*A cesarean poses documented medical risks to the mother's health. These risks include infection, [19] blood loss and hemorrhage, [20] hysterectomy, [21] [22] transfusions, [23] bladder and bowel injury, [24] [25] incisional endometriosis, [26] [27] heart and lung complications, [28] blood clots in the legs, [29] anesthesia complications, [30] and rehospitalization due to surgical complications; [31] rate of establishment and ongoing breastfeeding is reduced; [32] and psychological well-being compromised and increased rate emotional trauma. [33] Potential chronic complications from scar tissue adhesions include pelvic pain, bowel problems, and pain during sexual intercourse. [34] Scar tissue makes subsequent cesareans more difficult to perform, increasing the risk of injury to other organs and the risk of chronic problems from adhesions. [35] One-half of all women who have undergone a cesarean section suffer complications, and the mortality rate is at least two to four times that of women with vaginal births. Approximately 180 women die annually in the United States from elective repeat cesareans alone.

*A cesarean poses documented medical risks to the babys health. [41] These risks include respiratory distress syndrome (RDS), [42] [43] [44] [45] iatrogenic prematurity (when surgery is performed because of an error in determining the due date), [46] [47] persistent pulmonary hypertension (PPH), [48] and surgery-related fetal injuries such as lacerations. [49] [50] Preliminary studies also have found cesarean delivery significantly alters the capability of cord blood mononuclear cells (CBMC) to produce cytokines. [51] An elective cesarean section significantly increases the risk to the infant of premature birth and respiratory distress syndrome, both of which are associated with multiple complications, intensive care and burdensome financial cost. Even with mature babies, the absence of labor increases the risk of breathing problems and other complications. Far from doing better, even premature and at risk babies born by cesarean fare worse than those born vaginally.

*Cesarean rates are influenced by nonmedical factors. These include: individual philosophy and training, convenience of doctor or patient, the patient's socioeconomic status, peer pressure, fear of litigation, and financial gain. [55] [56] [57]

*In the United States, obstetricians offer defensive medicine as an excuse for the astronomical and sharply rising U.S. cesarean rate. Deliberately performing unnecessary surgery in the belief it avoids lawsuits is indefensible. That many obstetricians seem oblivious to the profound violation of ethical principles is shocking. [58] [59]

Source: ICAN, Cesarean Section Fact Sheet

Now, before you take me as a bitter woman radicalized by her own traumatic, c-section experience, EDUCATE yourself, especially (but not exclusively) if you are expecting a baby. If the above facts don't give you pause, consider this: your OB, hospital-based birth classes, or even your Certified Nurse Midwife will likely not share this information with you or challenge you to think about your options if faced with a possible c-section. So take my adivice, put down "What to Expect When You're Expecting" and pick up the following for research-based advice:

The Thinking Woman's Guide to Better Birth by Henci Goer
Ina May's Guide to Childbirth by Ina May Gaskin

You'lll be glad you did!

Posted by Sarah Shannon at 09:14 AM | Permalink | Comments (7)

Here's why. The photo on the right-hand side of the screen was taken mid-semester last Fall. To my left (your right) in the photo is the Director of Graduate Studies for the School of Social Work. So, not only do I look like a chunky-doughnut-eater, but also like a grade-A suck-up. Excellent. In any case, this picture of me, doughnut in hand, is a reminder to keep on keepin' on with my point-counting. 15 pounds shed, at least 15 to go!!! Wish me luck.

PS - Don't even think about writing me a "you're not fat!" comment. I will throw a doughnut at you!

Posted by Sarah Shannon at 02:46 PM | Permalink | Comments (4)

From the Strib:

"Emergency surgery puts Honeydogs' show on hold

The Honeydogs had to cancel its Friday and Saturday shows at 7th Street Entry this weekend after frontman Adam Levy underwent an emergency appendectomy late Thursday.

Levy's prognosis is good, the band's booking agent said. The show will go on with the opening acts filling in."

I worked with and for Adam (second from left) for a few years at HIRED. I certainly hope he is feeling better soon!

Posted by Sarah Shannon at 06:18 PM | Permalink | Comments (2)

...early pneumonia???? Not really, but according to my doctor, who says, "somethin's cookin'" in my left lung, I "possibly have early pneumonia." I guess that's why I've been hacking up so much phlegm and running a fever up to 103 degrees. A lovely end to my first semester as a PhD student!

I have to admit that I feel a bit guilty for laying around the past 24 hours, watching several movies (from "The Merchant of Venice" to "Old School"- I know, quite a contrast, but I guess I'm a woman of many contrasts, or at least, that's what I tell myself) and reuniting with daytime TV (which I have not watched since my days as a stay-at-home mom ended over a year ago). One thing I just can't understand is how Montel Williams is still on the air after all these years. I mean, I used to watch him when I was home sick in junior high school. The guy is such cheese, but I guess he has some kind of appeal. I don't know, but I'm currently half-watching his show on "medical horrors." Riveting.

