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Second Weddings

Why I care.

So I was thinking about the last thread that handfast posted, about the women who are having children with a new man while married to other men.  And when I came to Retread's comment that she was not born to a married couple, it made me start thinking about why I care about this issue.   Certainly, other people's ethics usually don't affect me.  And I would never blame a child born outside of a marriage for the circumstance of their birth (which is why I shy away from using the term illegitimate).  I think it comes down to the issues of women's reproductive rights.  Babies born around the time I was born (which I believe Retread is similar in age to me), were not born in an era where reproductive rights were protected.  Women struggled to have access to contraceptives, other than condoms, which require a partner's cooperation.  There were plenty of OB/GYNs who would not prescribe birth control pills/ devices to women who were not married.  And although Planned Parenthood was originated in the 20's, the first clinic was not until the 40's, and not widespread until the 60's.  As a women who came of age in the late 70's, the Women's movement fought very hard to make contraceptives available, and to make them a women's right and a women's issue.  At that time, there were some women who were not permitted to obtain contraception without their huband's permission. And whatever your opinion about abortion, that issue was also a central issue for women in that era as well.So, why I care about this topic -- I suppose that it is just as much a women's right to bear a child by choice while married to a different man.  But the compications for both the woman and the child seem to me to be significant, and I question why someone would choose to saddle their child with a significant complication even before they are born.  Also, I think that there are plenty of women who are just plain careless about contraception.  They "find themselves" pregnant, as if there were ignorant of the mechanisms of unprotected sex=> pregnancy.  And as someone who was part of the fight to make contraception available and affordable, it irritates me that someone would not take advantage of that option.  It is not dissimilar to the way that I feel about abortion.  In my opinion, it is important that abortion remain an available option to women.  However, women who use abortion as a method of eliminating pregnancies they were too lazy to prevent is a focal point of the opponents.  They have a hard time fighting against a woman who chooses to terminate a pregnancy conceived in rape, incest or some other forced manner.  They focus less on the woman who chooses an abortion when a typically reliable and properly used form of birth control fails.  But the abortion foes zero in on the woman who just couldn't be bothered to make the effort to obtain and use a reliable method.  And who make the same mistake over and over again.  There are some religions that do  not approve the use of contraception and abortion.  But, to the best of my limited knowledge, they also do not approve of sex outside of marriage, so I doubt a faith based argument would apply.  There are some women for whom hormonal birth control is contraindicated.  But, mechanical methods are also available, such as diaphragms and IUDs.  Are there babies concieved while their mothers are using reliable birth control properly?  Of course.  But those numbers are far smaller than the numbers of pregnancies that occur each year.  So...I guess that's my soapbox for today.  What's your opinion?  ~Donna

Re: Why I care.

  • handfast4mehandfast4me member
    Seventh Anniversary 1000 Comments 5 Love Its
    edited December 2011
    I'm right there with you, Donna.  Before contraception was practiced widely with your husband's permission (which meant if you weren't married, you didn't have permission, therefore you weren't supposed to have intercourse) it was ILLEGAL.  It still is in some countries.  And some of the methods of birth control, such as the old IUDs, in which women were seriously injured or died, or illegal abortions, which many women suffered through, were just plain barbaric.  But I think this whole argument may boil down to our puritanical and thusly Christian attitudes toward sex in general.  I have no issues with people having sex or children outside of a traditional marriage.  What I have an issue with is people who bring children into the world when they cannot afford them, or are unable to care for them due their own stupidity and possibly their own mental health issues.  For me, it has always been a dichotomous argument that I see-and you touched upon that, Donna, when you talked about the faith-based argument.  To me, it's similar to the women I've seen on other boards that don't want to live with their fiances, because that is against their religion, but it's OK for them to still be having sex with their fis.  That has never made sense to me, when the issue is the sex, not the living under the same roof--which is incidental.  The term "living together" was also referred to as "living in sin" and just another way to say "having sex while unmarried."   Hope that made sense. ::gets off soapbox to make way for the next woman:: 
    image Don't mess with the old dogs; age and treachery will always overcome youth and skill! BS and brilliance only come with age and experience.
  • JJWC3387JJWC3387 member
    10 Comments
    edited December 2011
    What's my opinion?? Well, I'm still working on putting that into words. Your words, however, are very well put together. Thank you for sharing and putting it very eloquently.
  • edited December 2011
    I am 27 years old and have been raised in an era when abortions have been accessible to myself and all of my friends. We also had access to condoms and birth control in schools and neighborhood clinics. I am the mother to 2 girls, one of whom I conceived as a single woman at age 19 and another who I adopted, primarily because her birthmother relinquished her for adoption due to the cultural norms in their society (Ethiopia) in the hopes that the baby would be able to live a non-stigmatized life. I am also a critical care nurse with a strong background in the life sciences. I have lived in urban, suburban, and rural areas. I have taken care of women who were pregnant and desperately wanted their child, but who were so ill that the treatments necessary to save their lives have killed their unborn child. I have taken care of women who suffered horrible consequences from unsafe abortions and reactions to abortive medications. I have cared for women who, at age 23, found themselves unable to bear children due to having a radical hysterectomy after discovering advanced cervical cancer.I am strongly pro-life.I believe that women should have access to contraception, just like I believe we should all have access to preventative care. I also believe that just because someone can be or is sexually active, doesn't mean that they should be sexually active- and certainly does not imply that they are responsible enough to manage their  sexuality and reproductive health.I am pro-life, but I am also pro-preventative (ie-contraception), and pro-options (ie-adoption). I think that true pro-lifers, who really care about the LIFE of the mother and the child need to remember that the best life is the one that prevents crisis, not the one that comes to a crisis point and has to overcome that crisis.There are many forms of contraception that are highly effective, abstinence being the most effective, but depo-provera injections and IUDs have high efficacy as well. Combined with safe-sex practices like the use of condoms with every sexual encounter, pregnancy can be highly preventable.Those who chose to not to be responsible do have some uncomfortable and unfavorable consequences to bear, which I know first hand and from which I have learned my lesson. People suffer under those circumstances- the birth moms, the birth dads, and especially the children. This seems unfair, especially because it is the children who suffer most.I do not make any statements towards those who are victims of incest or rape who become pregnant. While I am pro-life, I also respect that those are extrordinary circumstances and I am in no position to make suggestions about what they should or should not do.
