Strollerderby : Pamela Paul

The Trouble With Wanting a VBAC

Madeline Holler — Tue, 24 Feb 2009 19:54:00 GMT

With first babies, you have all the choices in the world how to give birth -- drug-free, with a doula, in a hospital surrounded by the family, c-section. Not that the plan always works out, but a mom-to-be can dream.

With subsequent babies, however, the options narrow quickly for a group of women who, for whatever reason, wound up giving birth to the first via cesarean section.

Pamela Paul's article in this week's Time, "The Trouble With Repeat Cesareans," would more accurately be titled "Hey, Good Luck With That VBAC."

Paul doesn't set out to argue whether women should be allowed to choose to give birth via c-section. Rather, she illustrates how, for an alarmingly large number of women, the choice to give birth vaginally isn't even there -- c-section is the only apparent option.

She writes that although VBAC is a safe option, nine out of 10 women with a prior cesarean undergo repeat cesareans for subsequent births. Of course repeat cesarean might be the woman's choice, but vast numbers of are basically forced into the operating room.

From Time:

...the International Cesarean Awareness Network (ICAN), a grass-roots group, recently called 2,850 hospitals that have labor and delivery wards and found that 28% of them don't allow VBACs, up from 10% in its previous survey, in 2004. ICAN's latest findings note that another 21% of hospitals have what it calls "de facto bans," i.e., the hospitals have no official policies against VBAC, but no obstetricians will perform them.

These bans left one California woman to drive 100 miles to a hospital where she would be allowed to attempt a VBAC.

This is interesting because the National Institutes for Health, recognizing the tremendous cost and associated risks of surgical birth, has set a goal of decreasing the number of cesareans by, in part, upping the VBAC rate to 37 percent by 2010. In 2006, VBACs only accounted for 8 percent of all births in the U.S.

Paul counters the studies and VBAC safety fears many women, doctors and -- probably most importantly -- insurance companies operate under. And explains how we got to where we are today, even though just over 10 years ago, attempting VBAC was quite common. Several high profile lawsuits sent malpractice insurance through the roof. She qoutes a doctor who admits the "once a cesarean, always a cesarean" is an issue of money, not patient safety.

Paul also writes on Huffington Post her own experience when she wanted a VBAC. She found who she thought was a VBAC friendly doctor, only when she was six months pregnant he wanted to talk c-section scheduling. She balked and when she went in to give birth, the on-call doc at her supposedly VBAC-friendly hospital wouldn't talk to her while she was in labor and didn't answer his pager when it was time for her to push. Lovely!

I'm curious whether what hoops you had to jump through to get support for a VBAC or if you had to through in the towel. If you had a repeat c-section, was that your choice? Avoiding the battle?

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Photo: Time

Should the Price of Toys Really Be Raised?

Jen Chaney — Sun, 04 May 2008 13:30:00 GMT

When someone makes an argument that starts with a reference to puffy stickers, I'm usually on her side. (Start talking scratch-n-sniff or googly-eyed, and you can completely convert me. But that's another story...)

Indeed, I agree with much of what the ubiquitous Pamela Paul -- you may remember her from such books as "Parenting Inc." and such Babble essays as "Hands Across America" -- has to say in this piece that appeared on Huffington Post. I concur that for those of us who grew up in the '80s, there was something special about buying one sticker at a time and having to save for that special treat. I also think she is quite right when she notes that kids today have too many toys, certainly more than they need since the words "need" and "toys" generally don't belong in the same sentence.

But then Paul loses me by suggesting that the way to solve this problem is by raising the price of kid playthings. "Toys are so cheap that it's hard to rationalize not buying them," she writes. "But perhaps we need to raise the price of toys so that parents and children learn to value them again."

First of all, in this economy, I don't think we should be encouraging companies to raise the price of anything. If things continue the way they are going, the price of virtually everything, toys included, may increase anyway. But even if that happens, it doesn't really solve the issue at hand because the Americans who make the most money -- and who are probably more likely to be the prime offenders of excess toy buying -- will no doubt continue their Barbie and Lego-purchasing sprees. Meanwhile, the middle- and lower-income families who can only afford five or six toys a year at most won't be able to afford anything for their kids. That doesn't seem fair.

No, the real way to resolve this is for each parent to show a little more restraint. We don't have to buy a doll for our daughter just because she's begging for it. We don't have to give our son a Wii just because his best friend has one and we feel bad about that. We don't have to drown our little ones in rivers of toys on their birthdays and at Christmas. We can set an example by making presents exactly what they are supposed to be: Rare and special things, as precious as a single, hard-earned puffy sticker.

Is Child No. 3 a Luxury Good?

Madeline Holler — Wed, 09 Apr 2008 19:31:00 GMT

If there's one person who has made the child/commerce connection, it's Pamela Paul. She's the author of Parenting, Inc. and Babble contributor with a dispatch this week that, and perhaps I'm speaking only for myself here, reassured those of us parents who never managed to follow through on the baby sign language classes, thereby condemning our children to low IQs and drool.

