Via Kleinheider, we learn that The Tennessean had a big report about Tennessee’s infant mortality rate back in December. I am of many minds about the report. I think you should read and watch and listen to it, though. (And note that no one seems to be singling out drug or alcohol use as a primary contributor to the infant mortality rate.)
I have questions, though.
1. Why don’t we hear from the mothers? I mean, I know we hear from the mothers about what happened to them, but I mean, what do the women this is happening to identify as problems they have getting the healthcare they need? The healthcare professionals seem to have a lot of ideas, but what about the ideas of the women who live through this?
2. A great deal of attention was paid to obesity as a cause of our high infant mortality rates. And yet, the fact that we have a lot of fat people in this state who are malnourished was mentioned once. But I’ll repeat it–we have a lot of fat people in this state who are malnourished. Is being fat really a bigger contributor to infant mortality than the fact that these women aren’t getting enough vitamins and minerals for their bodies to function correctly? I mean, I know it seems really weird that someone could be fat and be malnourished, but it’s true, you can be.
3. I know I say this all the time, but I repeat it. Twelve year old girls who are “having sex” are almost always not having consensual sex. And yet, while they mention in the report that many of the fathers of these children are “long gone,” there’s no acknowledgment of the difficult circumstances under which some of these women are becoming pregnant. I mean, if a guy rapes you, who the fuck cares that he’s not there for the birth of the baby? The very least he can do is be long gone. He should be in jail.
4. I was glad the report brought up the stress of living in general in a racist society and specifically in shitty neighborhoods and the detriment stress can be to carrying a pregnancy to term or to keeping a child alive once it is born.
5. Again there was brief mention of the role of abuse in all this–one woman miscarried because the baby’s father pulled her down a flight of stairs, but otherwise, there’s very little attention paid to the effect violence (and talk about a stressful environment!) has on infant mortality.
6. Frankly, I thought the report let doctors off the hook. I know this is going to be unpopular, but, if there is indeed a crisis, which there is, doctors HAVE GOT TO rethink how they do things. This idea of sending an ambulance out to pick up women? Why don’t you get in your car and drive to a neighborhood and start knocking on doors and looking at kids? Kids cannot bring themselves to you. And yet, all healthcare in this country revolves around a model where the patient goes to the doctor. Maybe it’s time to rethink that model.
7. When you read something like this, doesn’t it make restricting sex ed in school seem cruel? How any Republican can look at those little caskets and sponsor legislation to make it harder for women to learn about our own bodies and how to control what happens with them is beyond me. That breastfeeding your baby is good for your baby should not be a secret you have to rely on your mom–who may not know it herself–to tell you. That using a condom when you have sex can prevent pregnancy should not be a secret. That you can use the Pill to keep from getting pregnant should not be a secret. That you don’t have to have sex with people of the opposite gender should not be a secret. That, if you do become pregnant, you need to go to the doctor should not be a secret. A baby dies every other day and we want to give parents the right to pull their kids out of class if they don’t want their kids to know about their own bodies. Are you kidding me?
8. Until we can have some honest discussions about how men treat women, we are going to be thwarted in our ability to confront this problem. You don’t have sex with children. Even if she’s precocious. And yet, I know that if you’re looking at the ages of the men who father children on 12 and 13 year old girls, you’re not finding a bunch of 12 and 13 year old boys. And at some point, we have to get the point across that your wanting to fuck does not trump a girl’s right to be a little girl. You don’t beat on the woman you’re fucking (I mean, I’d like it if we could agree to not beat on anyone but I’ll start small). There’s nothing the person you’re fucking could do that justifies you abusing them. Nothing. And we have to be honest that there are often cases when women and children are better off without the fathers of those children around.
It shouldn’t be that way, but we don’t live in a world where everyone’s great and if you just give them a little encouragement, things will turn out wonderfully.
And we need to work on teaching boys a definition of manhood that is not precipated on “do whatever the fuck you want to women; that’s what they’re for.”
9. Doctors need to decide if it’s more important for them to hector women about losing weight or if it’s more important for them to make sure that women continue to go to their appointments. Let me be clear with you, medical community–we don’t like you. The lectures about how we need to lose weight for our own good and about how fat we are? They make us not want to go to the doctor. When you go in for a cold and the doctor tells you you need to lose weight or when you break your wrist and the doctor tells you you need to lose weight? The lectures are grueling. And you’re going to have to decide whether having a patient to treat is more important than making your patients feel bad. Oh, I know. “Well, tough if they feel bad, they need to hear it.”
I’m telling you that we won’t hear it. We would rather not go to you than listen to you go on about how we need to lose weight. So, if you want your high-risk patients to continue to see you, you’re going to have to find some other way to frame it.
That’s part of the reason I think it’s so important to look at the issue of malnutrition. You can talk to your patients about whether they’re getting enough fruits and vegetables, about whether they need to cut back on their salt, about whether they’re getting enough exercise. All those things a woman can hear. But you start talking about fat and you’re bringing in a lot of cultural baggage that’s going to make women resistant to your ministrations.
Anyway, we have to do something and it needs to start with giving women the information we need to make good decisions, radically rethinking how we deliver healthcare to poor people in this state, figuring out how to make sure people are well-fed, and ceasing any tolerance for violence towards women.
So, get on that and we’ll meet back here in twenty minutes for a progress report.