  • handfast4mehandfast4me member
    Seventh Anniversary 1000 Comments 5 Love Its
    edited December 2011
    I agree, I have an issue with adoption.  I know a LOT of people who are adopted. Present company excluded, of course :-)  I have found very few of those who I know are adopted who are well adjusted, and happy.  Of course, there may be others that are well adjusted, but I don't know that they're adopted.  Further, I'm not sure why giving up a child, given the current state of adoptions in this country is OK, but abortion is not.  I agree with the bumper stickers that say "don't want an abortion? then don't have one!"  The anti-choicers come and put their laws on MY body.  That's where I have issues.   And to force a woman to carry a fetus to full term, uh, well no.  Read author Lamb's "But what have you done for me lately?" and Marilyn French's "The Women's Room." 
    image Don't mess with the old dogs; age and treachery will always overcome youth and skill! BS and brilliance only come with age and experience.
  • handfast4mehandfast4me member
    Seventh Anniversary 1000 Comments 5 Love Its
    edited December 2011
    And that's why so many religions are afraid of the Pagans.  Because we treat sex as just part of life, and the rituals celebrate sex.  I guess that explains a lot about me!  LOL! 
    image Don't mess with the old dogs; age and treachery will always overcome youth and skill! BS and brilliance only come with age and experience.
  • edited December 2011
    I am not advocating one way or the other about what women should do when they become pregnant- I am advocating for women to be in control of their own bodies and prevent unwanted pregnancy. Except for instances of rape or incest, unwanted pregnancies are highly preventable in this country. I agree, women should be in control of their own bodies. But I think that begins with making informed and wise decisions about sexual activity and contraception. An ounce of prevention is worth a pound of cure! I do not think that abortion should be illegal. In fact, there is evidence that suggests that there are more abortions (by sheer number) when they are illegal or difficult to access than when abortions are legal and accessible. Certainly, there are more unsafe abortions when abortion is illegal. As a "pro-lifer," I am not concerned only about the child, but also about the woman. I strongly feel that women need to have true options counseling; at our local clinic, "options couneling" takes less than 1 minute and is combined with a description of the risks and side effects of the abortion procedure. That does not give women the information they need to make healthy and informed choices about their body, no matter what choice it is that they make! Additionally, I think that there needs to be action taken when 13 and 14 year old girls are getting abortions; could these girls be pregnant to their boyfriend? Sure. But is there a chance that this could be incest or "family friend" rape? Very possible. Why are these concerns not expored further? How are we protecting the woman if she goes back home to an unsafe situation? And I cannot understand women who are "frequent fliers" at the abortion clinic- those who choose to control their sexulity and fertility only through abortion services, not through methods that make sex safer for them, such as condoms. Abortion is not an option I would choose, but I don't think that it should be illegal, and I don't judge people who choose abortion. My very dear friend had an abortion when we were 25; despite being on the pill and using condoms, she conceived and was unprepared to become a mother or to manage a pregnancy and adoption process. I still love her dearly and listen when she grieves the circumstances surrounding that choice.As for adoption- I agree. The system is flawed. But any system that creates 6 million orphans in a country twice the size of Texas without having funding or infastructure to provide for their needs and education is also flawed. I am privledged to know several adults who came into their family through a variety of ways- some adopted internationally, some adopted domestically as young children, others adopted domestically as teenagers, and even 2 that were adopted by their new step-dad shortly after their mother married him and was killed within months of the wedding. I have seen sucesses and I have seen failures- but then, I also know that some people are successful parents and others are not- regardless of if their children are biological or adopted.I respect that you have issues with the adoption system, and I agree that it is not perfect. I am interested in hearing what ideas you have that would address the issue of 146 million orphans globally? Honestly, it is not a problem that can be "solved" by adoption. But it is a problem for these children to grow up institutionalized, without adequate food, clothing, education, health services and options to create a future outside of orphan care. This is a global issue that I feel strongly about and I am involved with several organizations that are working to create sustainable methods of caring for these children and young adults. But I would love to hear other ideas.I am thankful that in the US, we do no institutionalize children, and children that are orphaned, abandoned, relinquished or removed from birth families are raised in a family setting. The process from the time a child enters the foster care until they are returned to birth families or placed with adoptive families is certainly flawed. Birthparents rights are not protected the way they should be, including notification of birth father (especially when birth dad is unknown...) IMO, though, the circumstances that exist that would place a child into foster care in the US are also flawed, at least to some degree. I strongly believe that the best place for a child is with their birth family, but in circumstances where that is simply not possible, I think the next best option is permanent placement with an adoptive family... not being bounced about the foster care system.I am very proud to say that the US is one of the most open countries in terms of allowing adoptions. Most countries discriminate against adoptive parents based on age, religion, race, sexual orientation, health status, financial status, etc. In the US, we allow people who cannot (or can!) have biological children (such as same-sex couples or cancer survivors) to adopt, which many other countries do not. I think it is wonderful that children can be placed with a family that loves them without that family having to meet a specific mold. I would love to see an increase in older child adoption (let's face it, there is a wait list for newborns a mile long, but it's the older children who linger in the foster care system.) I would also love to see adoptive families become more open to transracial adoption, because no matter what color a child's skin is, they need families to love them.
