Saturday, May 13, 2017

We Saved Babies But We're Losing Their Moms: Women's Healthcare in Texas

We knew defunding Planned Parenthood would mean more babies, and we were right. 

27% more babies!

Following through on anti-abortion campaign promises, Texas legislators cut the state budget for family planning by two-thirds in 2011, while simultaneously diverting funds away from women's clinics that provide abortions, and poverty birth rates increased 27%.* (The state-wide birth rate decreased.)

As our poverty birth rate increased, so did our maternal mortality rate: doubling in just 3 years. Texas can now boast one of the highest maternal mortality rates in the developed world.

While maternal mortality isn't terrifyingly high (30 per 100,000 women), we should be concerned -- or at the very least, curious -- that the maternal-mortality rate in our state doubled in just three years, even as it decreases throughout the rest of the world.

What does it mean?

Well, it's not rich moms who are dying. And for the most part, it's not women dying during prenatal care, labor, or delivery. It's not immigrants crossing the border illegally and dying in the ER as they give birth to anchor orphans. (In fact, Hispanic maternal-mortality rates are lower than white maternal-mortality rates in Texas, so if anything, immigrants are helping our stats.)


Our problem is the state of Texas has no healthcare available for the poor.

Subsidies and tax credits through the Affordable Care Act were designed to serve the middle class, those earning from 138% - 400% of the federal poverty level ($33,949 - $98,400 for a family of four).

For those earning less than 138% FPL, states had the option to expand Medicaid, which the federal government would cover at 100% for the first three years, and 90% thereafter.

The same Texas legislature that sharply increased regulations for Planned Parenthood clinics, in the name of women's healthcare, opted out of expanded Medicaid.

Prior to the Affordable Care Act, not a single independent health insurance plan in Texas offered maternity coverage, even if purchased prior to pregnancy. 

This meant, for many poor women, whose employers would never think to offer health insurance, their only access to healthcare was a limited program called Medicaid for Pregnant Women, which cut healthcare coverage 2 months after a baby was born. 

Maternal-mortality rate is measured from pregnancy to one year after a child is born. Most maternal deaths in Texas occur in the gap between a child being 6 weeks - 1 year old.

The common denominator? Poor mothers losing health insurance coverage, being unable to obtain healthcare, including mental health services, and dying.

Maybe it's not an astronomical number of moms dying in Texas -- 30 per 100,000 -- but it's an upward trend, and indicates part of a bigger problem: inaccessible, unaffordable healthcare for poor women.

Interestingly, Medicaid for Pregnant Women pushes new mothers at birth to obtain permanent sterilization or longterm contraception. While Medicaid pays for a woman to have her tubes tied a day after giving birth, or to have an IUD inserted at her post-partum check-up, this same woman loses access to healthcare soon after, and has no recourse should problems occur -- and with IUD's, complications are common. (There are online threads about how to remove your own IUD, despite all medical advice to the contrary, for the many women who are sterilized by the state, in the name of healthcare, and then left without care.)

We can wring our hands about not having children we can't afford, about absentee fathers, about healthcare being fine the way it is, about drug-addict mothers, about poor people "abusing the safety net," about an over-burdened CPS system, about the working poor being ungrateful for minimum wage, maybe even wondering if it's a blessing-in-disguise for these babies that their mothers died...

...but who are we as a state and as a people, if we go to any legislative stretch to save a child, only to shrug at the loss of its mother?

Maybe Obamacare is failing. Maybe we hastened its failure by encouraging instability in the marketplace. Maybe it was never a good plan to begin with. But we need something. And it needs to be affordable and accessible for everyone, even and especially, the poor. 


Texas' maternal-mortality rate is at just over 30 per 100,000.
*The 27% birth rate increase is in counties with a Planned Parenthood that closed due to decreased funding and increased regulations. Birth rates in counties without a closed Planned Parenthood clinic remained constant or slightly decreased. 

Friday, May 12, 2017

Do You Have What It Takes To Survive The Bader House?

I'm often asked, "How do you do it?!" 