Posted by Sarah Shannon at 10:01 AM | Permalink | Comments (5)

I'm coming up for a quick breath in between major assignments. I thought I'd celebrate by sharing some insights I've gained while doing some historical analysis. Today I turned in an historical research paper (hopefully someday an article) on a particular intervention for juvenile delinquency in the 1940s. Along the way, I happened across a piece from 1946 titled, "How to Make a Juvenile Delinquent" by Judge Philip B. Gilliam of Denver, CO and William J. Harper, Director of Probation in Whilte Plains, NY. So, for any of you who are or aspire to be parents, here's a quick "laundry list" of tips.

First, the list has the following preface: "If these instructions are carefully followed, we guarantee that your child will become delinquent and subsequently tried in the Juvenile Court. If found not guilty, we shall be glad to return him to you for further training because we are certain to get him eventually. This formula is almost infallible."

A few of "The Rules:"
*Never give your child a reason for the commands laid upon him; let him guess...it's much easier.
*Don't consider his educational and emotional development a parental responsibility. What are schools for?
*Don't be calm and poised. Be shocked and explode when he tells you he has done something wrong. Then he won't confide in you the next time.
*Never let your child forget that only for you he would not have a roof over his head. You will become a pain in the neck to your child, and he loves to hear about the many sacrifices you make for him.
*Always leave your car key in the car. This encourages stealing, and since 98% of car thefts are caused by this method, it proves that you are doing your part to encourage delinquency.
*Always accuse your daughter of being promiscuous with every date she goes out with so that she will be impressed with the fact that you were a "good woman" when you went out with the boys.

This is but a sampling of the total list, but I thought these might be useful to some. I know this last one will be really challenging for me! In all fairness to Judge Gilliam and Mr. Harper, part of what's fun about poking fun at history is that, in many ways, we're really laughing at ourselves without having to own up to our own floundering.

Posted by Sarah Shannon at 04:28 PM | Permalink | Comments (0)

This evening, on the way home from the U, I engaged in a bit of DWC - Driving While Crying - listening to this NPR (National Public Radio) radio documentary feature on lobotomy survivors:
My lobotomy
Fortunately, DWC is not a citable offense according to Minnesota law. If it were, I would probably not be allowed to operate a motor vehicle...

Posted by Sarah Shannon at 09:16 PM | Permalink | Comments (2)

Halloween took on new meaning for our family this year as we found ourselves recipients of a rather disconcerting trick. Around 9:00pm we ran out of candy (except for the bag of Twix that we decided to save for ourselves). It was getting late, the trick-or-treaters had tapered off, and we were sick of getting up to go to the door regardless. So, we employed the method that had always worked in the suburbs we grew up in - turned off the outside and entryway lights signaling, "no more candy here, go away." At 9:30pm, the doorbell rang. We ignored it. I also turned off an additional interior light just to make the point crystal clear. Less than 2 minutes later, the sound of glass shattering on our front door sent us flying out of our chairs. The police were called and showed up one hour later, report was filed, though we were slightly disappointed not to see the "weapon" - a half of a neighbor's jack-o-lantern - dusted for fingerprints. No CSI team for such things? Hrumph.

What surprised me the most was my own reaction. I really wanted to see someone caught and punished. Why should we have to fork out hundreds of dollars to repair damage done by a (likely, though we didn't actually see the perp) juvenile delinquent pissed that we didn't open the door and dole out a couple of 25-cent candy bars? I guess because I spend a lot of my time thinking/learning about causes and treatment of juvenile delinquency, it took me aback that my reaction was so strong and, seemingly, so unforgiving, once I became a target of such behavior. I've had a chance to cool off a bit, and we've taken it as an opportunity to reevaluate our home's safety (nothing like a large vegetable launched through your front door to get you thinking about your overall vulnerability to even more heinous breaches). But I think the experience gave me a chance, as a wannabe scholar, to experience another point of view on an issue that I tend to think of in a rather distant and, I've realized, not necessarily multi-dimensional way. I guess living in the ghetto really does help one "keep it real."

Posted by Sarah Shannon at 09:32 AM | Permalink | Comments (9)

1) The license plates were stolen off of one of our cars on Friday night. This feat was accomplished in our driveway despite the "security" motion-detecting lights on our one-car garage. It is the first instance of crime against our property that we've experienced despite over two years of inner-city living. I guess it could be worse (although there were other, more serious and life-threatening crimes committed within feet/yards of our former home).