  • edited December 2011
    Oh, and for what it's worth... I am pretty spiritual and raised in a Christian home. We were always taught that sex is great and awesome and wonderful and one of the most meaningful experiences you can share in life. (And it is:) We were also taught that sex is best when it occurs under circumstances were both participants are mature enough and responsible enough to enjoy themselves without hurting themselves or each other- physically, emotionally, or spiritually. Traditionally, my family taught that this was within the confines of marriage, but having been through a not-awesome marriage, I don't agree with that statement, and will be teaching my daughters differently. However, I would agree that the level of maturity that it takes to be ready to committ to marriage is the same level of maturity that should be expected before you have sex. The repercussions of sex can be overwhelming, and you need to be ready to deal with those repercussions before you engage in the activity itself (not just pregnancy and the possiblity of a life-long tie to the other person, but also diseases like HPV, chlamydia, herpes, etc... and feelings of regret, remorse, and guilt.)It frustrates me that the religion with which I most identify in terms of faith structure has such a reputation for being divisive, hateful, hurtful, and judgemental. My faith structure never endorses these feelings or actions, and in fact seeks to avoid that in favor of being loving, kind, gentle, caring, and supportive. Of course, my beliefs inform my values and morals which I try to live out, but I never expect others to live by the same set of morals and values or to share in them. I also never expect that the laws that govern this nation should be informed by the beliefs and/or morals and values of any religion. As Aristotle said, "the law is reason free from passion." This would place it outside of the influence of religion, as it should be. But then, I am not your "typical" Christian, I guess, since I like sex, am friends with gays, and give my time and money to organizations that are actively working to do good rather than giving to the church:)
  • edited December 2011
    (I LOVE when this board grabs a topic and gets passionate about it!!)I know nothing about the adoption system- and will stay out of that debate.  Grace- you wrote a well argued point.  You and I agree on many things.  As I read your discussion, my strongest response is that you and I identify ourselves as opponents-- you say you are pro-life and I say I am pro-choice.  Yet, we both believe that the legality of abortion should continue.  We both would not choose to have an abortion ourselves (although as a college student in a Catholic college, I told my nursing class that if I were to become pregnant while a student, I would choose an abortion.  Different place and time...) We both feel strongly that women should make intelligent choices and not allow a pregnancy to just happen.I think the words pro-life and pro-choice are divisive and imprecise in describing the belief system.  I AM in favor of life.  I am in favor of the life of the mother, the life of her family and the quality of life of her children.  IF she makes the decision that she cannot give her child a life with quality, and chooses to terminate the pregnancy because she has searched her soul and that is the answer she finds--I support her having that right.  Frankly, my xH's neice bore 4 children from varying studs (aka sperm donors).  The oldest probably did the best- she got far far away from her mother at the first opportunity.  Although at 18 I think she already has 2 children of her own.  The remaining children were impacted by substance abuse during pregnancy, neglect and abuse.  They had profound developmental delays and were bounced in and out of the system whenever "mommy" thought for a moment that she needed to act maternal for a day or week.  I begged the social worker at the hospital I worked at to NOT let child #3 go home with her- she had delivered him in a toilet at her boyfriend of the week mother's house after swearing that of course she wasn't pregnant.  Her mother (idiot xSIL) swore she was going to foster the child, which lasted a day or less, then she needed to go out to the bar to see her friends.   Do I think these children would have been better off never born?? Yes, yes I do.  You are in favor of choice.  You do not believe that eliminating legal safe abortions will suddenly stop people from terminating unwanted pregnancies.  You and I may differ on how much effort is put into dissuading a woman from having an abortion, we may differ on other facets of the process, but we differ very little on the main point.  I think that the radical right and the radical left want to keep the divide open.  (I'm pretty far left, by the way.)  I think there would be less division if the two sides were called something like "pro-legal abortion" and "anti-legal abortion".  And finally Grace- I don't know which Christian church you were raised in, but you and I have very similar beliefs about faith versus organized religion.  ~Donna
  • handfast4mehandfast4me member
    Seventh Anniversary 1000 Comments 5 Love Its
    edited December 2011
    Thanks Donna-it give me, (and hopefully Grace) different words to use.  I have always called the Pro-lifers Anti-Choicers because that's what they are to me.  Also, I have NEVER understood how the same people who want to deny the right of choice over one's own body can advocate FOR capital punishment.  That just doesn't make sense to me.  And also, while we're on the topic, why do I always see the anti-choice bumper stickers on cars driven by elderly, old men?  Uh, yeah, NO.  Since you have never, and never will, have to make that decision, you, Mister, don't get to make it about my life and my body.  I'm 50.  I use birth control--although I have a hard time due to medical history, so I'm severely limited in my choices.  That being said, if my birth control method failed (and NOTHING is 100%, I don't consider abstinence 100% because I've yet to meet anyone who really has been successful with that method!) I would definitely have an abortion.  It's too much of a risk to me at this age, and any fetus would almost certainly have some issues.  My family has a history of being fertile into their 60's, so these are things I've done a lot of thinking about.
    image Don't mess with the old dogs; age and treachery will always overcome youth and skill! BS and brilliance only come with age and experience.
  • edited December 2011
    I was five when Roe v Wade came into being, and birth control has always been available in my lifetime. But when I wanted to have my tubes tied (daughter was 4 so I was 23), I went through 3 docs before I could find one who would do it, and he required that my husband sign a "permission slip" saying he wouldn't sue him for taking away my ability to bear a child. My issue right now has gone beyond the normal abortion/birth control argument. What's worrying me is that pharmacists can refuse to fill prescriptions if it's against their beliefs (i.e. the morning-after pill, or birth control pills). In a hospital, all staff down to the janitors can do the same. So, say a woman wants an abortion. It could concceivably take 12 weeks to set it up. Then what? This is a back door way of circumventing Roe v Wade. Adoption is the best of all solutions but sometimes it's just not feasible. This is an argument that will never be won, on either side. It's tied too closely to religion and sadly, women's rights. That battle is still being fought.