"We have systems," I say. 

But the truth is, systems only take us so far. No matter the structure, preparation, or discipline of our family, there will be chaos. 

If you're curious how you might respond to the regular chaos of our home, check out this quick survey! (Answers and Survival Score below.)


1. Your kids are eating breakfast in the kitchen, when the pediatrician calls. You don't get cell reception in the kitchen. Do you: 

A. Answer your phone in the kitchen and hope for the best.

B. Answer your phone in the living room, while whisper-singing "The Wheels On The Bus" with dynamic hand motions through the open doorway, while talking to the nurse.

C. Do not answer the phone. 

D. Your children can handle a few minutes without you in the room. Step outside and take the call. Not sure what the hype is about. 

2. You must mail a package TODAY. Your 2-year-old is tantrumming at the post office. The other toddler and baby are fine. Do you: 

A. Ignore the tantrum and finish mailing the package at the self-service machine.

B. Hold up the line at the self-service machine to console your 2-year-old.

C. Leave with your other two kids, because surely the crying 2-year-old will follow. Paying attention to a tantrum is the worst way to feed it. 

D. Never allow a child to tantrum in public. Demand that he stop.  

3. Your family is getting ready for church. What is the best order to load the car, if you want to make it to church on time? 

A. Big kids first. Then toddlers, then baby. The big kids are self-sufficient, and you can multi-task buckling little ones at the same time.

B. Baby first. Then toddlers. Then big kids. 

C. Send the toddlers out to the garage first. It takes them forever, so this will allow plenty of time, while the big kids go potty, and you put shoes on the baby. 

D. Just tell the kids to get in the car and buckle while you take a moment for lip gloss and mascara. How hard is this?

4. Your 5-year-old needs to go pee during church. You're holding the baby, your spouse has the toddlers. Who takes the 5-year-old potty, with the least disruption to everyone else? 

A. You, of course. Just carry the baby to the bathroom to help the 5-year-old.

B. Your spouse, with the toddlers, can take the 5-year-old to the bathroom. They need a walk anyway. 

C. You send the 5-year-old to the bathroom with the 7-year-old, who is pretty much a 12-year-old in maturity.

D. You don't allow the 5-year-old to leave during church. It's disrespectful. And besides, no kid should have to go to the bathroom twice in two hours. 

5. It's 4 p.m. Prioritize these needs: baby is crying, dog vomited on carpet, dinner is not ready, the mail has arrived, laundry in washing machine needs to move to the dryer, 5-year-old just spilled ice all over the kitchen floor, 7-year-old wants to play high-low, toddlers both have poopy diapers. 

A. Baby, Toddlers, 7-year-old, 5-year-old, Dinner, Dog, Washing Machine, Mail

B. Mail, Washing Machine, 7-year-old, 5-year-old, Toddlers, Baby, Dog, Dinner

C. Sit down to drink some coffee.

D. My house would never be that crazy. I am far too organized. 

ANSWERS

1. Your kids are eating breakfast in the kitchen, when the pediatrician calls. You don't get cell reception in the kitchen. Do you: 

A. Answer your phone in the kitchen and hope for the best.
  • The children behave like perfect angels while you're on the phone. But the call is dropped just before the nurse comes on the line. You'll play phone tag with the doctor's office for the next 24 hours. Eventually, your child's prescription will be refilled. 
B. Answer your phone in the living room, while whisper-singing "The Wheels On The Bus" with dynamic hand motions through the open doorway, while talking to the nurse.
  • Your kids threw their breakfast on the floor and ran into the living room with sticky fingers, because they need to be near you at all times. The nurse can't hear you over the noise, and she hangs up. You'll play phone tag with the doctor's office for the next 24 hours. Eventually, your child's prescription will be refilled.
C. Do not answer the phone. 
  • The doctor knows your family well enough that they didn't expect you to answer the phone anyway. The pharmacy will text when your son's prescription is ready.
D. Your children can handle a few minutes without you in the room. Step outside and take the call. Not sure what the hype is about. 
  • Best of luck to you, friend. Your kitchen's on fire. (But yes, the call went great, and your son's prescription is refilled.)

