Thursday, April 15, 2010

Reducing violence and crime

I was in a discussion with someone recently. The gist of the other person's position went something like this:

Why should I, who have spent my life becoming educated and working hard to support my family, spend my money to help someone who is poor and unable to support their family to go and have more kids?

You all have heard the argument, or yourself feel this way.

Then you hear about costs of all sorts: Medicaid, government support, education, crime.... I have worked hard and gone without to support my family, and "they" keep having children and expect me and my tax dollars to support them. Usually the solution proposed is stop having babies, but since you're having one and I don't think you should, I'm not going to "support" you in this and my denial of resources or disapproval of funding for you to receive help will not reward the behavior.

(I am going to address the latter part of this some other day.)

Or people simply say, I think this is a private concern and not something for which we as a society should be responsible.

I've posted a lot recently about why Open Arms does the work we do and the importance of investing in children and parents from the very earliest time - prenatal through birth to postpartum. There are many ways I can come at this (and I have some more coming!), and I've been touching on many different perspectives in previous posts.

Every way I come at this, the evidence is inescapable. It is the RIGHT THING TO DO for ALL of us, and the cost to society of NOT doing it is so sky-high that we cannot afford to stand back. We must support mothers and babies from the very beginning.

If you want a world where we can actually have children succeed in school, have lower health care costs, create healthier children and parents, create stable families, lower domestic abuse and have less crime, then you come to the conclusion (and well-respected scientific evidence agrees) that programs that are involved very early, such as the birth doula and outreach doula programs at Open Arms, are worth the small investment for very large gains. And, I will stress that it is not only within poverty that all these issues come up. These issues and the need for support for families cross socioeconomic lines. It is not only "they" who need support, it is "we" who need support. It's our sisters, daughters, friends, aunts. It's just that if you have money, it's a little easier to get it.

So it's long term change, and it's powerful. If you are a parent yourself, you know that everything changes when you have a baby - it's a time when you're receptive to change, and you have a reason to do it. When one starts parenting feeling competent and strong, one can make healthy choices and continue that way, making good decisions and facing difficulties with confidence. But when one feels out of control, inadequate, unhealthy, and hopeless, nothing changes and cycles of poverty and violence repeat.

Evidence shows again and again (and I'm providing some of it in this blog) that is so much less expensive in terms of time and money and so much more effective to provide support from the beginning - and then not need so much support later! Early intervention works!

In this post, I'm going to talk about crime. The worst stereotype is of course that of the young mother (usually minority, or immigrant, or what have you), having child after child who will be neglected, be a drain on the educational system and society, and eventually all the kids will turn to crime. You know how that stereotype goes.

Here's a video from yesterday's King5 Learning for Life called Investing in Kids Now Fights Crime Later.



I'll quote from the program (my emphasis):

The other program areas for which we advocate are intensive voluntary home visiting programs to help young families develop the skills and have the information they need to get their kids off to a good start, to not engage in inappropriate discipline or at worst, child abuse, and to really promote bonding. Again the research shows that when children get off to that kind of a start they are far less likely to be abused or neglected and far less likely to be involved in crime when they grow up.


The officer goes on to talk about a recent case where a 17-year-old mother had killed her child. He says this mom was alone, with absolutely no support at all. She just didn’t have the skills to raise a child, and it was so overwhelming. He says, "To me, there were two victims." Yes, an infant murdered, and a 17-year-old whose life is ruined. What if she had a trained outreach doula that she trusted and could relate to, who knew her, who could teach her, support her and connect her to her community, other mothers and role models - even crisis centers - to help? This young girl would not be incarcerated, her life ruined, and her beautiful baby would be alive.

All of us who turn away and say "not our problem" carry some of the burden for this type of story. It is not the baby's fault. They come into the world just as innocent and open to experiences and love as your children did, your nieces and nephews, all the children that you know and love, and you yourself when you were born. I'd argue that in cases such as the above, it really isn't even that young mother's fault, ultimately - she did not act in a vacuum. She had no way to change and grow into a new way of mothering because no one stepped forward to help, and so ultimately two lives were broken. When we as a society fail to be there for our most vulnerable members, our infants and children, then we fail as a society.

Open Arms does not track crime statistics. That's not our focus.

This is the Open Arms mission statement:

Open Arms embraces a world that cherishes birthing women, their babies, families and communities.

Our mission is to provide services that support, educate, respect, honor and empower women and their families throughout the childbearing year.


And we believe by doing this, so many good things happen.

Visit us on our website to learn more about our programs and the work we do.

Things have gotten a little heavy lately - I'm looking forward to posting on some lighter topics over the next few days!

Another article on the maternal deaths declining

This article is from the New York Times:

Maternal Deaths Decline Sharply Across the Globe

It is about the same study that I referenced yesterday on the politics of public health funding.