  • edited December 2011
    ck - while what you say is true- the pharmacist is more of an issue than the hospital.  As an administrator, I have to honor employee's beliefs, unless honoring that wish impedes someone's safe care.  That typically means finding someone else to do the case.  In 25 years, I have never heard of a problem with that.  However, I have only worked here in true blue Massachusetts.  Maybe in a redder state, it could be an issue.  ~Donna
  • edited December 2011
    I love the wonderful, respectful, insightful discussion on this topic. I agree, this is a problem that will never be solved; as long as there are children without parents, the issue of adoption will continue, and as long as there are mothers who do not want to give birth, the issue of abortion will continue. So, these will always be topics of discussion.   There are a few topics that came up that I think are interesting. First, the provider’s right to refuse to perform an abortion or dispense abortive medications (I assume this refers to “Plan B”?) As Donna mentioned, the rights of the provider must be respected as long as they are not abandoning or neglecting their patient- ie, as long as another provider can be found to provide necessary services. However, because abortion is considered an elective treatment, even if another provider was not readily accessible, it would be difficult to argue that any provider MUST provide any service. I think of it like plastic surgery; there are some cases where plastic/reconstructive surgery necessary, but for the most part, no one would throw a fit if a doctor refused to give someone a tummy tuck or nose job because the procedures are elective. It’s the providers right to choose which cases he feels are appropriate for him/her to take. I am not trying to compare abortion to something significantly less important like cosmetic surgery, but the idea of provider rights is applicable. As a nurse, there have been a few times I refused to participate in or administer care. I have never regretted those choices, and I know that at least one person died because someone else decided they would follow orders that I would not follow. As a provider, I should never have to sacrifice my morals, values, or ethics in order to provide an elective procedure. I shouldn’t have to sacrifice my peace of mind and sense of “doing the right thing” period, although I once did in a code situation. I still regret that and wish I could change the course of events. Another interesting point is the idea of abortion as a choice vs. adoption as a choice. I cannot understand how one can be “pro-choice” and support a woman’s right to choose not to give birth to her baby without also supporting a woman’s right to choose not to parent or to stop parenting her child. They are the same basic issue, and the woman ultimately has to decide if at that point in time if she wants the child and if she is able to physically, emotionally, and financially provide for herself and her child. If the answer is “no,” then she should have the right not to parent that child. Many people agree with this when discussing abortion but do not see the issue the same way when discussing relinquishment. I have a friend who did not discover that she was pregnant until after her 20th week of gestation. She had endometriosis and because she had erratic periods and vaginal bleeding (which continued after the time she conceived), she didn’t even consider that she might be pregnant until she started feeling the baby! Thankfully, she was in a situation where the news of pregnancy was good and welcome, not a crisis. In our state (and most states) she would not have had access to any abortion procedures at that point because of her advanced pregnancy. Other women also do not know or do not choose to address their pregnancy until they are past the point of no return. Adoption services should be available to them if they choose not to parent.     Additionally, there are parents who choose not to parent well after a child is born and relinquish their child. My daughter was parented for 13 months by her bio mom before she decided that she could not continue to parent and relinquished her child. She had no family or friends who would care for her child, so she relinquished and the child was placed for adoption. Contraception and abortion simply do not solve the problem of unwanted children or parents who are unable to parent. Certainly, it does not address the problem of orphans. I would love to think that all children could stay with their birth parents, but sometimes this is not possible or not desired by the birth parent. In that case, services must be available, and the services should focus primarily on the interest of the child since they are the most vulnerable of the parties involved.   The adoption system is flawed, but that does not mean that there is not merit to it. International adoptions are highly regulated in Hague countries, and the paperwork and approvals necessary to even be considered as an adoptive parent are complex, to say the least; I always think that if we required such evidence of ability to care for and parent a child from anyone who wanted children (bio or adopted) we would never have need for Child Protective Services or any of the like. In almost every situation of international adoption, children are being placed into families after being abandoned or relinquished under circumstances where there is no support for them to continue to parent their child (poverty, death of spouse/caregiver), or no desire to parent their child (unwanted gender, stigma of unmarried mother and/or "bastard child".) What other choices are there under these circumstances? Especially in undeveloped or developing nations where basic education and health care infastructuers are not in place, let alone human services.International adoption is a completely different story than domestic adoption. With domestic adoption there are a slew of issues. There are many agencies that are working towards creating a better kind of adoption experience for the birth mother as well as for the adoptive parents and most importantly for the adoptee. Gladney Center, for instance, has a program that offers free housing, food, clothing, educational opportunities, career planning services, social support, and post-partum services to birth mothers. Their program is wonderful, and while it is not perfect, it is one of the most respectful services out there for birth mothers who choose to relinquish.     Retread, I am sorry if I offend you with my pro-adoption viewpoint. It is clear that you are dissatisfied with your adoption experience and your POV is certainly unique and to be respected. I visited several blogs (including bastardnation.com) and read several books by adoptees in an effort to prepare to become an adoptive mother (in particular, since I engaged in a transcultural, transracial adoption, I read about the unique struggles of this type of adoption.) There is so much pain and guilt involved in adoption- and from each part of the triad- that it is impossible for me to say that once choice is good and another is not; the choice to parent is wonderful, but the choice to relinquish when a birthparent is unable to parent and the choice to adopt a child and love them are also wonderful. I have a huge amount of respect for those who chose to adopt sibling groups and older children since these types of adoptions are usually much more difficult on the child- and there the bio and adoptive parents- than infant adoptions. However, some of the things you state are simply untrue. With regard to open adoption(which is a very popular phrase that has unique interpretations), I would like to direct you to my friend Julie’s blog: www.journeytofamily.com   Julie is mom to a bio son, a son who was adopted domestically through an open adoption, and a daughter who is adopted from Ethiopia. Julie writes about her open adoption several places in her blog, and Alexa (birth mom) is a part of Seamus’s life in an active way. One particular post that comes to mind is Julie’s annual honoring of Birthmother’s Day. She has also posted more info about their open adoption here: http://www.journeytofamily.com/2008/11/faces-of-open-adoption.html Perhaps if more open adoptions were as loving and inviting as Julie, Marshall, and Alexa have created, you may not have such a bad opinion of them.   http://www.youtube.com/watch?v=4t2Stki4G5A   The reasons that birthparents choose to relinquish are many and varied. When a woman is impaired by alcohol or substances- when a young girl does not have a support system, income, source of food or shelter, or ways of meeting those needs- when birth mom suffers from mental illness and is not functional as an individual- when birth mom has no desire to parent a child… these are all situations where I doubt it is in the child’s best interest to be parented by their birthparent. Good intentions do not provide food, shelter, clothing, medical care, toys, education, etc. I cannot agree that it is best to “keep your baby at all costs.” But for women who want to keep their child and have a plan to overcome the obstacles that would prevent them from parenting their child, I applaud and hope only the best for them and their child.Good Lord! I've written a novella!