2. You must mail a package TODAY. Your 2-year-old is tantrumming at the post office. The other toddler and baby are fine. Do you: 

A. Ignore the tantrum and finish mailing the package at the self-service machine.
  • It was rough, but you did it! Back to the car with all the kids, who are now happy, and you will never see those strangers again! Wait, did you leave the package on the scale of the self-service station? 
B. Hold up the line at the self-service machine to console your 2-year-old.
  • You're a great mom. Your son feels loved. Your package is mailed. Everyone in line hates you. Wait, where did your other toddler go? 
C. Leave with your other two kids, because surely the crying 2-year-old will follow. Paying attention to a tantrum is the worst way to feed it. 
  • It worked! He stopped crying! But he didn't follow you out of the post office. You return for him, leaving your other toddler holding the stroller just outside the door. In three seconds, the outside toddler has pushed the stroller down the handicap ramp into the parking lot.
D. Never allow a child to tantrum in public. Demand that he stop. 
  • Best of luck to you, friend. 

3. Your family is getting ready for church. What is the best order to load the car, if you want to make it to church on time? 

A. Big kids first. Then toddlers, then baby. The big kids are self-sufficient, and you can multi-task buckling little ones at the same time.
  • Good job! You are on time! Wait, one of the big kids forgot to go potty. You are late.
B. Baby first. Then toddlers. Then big kids. 

  • Yes! Everyone is in! Baby was upset at having to wait and spit up all over his church outfit. You are on time, but smelly.
C. Send the toddlers out to the garage first. It takes them forever, so this will allow plenty of time. 
  • The toddlers hit the garage door opener on their way out. The dog escaped and is chasing the neighbor's handicapped dog half a block away. Your kids are laughing maniacally. Your neighbor hates you. You are late for church.  
D. Just tell the kids to get in the car and buckle while you take a moment for lip gloss and mascara. How hard is this?
  • Best of luck to you, friend. 

4. Your 5-year-old needs to go pee during church. You're holding the baby, your spouse has the toddlers. Who takes the 5-year-old potty, with the least disruption to everyone else? 

A. You, of course. Just carry the baby to the bathroom to help the 5-year-old.
  • The toddlers lose it when you leave the pew without them. Your entire family ends up standing at the back of the sanctuary for the rest of Mass. Wait, where is the 7-year-old?
B. Your spouse, with the toddlers, can take the 5-year-old to the bathroom. They need a walk anyway. 
  • Your spouse, toddlers, and 5-year-old never return to the sanctuary. You find them in the courtyard picking flowers 30 minutes later.
C. You send the 5-year-old to the bathroom with the 7-year-old, who is pretty much a 12-year-old in maturity.
  • Everything is calm, baby and toddlers are happy, 5-year-old and 7-year-old return quietly to the pew in about 5 minutes. As you leave Mass, you exit by the bathrooms. The carpet feels soggy. You keep walking. 
D. You don't allow the 5-year-old to leave during church. It's disrespectful. And besides, no kid should have to go to the bathroom twice in two hours. 
  • Best of luck to you, friend. 

5. It's 4 p.m. Prioritize these needs: baby is crying, dog vomited on carpet, dinner is not ready, the mail has arrived, laundry in washing machine needs to move to the dryer, 5-year-old just spilled ice all over the kitchen floor, 7-year-old wants to play high-low, toddlers both have poopy diapers. 

A. Baby, Toddlers, 7-year-old, 5-year-old, Dinner, Dog, Washing Machine, Mail
  • Your children will arise and call you blessed! They know you love them. And Bonus! The dog cleaned up his own vomit! You forgot the clothes; they will mold in the washer overnight, and your mail is now suspended indefinitely from failure to empty the box too many days in a row. 
B. Mail, Washing Machine, 7-year-old, 5-year-old, Toddlers, Baby, Dog, Dinner
  • The solo trip to check mail did your heart good. Go conquer the rest! 
C. Sit down to drink some coffee.
  • Yes.
D. My house would never be that crazy. I am far too organized. 
  • Best of luck to you, friend. 

