WHINE & CHEESE
On Memorial Day, we honor our fallen soldiers and our deceased family members.
But, as the United States is being propelled into a war over reproductive rights, I am reminded of others I would like to memorialize on this Memorial Day, 2019.
I’d like to start by memorializing our fertile ancient forebearers, who survived harsh conditions to reproduce our species.
However, as an infertile female, I don’t want to forget our less fertile predecessors who died out.
I’d like to memorialize all of the ancestral fetuses that managed to survive pregnancy.
But I DO NOT wish to memorialize the fertilized eggs that were never meant to be. The natural phenomenon of miscarriage, the spontaneously discharges of an imperfect conception. It should be understood that:
- The uterus spontaneously discharges most defective fetuses, early in pregnancy, often before pregnancy is recognized. It’s suspected that as many as 30–50% of fertilized eggs don’t even get to be embryos.
- In women who have recognized their pregnancy and presented for prenatal care, the miscarriage rate is 10-20%. The miscarriage rate is probably much higher for the many women who do not seek prenatal care in early pregnancy.
- Half of miscarried fetuses have genetic defects. Unfortunately, nature is also imperfect and it allows some mistakes to survive pregnancy.
- Older age, smoking, obesity, diabetes, thyroid disease, drug and alcohol misuse, and abnormalities of the uterus, are some of the numerous factors associated with increased risk of miscarriage.
I also want to memorialize all of the fetuses that were naturally expelled from the womb prematurely, looking perfectly formed, but unable to breathe on their own. Fetal lungs don’t typically function well outside of the womb until after the 37th week of pregnancy. I also want to honor the families of those wanted premature babies, who in the days before neonatal medicine, could only watch them perish.
I’d like to memorialize President Kennedy’s prematurely born son, Patrick, who at 34.5 weeks of age, died from complications of prematurity in 196, after First Lady Jacqueline Kennedy had previously suffered a miscarriage and a stillbirth.
But I don’t want to forget that after the nation mourned the death of Patrick Bouvier Kennedy, prematurely born infants quickly became part of a great human experiment, called neonatal intensive care.
Nor can I forget my neonatal training as a pediatrician in the early 1980s, when infant mortality rates were rapidly dropping from 20% to10%, as hospitals acquired the equipment and the personnel to sustain these prematurely born fetuses with:
- mechanical ventilation
- cardiovascular monitoring
- new antibiotics to fight infection
- transfusions to combat hemorrhages
- surgeries to correct deformities, and
- constant, painful needling to measure their levels of oxygen, glucose, bilirubin, blood counts, electrolytes, and all the other parameters needed to artificially sustain their lives outside of the womb;
even though, in spite of all this intervention, many died anyway, as nature intended, or, if they survived, ended up profoundly disabled.
- It seems only right to honor those fetuses who died in early NICUs for helping to develop a medical specialty that can now sometimes save fetuses as immature as 22-24 weeks.
- Perhaps in the future we won’t need human wombs. Fertilized eggs will be able to go straight from a test tube to a man-made incubator.
- Take note, those of you have contributed your DNA to the databanks of ancestry.com, 23 and Me, and other entities that are playing with genetic information. If we allow politicians to control the mechanics of creating new humans, how will we prevent them from deciding who should be born? Genetic wars are falling out of the realm of science fiction.
Today I’d also like to memorialize all of the women who died giving birth. Before the advent of antibiotics in the 1930s, and other medical advances, the maternal death rate in the U.S. was as high as 20%. According to the United Nations statistics, in 2015:
- The number of women who die per 100,000 live births ranges from 1,360 in Sierra Leone, to just 3 in Poland, Finland, Iceland and Greece.
- The U.S. is one of just a few countries whose rate of maternal death is increasing. Between 2000 and 2015, the number of U.S. mothers who died from complications of pregnancy more than doubled from 12 to 28.
- Most modern countries have rates in the single digit range, and many not so modern countries have lower maternal death rates than the U.S.
But while memorializing all the mothers who died, I don’t want to forget all the women who managed to survive their reproductive lives in spite of:
- complicated pregnancies
- loss of their babies
- having more children then they could provide for, forcing them to have to give some away in order to support the others
- mental anguish due to forced pregnancy
I’d also like to memorialize all of the infants and children who died from illnesses that are now preventable or treatable.
But I don’t want to forget all of the children who didn’t die, but survived and were left disabled and:
- disfigured from diseases like smallpox and syphilis
- blind from diseases like syphilis, rubella, and CMV virus
- deaf from diseases like rubella, syphilis and measles
- crippled from diseases like polio and tuberculosis
- stunted from diseases like rickets and malnutrition, and
- cognitively impaired from lack of oxygen at birth, infection, toxins, trauma or other causes of brain damage.
Measles and syphilis are currently making a comeback in the United States.
I also want to memorialize all of the children who have died from neglect and abuse at the hands of parents who did not want them. The few cases of unspeakable starvation and torture that make the news, represent but a small fraction of intentional child deaths that are often improvable if even suspected.
- How many fatal falls are pushes?
- How many frustrated parents stage poisonings, drownings, shootings, and other credible accidents to unburden themselves of an unwanted child?
- How many lost little children were actually abandoned?
But I don’t want to forget the children who survive the neglect and the abuse. From my decades of observing tens of thousands of sick and injured pediatric patients and their accompanying family members in ERs, urgent care clinics, and hospital beds, I cannot forget the faces and the stories of:
- The depressed looking 3-year-olds
- The anxious acting 5-year-olds
- The angry 8-year-olds
- The rebellious 11-year-olds
- The foster kids who were scared of everything
- The runaways who survived by prostituting themselves and running drugs
- The gang members who just wanted a protective family, and wound up involved in drugs and violence
- and the suicidal teenagers, and sometimes, suicidal preteens.
- Most of these children bore the scars of being unwanted, and one can only wonder what scars their dysfunctional parents bear from having themselves been unwanted children.
- Our society does little to help unwanted children develop into well-functioning adults. Families, schools, communities, and health and social service systems, all lack the resources to provide adequate assistance to the children whose parents aren’t able to provide the support that is essential to healthy human development.
- Only the most severely deprived and abused children qualify for assistance in many regions of the United States.
I’d also like to memorialize all of the children who have been murdered and maimed while attending school, because the adults in the United States place higher value on access to weapons capable of mass murder, than they do on the safety and the lives of children. School shootings happen so often now, that no loving parent can send their child to school without experiencing anxiety.
But I do not want to forget the families and friends and survivors of those murdered and maimed children, who will live with broken hearts for the rest of their lives.
I’d also like to memorialize all those unwanted people who have taken their own lives.
- The suicide rate in the U.S. is twice the homicide rate.
- In 2017, 47,000 people committed suicide – that we know of
- Suicide is the second most common cause of death in teens and young adults aged10-34.
- How many victims of rape and incest might commit suicide if they are forced to carry their unwanted pregnancies to term?
- Mental health care in our country is very hard to access, especially for depressed children.
And finally, I’d like to memorialize the impending death of some of the most important human rights that exist:
- The right to autonomy and privacy in managing one’s own bodily functions
- The right to manage one’s own reproductive capacity and control the size of one’s family
- The right of born children to be loved and provided for, and
- The right of born children to inherit a future where there will be:
- Livable climates with clean air and water