  • handfast4mehandfast4me member
    Seventh Anniversary 1000 Comments 5 Love Its
    edited December 2011
    Grace, WOW!!!  One experience that you've had does not make the entire process OK-- When you self-identified as 27 my first reaction was, well, OK, most of us here are over 40, so she might learn something.  Hope you do.  And regarding the Plan B (which, BTW, is NOT the same as what you refer to as the "abortion pill" which is commonly referred to as RU 486):  Many pharmacists refuse to give it (Plan B) because of their own moral hang-ups.  And usually, these are MEN who are in small towns, where there is no other place for these women to go.  And Plan B PREVENTS pregnancy. Finally, in every other developed country on this planet RU 486 and Plan B are given much more widely than in this country.  RU 486 is much safer than a surgical termination.  Period.  Women under 18 suffer severe consequences of pregnancy.  It is safer for a woman to have an abortion under the age of 18 and over the age of 44 than it is for her to carry to full term.  Not to mention that RIGHT NOW pregnant women who contract H1N1 are dying at the following numbers:  1 in 4.  My daughter is pregnant, and under the age of 24 (they have a 1 in 6 chance of ending up in the hospital with severe complications with H1N!--and that's HEALTHY people without any underlying conditions!)   I talked with her about terminating the pregnancy, but she wanted to carry to full term.  It's her choice, even though she's only 23.  It makes me nervous, though.  People think that if these methods are available, that people will have unsafe sex due to the availability. No, the discussion itself may prevent unsafe sex. 
    image Don't mess with the old dogs; age and treachery will always overcome youth and skill! BS and brilliance only come with age and experience.
  • edited December 2011
    Most often the primary provider of abortion services is the physician.  Here (blue Mass), it is uncommon to find a gyn who does not provide therapeutic and elective abortions.  They don't advertise in the yellow pages.  But, other than a few, most will provide the care to a woman who requests it.  The assisting providers who are reluctant to assist are scrub and circulating nurses.  Most OR directors that I know vet this very question early on after hire, so that they have their staffing plan lined up ahead of time.  Most hospital policies that I have seen allow employees to decline unless it will risk patient care.  That is different than a life threat.  So if a case is booked (they are rarely emergent- except for a partial or a missed, in which the fetus is not able to survive) the appropriate staff are assigned.  I thought Plan B and RU 486 were the same thing... but the pharmacists who decline to dispense are certainly interfering with a woman's rights.  I have a tougher time with this one however, since I am no more inclined to impose upon their moral beliefs than I am upon the woman.  I do feel that part of professional obligation is to follow the laws of the land.  So, I can't say I weigh in clearly on either side of this.  And I'm still staying out of the adoption debate, due to personal ignorance.  However, not every unwanted pregnancy ends up aborted or put up for adoption.  I personally believe that a large number end up with the birth mother, in situations that are abusive, neglectful, hate filled, and often dangerous.  The BEST thing that happens to those children is that they get removed by child welfare agencies, but unfortunately, the foster care system is so overwhelmingly broken, that the children are sometimes worse off.  Occasionally the child ends up like your child, Grace, free of parental rights for adoption.  That is a minority, however.  And, with 25 years of critical care experience, I would agree with you that there are a multitude of cases where my personal level of moral distress has been significant.  My only advice is to work to change it.  I have had a significant impact on the Ethics committees and on patient care in the settings where I have been employed, through educating my peers and colleagues, including presenting CME programs to physicians.  If your hospital does not hold Schwartz rounds, you can encourage them to look into them.  http://www.theschwartzcenter.org/programs/rounds.html  ~Donna
  • handfast4mehandfast4me member
    Seventh Anniversary 1000 Comments 5 Love Its
    edited December 2011
    No, Plan B and RU 486 are not the same thing.  Plan B, is in effect, just like taking 4 medium-hormone dose BCPs all at the same time (not 4 months worth, but just 4 pills).  As a matter of fact, many physicians, NPs, and PAs will recommend that one take 4 of their BCPs (or friends pills) in an emergency.  Plan B PREVENTS the egg from being implanted, RU 486 has a different purpose.  Look at this link: http://www.planbonestep.com/plan-b-pharmacists/faqx.aspx#4Also, I've been thinking about the earlier statement that it was OK for pharmacists, etc., to NOT do something that is against their religious beliefs, or credo, or however it was worded.   I strongly disagree.  They should do what their patient's need, and if that's Plan B, or RU486, then so be it. Here's my reasoning.  Let's turn it around.  Let's say that a physician thinks that no more of a certain type of person (for this argument, let's say Whites of British descent) should ever have children.  And they have some sort of "religious" belief that backs them up on this.  They can point to some text from 2000 years ago that says this exactly.  "Thou shalt not allow the birth of Caucasians who have been born or parent's born in England."    And so this physician recommends sterilization to all who fit in that category, telling them that because they have significant genetic issues (being white, in this case) that they should get spayed or neutered :-)  immediately.  And when they consent, and due to their own lack of understanding of his religion, they consent.    It sounds absurd, but that's basically what you're doing when you say it's OK for a health care provider to NOT provide safe, effective, ways to prevent or eliminate pregnancy.   And it's actually NOT that absurd.  It's happened here in this country, to those who were less than what was deemed "normal" IQ,  or those who were deemed psychologically unfit.  (Which, in many cases, just turned out to be strong minded women who were committed to an institution by their husband.)   There are several famous law cases about this.  And it's hinted at in The Women's Room.  Again, read that book--especially for those of you under 40.  This is what I went through, and those women of my age and those who went before me. And learn the credo of NOW.  
    image Don't mess with the old dogs; age and treachery will always overcome youth and skill! BS and brilliance only come with age and experience.