Well, she's digging in deeper to the idea of kids and cost in a recent Washington Post essay, where she's talking about the status of the third child, particularly for those raising their families in expensive cities. Apparently, Baby No. 3 is something of a luxury good. Or, as some would believe, a completely insane, misguided, poorly thought out idea that she and her husband -- New York City dwellers and parents of two -- will nonetheless be adding to their lives.

Kids these days are expensive (private schools! nannies! 70 new toys a year!) and they take up precious real-estate. So no wonder, she argues, there's the perception that a third (or fourth or sixth) child is an achievement bestowed only on the fabulously wealthy. It's also something people of means are largely doing, rather than the recession-sensitive middle-class. The showoffs!

From washingtonpost.com

It's true that, following in the designer maternity clothes of such fecund celebrities as Posh Spice (three kids) and Angelina Jolie (speculatively six), most of the people going for a third baby are well-heeled moms and their high-salaried husbands. A February analysis of Current Population Survey data by the Council on Contemporary Families found that in the past 10 years, the top-earning 1.3 percent of the population has seen an uptick in families with three or more children. According to the National Center for Health Statistics, 12 percent of upper-income women had three children or more in 2002, compared with only 3 percent in 1995.

She also cites that breathtaking stat that each child costs on average $204,060 to house, clothe, educate and entertain until the age of 18. (Jeez, my kids are the ones holding THAT number down ...)

So what do you think? Did you trade in financial security and your Birken bag for a third child? Are large families just for crazy ladies like Angelina and that Mormon mom in the RV?

Image: Celebrityhack.com

Babble Talk: Sign, Sign, Everywhere a Sign

Jen Chaney — Tue, 08 Apr 2008 21:32:00 GMT

Pamela Paul has an essay on Babble today that analyzes the merits of teaching our babies sign language. In the piece, excerpted from Paul's book, "Parenting Inc.," she finds that there isn't anything wrong with showing infants how to communicate with their hands. But she also discovers that it may not be as overwhelmingly beneficial as the initial studies by Linda Acredolo and Susan Goodwyn, founders of the Baby Signs Institute, suggested.

"Parents who sign to their children are also talking to them — and no study can prove that talking alone didn't lead to later verbal advances," Paul writes.

Like so many parents, my husband and I have tried to teach our son a bit of signing, figuring it can't hurt and, potentially, might help him communicate with us. So far it has not been a successful endeavor. I repeatedly gesture -- "Eat. Eat." "More. More." -- when he's buckled into his high chair at meal time and he just looks at me like, "Whatever, lady. Just bust out the Cheerios and get it over with."

I also noticed that the signs I learned differ from the illustrated examples in Paul's piece. So it's entirely possible I actually have been teaching my child to say, "Mom, seriously. Enough with the hand motions."

Have you tried signing with your kids? Did they pick it up more readily than mine? And do you feel it ultimately helped their communication skills?

Unfortunately, we can't use sign language on this blog, but feel free to share your thoughts the old-fashioned way, by typing, in the comments section.

Photo: Babble.com

Parent Trap, Baby Crap

Madeline Holler — Mon, 31 Mar 2008 18:33:00 GMT

Remember the mile-long checklist of stuff your area mega-store recommended for your baby registry? Stuff your mom had never heard of, like breast pads, and stuff you had never heard of, like, um, everything else? Of course you know now, but did you even know back then there were so many baby shampoos to choose from?

This was your entry to Parenting, Inc., what one author calls the modern way parents' every fear, hope and dream are exploited to get them to buy things like a souped up baby blanket (the Miracle Blanket) and $800 Bugaboos.

Salon interviewed Pamela Paul, author of the new book "Parenting, Inc." which looks at the new ka-jillion dollar market of all things baby/kid/parent.

Personally, I think we parents know we're being taken for a ride, but swaddling a kid isn't a natural skill all of us develop, hence, the Miracle Blanket. And just try to pry the Bugaboo out of the hands of actual city dwellers. Turns out, they're worth every penny for people who actually haul their kids longer distances than from the SUV to the mall entrance. These are conveniences for parents, not enhancements for the baby. I am very much in favor of convenience for me.

Still, I get the author's point. Other products in the crosshairs: baby signing classes, Baby Einstein videos (I think we all agree on that one), infant sleep positioners, and Time's Up/Time Out Teddy Bear (yes, that's stupid).

What totally unnecessary baby thing do you think, in hindsight, was probably a load of baby crap? For us, quite literally, it was the Diaper Genie.

The More Things Change

Adrienne Martini — Thu, 27 Mar 2008 14:30:00 GMT

When it comes to mixing work and pregnancy, I have been extremely lucky. With baby number one, I worked for a weekly paper whose maternity leave policy was, in essence, do what you need to do and come back when you're ready. With baby number two, I was (and, um, am) a freelance writer who also taught at a university and was off during the summer that I delivered. Hooray for me!

Sadly, my experience has been the exception rather than the rule. Pamela Paul's impassioned column is a reminder that announcing you're pregnant can be a career killer. Hell, even just being female and therefore potentially pregnant is enough sometimes.

Have we really come a long way, baby?

Photo credit: abc.net.au