2) A few weeks back, as we were loading our son and gear into the car for one outing or another, a group of pre-teen boys threw a rock at our car, nearly missing my (oh-so-precious) noggin and hitting the back window. I was livid of course, and my Eddie Murphy/Mr. Robinson's Neighborhood/"this is how you answer the door in my neighborhood"-esque "HEY!" sent them running down the alley. My social worker self recognized the behavior as a "pre-delinquent" act probably due to the lack of supervision, low availability of "pro-social" activity, and resulting boredom common to being young in the 'hood. Now, if their aim had been more precise, we would have had a whole 'nother scenario...

3) We seem to have quite a knack for ridding whatever neighborhood we live in of pesky pit bulls. At our previous residence, we had to call the police on the neighbors for a loud domestic dispute one night. This resulted in the fatal shooting, by police, of the family's pit bull. Oops. At our new abode, the new neighbors brought with them a mangy, mean-spirited pit which was the bane of my existence for several weeks. About two weeks ago, the beast mysteriously disappeared from his leash one Saturday morning. He was probably stolen by the same crooks who took our license plates, likely for the sake of dogfighting. I have yet to shed a tear over the loss...

Posted by Sarah Shannon at 03:17 PM | Permalink | Comments (4)

Normally, the following graphic would capture my feelings exactly after taking a test in statistics class:

However, today, after turning in the first test of the semester, I felt good. In fact, ask me at a particularly optimistic moment, and I might tell you that I feel quite confident that I will get a good score (but you have to catch me at just the right moment!). Upon reflection, I've come up with several options as to what happened to make me feel so much better about this test than tests past:

a) I've actually learned something
b) The instructor made the test easier this semester because he got spanked! on his evaluations last semester
c) It was the tasty Vietnamese curry chicken I had for lunch
d) The stats gods were smiling on me today
e) both a & b are true

I think the answer is probably e, but I would never, ever underestimate the power or either c or d.

As an added bonus, my spousal unit found out today that he gets to keep his job at the U of M's General College for another year, escaping a lay-off in a year of transition as the GC is gutted for "strategic re-positioning." Yay!

Posted by Sarah Shannon at 07:34 PM | Permalink | Comments (2)

Comments made by Minneapolis Mayor RT Rybak have already garnered him some amount of flack in the mayoral race leading up to this November's election. In the context of debate regarding public safety in our fine city, Rybak said, "Minneapolis is a safe city for those not involved in high-risk lifestyles." By this, we all must assume, the mayor means the city is safe for those who are not drug dealers, gang bangers, or hookers. After all, these are the folks who find themselves engaged in violent/life-threatening situations due to their own choosing of these "risky lifestyles." While this statement and its assumed meaning may make perfect sense to Rybak and his supporters in well-to-do Southwest Minneapolis, those of us on the Northside might have a few questions.

I'm wondering what kind of "risky lifestyle" Randy Sherer, owner of Jerry's Flower Shop at 33rd and Lyndale Ave N, was engaged in when he was shot dead by a 17-year old? Is owning a business is a low-income, high-crime part of town a "risky lifestyle?" How about Qwest employee Steve Pawloski, shot while working in a 46th Avenue alley between Bryant and Aldrich Avenues N.? Is providing a service, as part of one's job, in a low-income, high-crime neighborhood a "risky lifestyle?" I was sure thankful when Xcel restored power to our home within 24 hours of severe weather that pounded the northern metro a few weeks back. I'd hate to think that Xcel might consider working in my neighborhood too "risky" for their employees next time around. And, of course, let's not forget the "risk" it is to be a 68-year-old man eating steak at your favorite local steakhouse on Penn Ave N or a three-year-old shopping with you mom at Walgreens on Broadway and Lyndale Ave N. In light of these incidents, I wonder if Mayor Rybak might want to reconsider his conception of what makes for public safety.

At the same time, solutions proposed by both mayoral candidates, Rybak and challenger Peter McLaughlin, primarily involve putting more police on the streets. While I appreciate that law enforcement officials and their presence in neighborhoods like mine are a necessary and sometimes helpful means of promoting law & order, as a wannabe social scientist and a person of faith whose concerns for public safety extend beyond the catching and punishing of crooks, I'm a bit more interested in policy proposals that might include addressing some of the finer points of social reality that influence the presence or absence of public safety. Take poverty, for example. I can scarce think of a "variable" more frequently empirically corellated with crime and violence in social research, nor a concept whose existence is more roundly criticized in the Biblical scriptures (over 3,000 references in both "testaments" combined and the primary thing that pisses God off next to the worship of other dieties). And Christianity is by no means the o