  • edited December 2011
    I hear you Stacy - and I HAVE read The Women's Room, although not recently.  And, your example makes a strong argument.  But...turn it around.  What if an institution, like a large health system...develops a policy similar to the one you used?  All patients admitted to gigantic mega hospital system who are Caucasian and of British descent will be sterilized within 48 hours of admission.  Shouldn't the employees be able to decline to comply when it conflicts with their moral ideals?  That example may not have existed but places like the Fernald School did incredibly wrong things to their residents back in the day.  If a professional had moral distress in participating in those situations, should they not have the right to decline? Even better if they can protest, whistleblow and bring about change, but if they do not have the wherewithall to do that, at least protecting the individual's rights to decline to participate should remain intact.  And there may not be an ethical difference between an act of omission (refusing to provide) versus an act of commission (imposing sterilization), there is a feeling of a difference of intensity of the act. Having said that, if the employer cannot or will not excuse the employee from participating in that act  (eg. CVS corporate says we will dispense these drugs, if you work here you must) the employee then has to choose to work there or not.  I have no problem with that.  The situation becomes stickier when the provider is the owner - some of the small isolated pharmacies in the country.  Here- there's a pharmacy or two in every town, so not a problem.  Elsewhere, if its hours between pharmacies, I do have an issue.  Thanks for the clarification of the two drugs.  Now I remember the difference.  Is RU 486 sold in the US?  ~Donna
  • handfast4mehandfast4me member
    Seventh Anniversary 1000 Comments 5 Love Its
    edited December 2011
    Hmmm.  Absolutely, they should refuse.  But you see, that's why I investigate things thoroughly before I work for them.  If I found something like that going on, I'd quit, immediately. And my current company (well, a certain part of them) had a horrific history, but it was exposed, and hopefully, with watchdogs like me, won't happen again.  I'm vigilant in watching that section, and many others. Currently, (and I won't "out" her on the board), but there's a recent bride whose DH's company covers his and her medical insurance.  But they won't cover ANY birth control expenses--not an exam, prescription for, nor the BCPs or any barrier method even.  I could not work for a company like that.  But that's why I won't order Domino's Pizza, either-because they donate to the anti-choicers.
    image Don't mess with the old dogs; age and treachery will always overcome youth and skill! BS and brilliance only come with age and experience.
  • edited December 2011
    Here in Mass - both birth control and infertility treatment are required to be covered under a health care plan.   I could start a different thread about how I used to take care of women on public assistance, who were unmarried, who already had one child by a father other than the man they were with now, who were receiving expensive infertility treatment - paid for by Medicaid.    Even the blue thing can go too far!! LOL.  ~Donna
  • handfast4mehandfast4me member
    Seventh Anniversary 1000 Comments 5 Love Its
    edited December 2011
    Yep, I defintely have an issue with those on Public Assistance recieving infertility treatment.  Oh boy. That's an entirely different debate.
    image Don't mess with the old dogs; age and treachery will always overcome youth and skill! BS and brilliance only come with age and experience.
  • handfast4mehandfast4me member
    Seventh Anniversary 1000 Comments 5 Love Its
    edited December 2011
    You're right, Retread, infertility is not required coverage in every state, but in a few, they do cover infertility treatments, paid by the government, for women on public assistance. In other words, unmarried welfare moms are being given fertility treatments.  That makes no sense to me.  EXACTLY about the adoptee issues.  As I stated earlier, most of the adoptees I know have been abused physically or mentally, or carry the scars of the adoption process itself, so they are not well adjusted, nor particularly happy people.   Not that birth parents are always great either.  Yellow_Grace, your adopted son is not a grown man yet, so the jury is still out on your situation.  We'll see in 18 to 20 years.
    image Don't mess with the old dogs; age and treachery will always overcome youth and skill! BS and brilliance only come with age and experience.
  • edited December 2011
    Retread, I am sorry to hear that you had such a horrible personal experience with adoption. The pain of what you experienced as a vulnerable child is unimaginable. I am sorry if I offended you with the term “dissatisfied.” As the child of a convicted sex offender, I personally experienced physical and verbal abuse, and sadly many other children experienced sexual abuse and assault at the hands of my biological father before he was sentenced to 20 years in prison (I think it should have been more.) Certainly, given my personal experiences, I am inclined to believe that children should never be placed with abusive parents, even if they are the birth parents. Our personal experiences often lead us to interpret and apply facts in different ways, and I can see how each of our personal experiences could lead us to view the same set of facts about adoption in such different lights.   While I am an advocate of adoption, I have never disagreed that the system is flawed and could use much improvement. However, just because something isn’t perfect- or even close to perfect- does not mean that it cannot be useful, appropriate, and even good. I believe adoption to be all of those things, under the right circumstances. I also think that as more openness comes to adoption in terms of information sharing and social acceptance, the process will improve. There are a lot of good things happening in international adoption (for instance, the adoption of the Hague treaty by many countries, increasing Hague-compliance and certification by many US adoption agencies, and the closing of Vietnamese and Guatemalan adoptions.) I hope further legislation will pass that will ensure more transparency in adoption while honoring the adoptee’s past and embracing the adoptee’s future. Overhauling an entire system is a big process, but I think things are on the right track; they may not be going as quickly as possible, but when you consider that even just 50 years ago adoptions were almost always kept secret from the adoptee (my friend Libby did not know she was adopted until she was 17!) and transcultural/transracial adoptions were practically unheard of, we have covered some major ground.   I personally know 2 families who had their adoptions disrupted, and the pain and devastation those families experiences, both while trying to work to make their adoption process possible and after the disruption, was immense. One family disrupted over 2 years ago and still grieves the loss of that child- much like they grieved the loss of their bio child who passed away. I personally have struggled with incredible feelings of guilt relating to my adoption process, and despite meeting, interacting with, and continuing a relationship with Hosanna’s birthmother (as much as one can, considering she is in Ethiopia and we have no means of communicating with each other except hand-delivered letters which are written in languages we don’t understand), I cannot overcome these feelings. I also struggle with knowing how much pain Hosanna’s birth mother must have experienced and continues to experience, and I cannot anticipate how much pain Hosanna might experience as she comes to understand her adoption. I don’t bring this up to diminish the painful experiences of the birth mother or adoptee, but to also bring light to the fact that all persons in the adoption triad experience pain and guilt, because any circumstance that would make a child available for adoption is one that involves pain.   