SURVIVAL SCORE

Mostly A's: You'll be fine. 

Mostly B's: You'll be fine.

Mostly C's: You'll be fine. 

Mostly D's: You will not be fine. 





Subsidiarity Is Not Libertarianism

Thanks to 2016 politics, "subsidiarity" is quite the buzz word among amateur economist-theologian hybrid experts on social media comment feeds (present company included). 

"Just do it yourself" is the starting point for subsidiarity, a Catholic approach to social and economic problems that uses the lowest level possible to resolve problems. If you can't do it yourself, form a small team. If the small team is insufficient, get a bigger team. 


In democracy, subsidiarity prioritizes local oversight as best-resourced to serve the common good, whether it's security, occupational safety, education, transportation, beautification, or health. 

An important, yet easily-overlooked, caveat to subsidiarity is its limited endorsement of low-level solutions, only to the extent that they accomplish the common good. 

If the local government is incapable, or unwilling, to sufficiently resolve the social or political problem at hand, it is a moral mandate of subsidiarity that the problem escalate to the next level up, until resolution is accomplished. 

Ex. 1: My small, middle-class neighborhood doesn't have the resources to independently monitor crime. For the common good, we participate in the city police department. Many towns nearby don't have the resources to form their own police departments, so their problem of security escalates to the next level up, and they participate in a county-wide police department. 

Ex. 2: Regarding the drinking water crisis in Flint and the principle of subsidiarity, it is the responsibility of local government to resolve this sanitation problem, in service to the common good of its citizens. 

However, by the same claim of subsidiarity, the rest of the nation cannot shrug and wish them well, if the local Flint government is incapable of producing safe drinking water. This crisis must escalate to the point of resolution, whether that occurs at the county level, state, region, or even national.

CNN's Timeline of the Flint water crisis demonstrates an escalation through levels of government in pursuit of resolution, which has yet to come.
Source
A List Of Things Subsidiarity Is Not: 

Subsidiarity is not a defense of states' rights; its end is social justice, not federalism.

Subsidiarity is not an excuse to underfund legitimate social welfare initiatives, in the name of "subsidiarity." 

Subsidiarity is not an innate preference for private or non-profit over public programs. 

Subsidiarity is not a mandate that all work for the common good be accomplished through voluntary charity as opposed to taxation. 

Subsidiarity is not a belief that taxation is wrong.

#wrong
Subsidiarity is not "rugged individualism," every man for himself. 


Subsidiarity is not a presumption that large-scale programs are inherently less successful than small-scale programs. (The World Health Organization tracks communicable disease outbreaks, coordinating international response efforts with local health programs. It is necessarily large-scale.) 

Subsidiarity favors decentralization of power, but does not necessitate it.


To the point, if a public good cannot be accomplished at a lower level of government, it obligatorily begs federal involvement.

Regarding healthcare, a legitimate argument can be made, in the name of subsidiarity, that a single-payer healthcare system would be a simpler, better use of resources than most citizens' current arbitrary, inaccessible, unaffordable patchwork of care, primarily provided via for-profit insurance companies that are more accountable to shareholders than patients. 

The New Yorker, calling it like it is.
Source
Granted, subsidiarity favoring a national healthcare initiative may not be the case; perhaps adequate healthcare provisions can be created and maintained at more local levels, without a single payer system. Nonetheless, if affordable, accessible healthcare for all cannot be accomplished at a low-level, due to disaffected politicians, lack of funding, lack of local health resources, geographically-concentrated disability needs, or any other incapacity, the problem must escalate to the next higher level. 

While left-leaning politicians might err on the first component of subsidiarity, that social and political work be done at the lowest level possible, right-leaning politicians might overlook the second: that a social or political problem must continue to escalate through higher levels of intervention, until it reaches resolution. 

Every political party likes to claim sole alignment with Catholic teaching, using adopted buzz words of subsidiarity, solidarity, pro-life, whole-life, and social justice.  