It's a good article - again, it lists the same things we've been talking about that make the difference.

The study cited a number of reasons for the improvement: lower pregnancy rates in some countries; higher income, which improves nutrition and access to health care; more education for women; and the increasing availability of “skilled attendants” — people with some medical training — to help women give birth. Improvements in large countries like India and China helped to drive down the overall death rates.


I can understand the fuss over funding - in today's short-attention span world, people worry that if numbers improve, it implies that it no longer needs funding and focus moves on to the next crisis - as if the problem is solved. It isn't solved. But the good news is, women's (and babies') health can be affected positively with funding and worldwide attention toward maternal health.

Dr. Horton contended that the new data should encourage politicians to spend more on pregnancy-related health matters. The data dispelled the belief that the statistics had been stuck in one dismal place for decades, he said. So money allocated to women’s health is actually accomplishing something, he said, and governments are not throwing good money after bad.

Wednesday, April 14, 2010

Reducing Infant Mortality - watch this video!

This is, hands-down, the best video I have ever seen on the topic of maternal and neonatal health. Settle in - it's about 17 minutes long. If you are interested in these issues, you will love this.

If you are unsure of the critical importance of having full term babies and avoiding prematurity, you will get your answers. If you wonder why we keep talking about lowering the birth intervention rate (epidurals, c-sections, inductions etc.), supporting women in receiving their perinatal care and promoting breastfeeding, you will have to ask no longer.

If you wonder why we as a society need to support all mothers in having healthy pregnancies, births and babies, just listen to the cost of NOT supporting them.

In the end, the video talks about the midwifery model of care - it mentions doulas once or twice in passing, but it is not a doula promotion. It is a HEALTH promotion.

I think I'm going to revisit this topic again later. But for now - put away anything else you're doing - watch. And pass it on.

Reducing Infant Mortality from Debby Takikawa on Vimeo.



If you want to share this video, go to the Reducing Infant Mortality website for instructions to link, share, embed, download or order CDs.

Politics of public health funding

News article today:

Fewer women dying in childbirth: Report finds 35 percent decline over 28 years

Remember, this is worldwide, not in the US.

On the one hand:

The British medical journal Lancet rushed out a paper on Sunday that found the number of women who die in pregnancy or childbirth has dropped by more than 35 percent over 28 years.


On the other hand:

But on Tuesday, another report by the Partnership for Maternal, Newborn and Child Health, a global alliance hosted by the World Health Organization, claimed progress in maternal health has "lagged." According to their "detailed analysis," from 350,000 to 500,000 women still die in childbirth every year. The authors did not explain where their data came from or what kind of analysis was used to obtain that wide range of figures.


Enter politics and funding:

"Experts say public health figures need to be taken with a huge grain of salt, particularly when they come from people who are also soliciting funds for the campaign.

The U.N. has a track record of inflating disease figures to keep the aid money flowing, so I'd probably place more faith in the figures which show a lower disease burden," said Philip Stevens, of International Policy Network, a London think tank. "This is yet more confirmation that whoever paints the most apocalyptic picture gets the most cash, even if they have to manipulate and spin the data."

Tuesday, April 13, 2010

Current research on early language and brain development

This is for the people who are as into research as I am. I love this stuff.

A while back, I went to a seminar at the Women's University Club here in Seattle. The speaker was Dr. Patricia Kuhl. Some of you might know her - I have to say that everybody I have encountered who has met her thinks she is brilliant and I thought she was amazing. She made me think a lot about how we begin interacting with our children as infants - or even in utero.

I'm putting a link to her webpage here. If you're interested in early brain development of children and language development (all you early learning folks - this is key for school readiness), you have to check out her page.

Dr. Patricia Kuhl, Ph.D.

She has a lot of research links with reprints of her articles (click Research down at the bottom of her page).

What really fascinates me is how live interaction with speech is the key for sophisticated language learning. Kids learn nothing (in terms of language development) from television and radio - it has to be live! Also, motherese - that sing-songy language that all of us seem to instinctually do with infants and small children - is essential in learning the sounds of our native languages.

What does all this mean for Open Arms and new mothers? Moms - talk to your babies! Dads too! Not everyone really understands the importance of language exposure - live conversation and interaction, not tv-watching. If we want children's brains to be ready for school and for learning language, we have to talk to our babies! They are ready to absorb what we give them, and babies' brains measurably change as we talk with them.

Anyway if this sort of thing interests you, check out the webpage. I think this work is just amazing.

Monday, April 12, 2010

Do You Doula?

This video was sponsored by Birth Matters Virginia. It's pretty good in describing what a birth doula does. I am hoping at some point, we'll be able to produce a similar video about outreach doulas and Open Arms clients. Ah... Maybe someday!