I don’t think adoptive parents speak of this very much (even amongst their network of AP’s) because we don’t want to seem ungrateful for the beautiful child who has become a part of our lives. But it doesn’t mean that it is not a valid experience of pain. Your point about adoptee’s who question the status quo and are then labeled as ungrateful- or worse- is such a true point, and is just as true on the AP’s side; we don’t want to seem as though we love our adopted child any less than a biological child by admitting to the pain that we experience surrounding the adoption process. In fact, I am careful about who I talk to about my parenting  problems/issues/concerns/questions because of this stigma of seeming ungrateful or not loving my adopted child as much as I love my bio child. Again, I don’t say this to diminish your personal experience or the experience of adoptees or birth mothers, but simply to recognize that there continues to be difficulties in the adoption process for all members of the adoption triad.   With regard to my statement that some of what you wrote was untrue, I am referring to 2 particular statements:   “Frankly, they sell babies. Many agencies claim that the fees cover the birthmother's medical expenses. I can tell you that this is an outright lie because I worked in the state welfare office and the agencies bring those women in to file for medicaid. So where do those thousands of dollars go? Into the agency's pockets. "Legal fees"? They have their own lawyers on staff.”   and   “Identifying info cannot be exchanged even if adopting and birth families agree to it, and social workers are present at meetings to ensure that this does not take place.”   With regard to the first statement: Yes, agencies apply for state assistance for birth mothers; most are very up front about this. However, for a variety of reasons, those birth mothers may be declined assistance. I have personally applied for public assistance, and I was surprised at difficult it can be to be approved, even if you meet the criteria for inclusion. When I initially applied as a single, jobless mother, my daughter was offered coverage and I was not. I had to appeal to be granted coverage. Then, when I did have coverage, I could not find any preventative care docs  (PCPs, GYNs, etc) that were accepting public assistance patients, so even though I had coverage, I did not have care unless I went into the emergency room. Often, if the birth mother is from out of state, they will be denied coverage within the agency’s state, and even if they qualify for public assistance in their home state, they most likely do not have preventative coverage in the state where their agency is located. So yes, some of the fees go to the healthcare for the birth mother. Additionally, most agencies offer assistance of other sorts to the birth mothers, including services such as free residential care, food, clothing, education, etc. Agencies also provide transitional care foster families between birth and placement. For families who are adopting non-infants, young children, and teens, the agency often covers many services that benefit the children and assist the foster families in caring for these children. All agencies are required to offer post-placement services to the adoptee and adoptive family (some of which I have personally utilized.) Certainly, like most other “non-profit” organizations, adoption agencies make money and the higher-ups are well-paid, but this is true in all sectors (don’t get me started about how much our CEO makes at our non-profit hospital…) Long story short, agencies aren’t “selling babies,” and especially not so when they are working to place older children and teens.   With regard to your second statement, I think my friend Julie’s open adoption proves that statement to be false. Information can be exchanged if the parties agree. It is not done in every case, but that doesn’t mean it never occurs or is even the “norm.” I think open adoption is changing, and that is a good thing.   As you said, the system can work for all. And it is up to everyone who is a part of this process to make it better. I am a big advocate for ethical adoptions in the international adoption world and very active with agencies working in the US and in Ethiopia to maintain open, honest, ethical and legal adoptions. I am also working with an Ethiopian friend who is trying to increase local adoptions within Ethiopia (adoption of anyone outside of your immediate family is still considered abnormal and socially unacceptable in Ethiopian culture. We believe the best place for Ethiopian children is with their birth families, the second best place is with another Ethiopian family, and finally international adoption as a last resort. We are working to make this possible. Unfortunately, Ethiopia is laden with children who are true orphans due to the death of both birth parents or are abandoned with unknown birth parents; cultural change is slow, especially in a culture as ancient as Ethiopia’s.)   When I found out I was pregnant at 19, I never once thought about having an abortion (even though the father asked me to do so), but I strongly considered placing my child for adoption. As it turned out, circumstances changed, and I did not relinquish. This was taking place as my aunt was completing 4 years of searching for the child she placed for adoption over 50 years ago. She has spent so much time and energy searching for that child- a little girl- my cousin. Her experiences certainly factored into my decision. But later experiences have also affected my viewpoint, not the least of which was finding out that my role model was in fact adopted as a child. She was one of my biggest supporters when I began my adoption process. Personal experiences affect us so much in ways we often cannot articulate. They are what lead us to differing viewpoints in the face of the same set of facts. I appreciate your viewpoint and again offer my most heartfelt sympathy for the experiences you had with adoption. I also have experienced pregnancy loss and was told I was infertile (although the jury is now out on that), so I extend my sympathy to you as you work to create the family you desire.Also, I did visit txcare.org. I was unable to search the site and did not locate any info about Gladney during my time on the site. Do you have a different or direct link to the info?
  • edited December 2011
    Handfast, excuse me for my lapse in memory regarding RU 486 and Plan B. It has been some time since I was involved in similar discussions regarding these medications, and in my head I got them confused. I could not agree more with your statement “People think that if these methods are available, that people will have unsafe sex due to the availability. No, the discussion itself may prevent unsafe sex.” I liken this to the present “argument” regarding the HPV vaccine. I have personally received the vaccine and both of my daughters will receive the vaccine. I could not be more in favor of it, and cannot discuss it enough. People often believe that a highly available HPV vaccine will increase the occurrence of unsafe sex, but in my experience educating people about how easily transmittable HPV is, they seem to want to make sure to practice safe sex even more! The discussion probably does prevent unsafe sex, especially when you tell them that there is no reliable test for HPV in men, so even if their boyfriend has been “tested,” they could still contract HPV from sexual interaction with him- even if it’s not intercourse! I wonder if people believed that a Hepatitis B vaccine would increase the number of people having unsafe sex or using IV drugs? Or if they thought a Rotavirus vaccine would increase the number of people who put their hands in their mouth after defecation?   I only hope that the HPV vaccine is recommended for young men, too, due to it’s high efficacy in the prevention of anal cancer in males who engage in same gender sex. (BTW- as a student, FI worked for Merck and help develop methods to increase their testing for and development of the HPV vaccine. He is so proud to have been a part of creating the vaccine!)   And you’re right- we will have to wait and see how Hosanna turns out. But we will have to wait and see about Abigail (my bio daughter), too. Abigail is a child of divorce, and her bio father has not spoken to her in 2 years; I think his blatant rejection of her is likely to leave just as much of a scar as the wound that Hosanna was given by being relinquished and placed in a transcultural/transracial adoption. I personally think and hope both of my children will fully know and experience the love that I give them, that their family gives them, and that FI gives them. And while I don’t think love is “enough” to create competent, caring, responsible, happy, intelligent, giving, loving, well-adjusted individuals, I think it is a good start, and we can figure out the rest as we go along. At least I hope so- we seem to be doing well so far.