To be sure, the Church cannot be contained by any American political organization -- Republican, Democrat, Libertarian, Green, or even the American Solidarity Party, whose platform explicitly identifies as Catholic.


We must remain free to criticize and compliment our polarized national political ideologies at will, change our secular allegiances day-by-day, in response to their changing words and actions. And most importantly, we remain beholden to none, even if they quote our mantras, take photos with our clergy, or use our social teaching as pop-culture jargon.

Monday, May 8, 2017

Fear and Homicide: Self-Defense, Andrea Yates, and Abortion

To hear someone describe the moments before pulling a trigger in self-defense, it's just terrifying.

"I was alone."

"I was afraid they would hurt my family."

"I feared for my life."

But then we find out the victim was unarmed, and everything turns upside down. We begin to question the shooter's fear. Is fear even a justifiable emotion, and is pulling a trigger justified, if the threat wasn't actually lethal?

Professionals gather in the police station and court room in an attempt to find justice.

"No one was here to help."

"I had no other choice."

And we-the-people gather on our tiny screens with fat thumbs, loudly calling out to Facebook, to Twitter, to everyone and no one, screaming at each other like it's the only way to figure out at what point fear might justify self-defense, might justify homicide.

Or can it ever?
...

It's been 16 years since Andrea Yates drowned her five children in her bathtub. I still start to cry, just reading the Wikipedia page.

Those precious souls, innocent children, trapped in circumstances not of their making, now dead, by the actions of their mother, and by the choices of everyone else around them. Andrea Yates killed her children by her own hand. But I believe God holds every person involved complicit:

Her husband kept pushing to have more kids, despite his wife's repeated suicide attempts and obvious unstable health. He believed the best cure for depression was a swift kick to the pants.

Her extended family knew they were going against psychiatrists' recommendations by insisting Andrea be alone with the children.

They worried she would become inexcusably dependent, a lazy mother, if they helped her any more, so they decided not to help.

She was released from in-patient psychiatric care before reaching stability, because her health insurance only covered 10 days, regardless of doctor's concerns.

Andrea Yates and her five beautiful, innocent, helpless victim children were left alone in an empty house. They were left alone by a father who had no tolerance for weakness. They were left alone by a family who feared enabling more than helping. They were left alone by an unknowing community, by an unconnected church, by a distracted psychiatrist. They were left alone by healthcare and a system that still, 16 years later, denies the gravity of mental illness.

They were abandoned to the mercy of a merciless situation, and she killed them.
...

My friend used to be a counselor in an abortion clinic.

She's pro-choice. I'm pro-life.

She walks the here-and-now with women who just read a positive pregnancy test, and it's a crisis.

I believe that positive pregnancy tests should always and everywhere be a reason to celebrate.

She's held women's hands who know the fear of being one rent check short of homeless.

I say we can resource for this mom from within our parish. Maybe someone has a room to rent?

She's heard it all: I'll lose my job, I can't afford daycare, no one can help me, if I don't work, my other children can't eat, I was raped, I don't have health insurance, I can't raise a special needs child, my husband is abusive, my parents will kick me out, I'm afraid my child would just be lost and abused in a broken foster care system.

I push that we're working to change all of that. We can network. Maybe a family can help with childcare. Maybe a local doctor will help with prenatal care. There are food pantries! We will petition the legislature for better support for special needs kids. I've heard families say that they'll personally adopt children who need a home, if the only other choice is abortion. I'll find them.

But all of my stammering is future tense and conditional. It's about stuff I want to see happen. It's about platforms I support that could enable moms in crisis to choose life for their children.

This is now, and she is scared, and even though the child within her is unarmed and innocent, she's afraid, she has no back-up, she feels she has no other choice, and she's ready to pull the trigger.

If only we could remove the fear from this situation, so she's no longer afraid of the baby she carries.

She needs job protections, affordable daycare, advocacy for sexual assault victims, healthcare, special needs support, affordable housing, a reformed foster care system...

This doesn't need to be a homicide of self-defense.
...

We can help remove the fear.