  • edited December 2011
    Handfast, I also wanted to offer my good wishes to your daughter in her pregnancy. H1N1 is pretty scary- our hospital (a large, academic tertiary care center) has had several deaths from H1N1, thankfully none are maternal, and only one was pediatric; the others were all elderly who had chronic health conditions. I had H1N1 when we had our first outbreak this spring, and I almost ended up in the hospital (FI still gets a lot of grief about how he is an interal medicine doc and let me sit at home nearly unconscious when I was sick... in his defense, he didn't know that we had an outbreak in the hospital because I was one of the first cases. I caught it from 2 patients who I cared for who ended up H1N1 positive but we didn't add that to the differential until after I was exposed.) Our community is "highly contagious" right now, and I know how scary it can be as someone who understands disease transmission to know that there is basically no way to prevent exposure, even if you wear a mask and have pristine hand hygiene.I hope all goes well for her and she has a healthy and safe pregnancy.
  • edited December 2011
    Provider rights are such a difficult subject, but like Right1 said, I think it comes down to a matter of respecting the moral beliefs of individuals, no matter which side of the bed they are on. I think as long as patients have the right to refuse the recommended treatment/therapy and the right to a second (or third, or fourth) opinion, physicians must also have the right to refuse to provide a treatment/therapy. I can see the concern with access to Plan B and RU 486 due to pharmacist refusal, online pharmacies such as CVS.com can provide these medications and ship them to women when their local pharmacist will not provide the medication, especially with Plan B which is available OTC for women age 18+.   Also, FWIW, I know my parent’s urologist required that both my mom and step dad be present at a pre-surgery consult before he would agree to perform a vasectomy. I think the idea of requiring spousal approval for vasectomy or tubal ligation is antiquated in an age of HIPPA, sperm and egg banking, and surgery reversal.   Right1, we do have Schwartz rounds at my hospital. Unfortunately, everyone BUT nurses seems to be able to attend. We are always short these days and our acuity is so high that we can’t even get to the bathroom, let alone educational programs! (partially thanks to all our H1N1s, and to all our staff being out with H1N1 or their kids who have H1N1…)   Our institution needs change- in more ways than one! Or, perhaps this is just the norm with nursing? I am not sure.
  • edited December 2011
    http://www.cdc.gov/std/hpv/default.htmAs a woman who had a clean bill of health for 6 years, negative Pap tests for 6 years, and all STD testing was negative, I was shocked when I had grade I-III carcinoma in situ.I received the vaccine in hopes that of the 100+ strains of HPV, I would have immunity against the most virulent 4-6 strains.At least 50% of women will have an HPV infection during their lifetime. The only way to find out if their infection will advance to cervical cancer is through Pap tests... or to wait until their cervical cancer has metastisized so much that it has created lesions on their lungs or other organs and is diagnosed. (My first hospital paient as a nursing student was Stage 4 cervical cancer. Her prognosis was 6 months or less at the time of diagnosis.)The HPV vaccine and the discussion surrounding it should focus on preventative care. Since my health insurance covered the vaccine, it was a no-brainer that when my GYN suggested I receive the vaccine, I did. Even if my insurance had not covered it, my doc was offering the series of vaccines AT COST because the research was so compelling. 29% of women diagnosed with any stage cervical cancer do not survive past 5 years.Pap test compliance in the US is in the gutters. Those most compliant with their pap testing are those who are least at risk for cervical cancer. This is a problem, and we don't know how to fix it. Until we do increase Pap test compliance, I am in favor of anything that makes sex safer for women- from condoms, to monogomy, to the HPV vaccine.Echoing the sentiments that many expressed about abortion: you don't like the HPV vaccine? Then don't get it! But please don't limit it's availability to those who could benefit most from it, and don't think that because you don't like, it is not appropriate for others who believe the that the vaccine is in their best interest to receive it.As for open adoptions, you are right. They can work. They don't always work. Like legal documents entered in family court, probate court cases are difficult to enforece or unenforceable (oh yeah, that child support that I am supposed to receive? Unenforceable. That visitation that my daughter is supposed to have with her bio dad? Unenforceable.) Oh, and my union contract and state legislation that prevents me from having to work mandatory overtime? Unenforcable... or, at least, not enforceable in a timely manner. But, as I have said throughout, while a system is flawed, it does not mean it is without merit. Research supports openness in adoption, but also reinforces that there is not a "one type fits all" set of circumstances and expectations for the level of openness. You state that about half of open adoptions work. This number is growing. Julie's adoption is a valid example of an open adoption because her open adoption was completed legally within the state of California; she may be an example of the "best case senario" or an outlier to use a statistical term, but it does not mean that it was not a valid experience. The APs who violiated their open adoption agreement and birth mom later committed suicide is also a valid example. Again, there are positive and negative experiences on all sides. Just because I look at the positive experiences and choose to believe that they are a good foundation for building a better system that treats all persons in the adoption triad with respect does not mean that my viewpoint on adoption is wrong or invalid. Just because you look at the negative experiences and view them as a situation that should be avoided at all costs, including the cost of avoiding adoption all-together does not make your viewpoint wrong or invalid. It just makes them different. I am okay with that- being able to have differing opinions and state them publicly without fear of retaliation by individuals or the government is one of the best things about living in this country.As to pharmacies being a business, well, so are health insurance companies. As businesses, they have the ability to set their terms of employment and determine which practices are most beneficial to their business. Health insurance companies come between physicians and patients all the time; this doesn't always mean they need to change their company practices. They are trying to make money just like every other capitalist in this country. The moment we start telling any business that they must not engage in certain practices, despite the fact that the practices are in fact legal, then we have bigger issues. Pharmacies being businesses is one of the biggest reasons why they should be able to set their own business practices.
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