The AFA Blog

Update on the U.S. Senate and Planned Parenthood

According to a  report issued today by Naral Pro-Choice America,  the U.S. Senate has successfully rejected efforts to defund Planned Parenthood.

This significant vote, geared towards stopping the potentially catastrophic closures of the nation's family planning and health centers, has essentially toppled the House’s proposed budget bill. It is important to note that this may, however, be a temporary victory. 

In reaction to today’s events on Capitol Hill, Nancy Keenan, president of NARAL Pro-Choice America, issued the following statement:

“We commend fair-minded senators for rejecting the anti-choice House leadership’s efforts to defund Planned Parenthood and dismantle the nation’s family-planning centers,” said Keenan. “Unfortunately, the Senate action coincides with a War on Women in the House that continues to escalate. This extreme and far-reaching agenda is a wake-up call to Americans, who are realizing just how much time and energy anti-choice lawmakers are willing to expend attacking a woman’s right to choose instead of focusing on the jobs agenda that they promised Americans.” 

Clearly the heros of the day are the close to 100,000 individuals who contacted their local senators in protest against this potential action against Planned Parenthood.

The U.S. Senate rejected the extreme House version of the continuing resolution (CR), legislation that defunds preventive-health services at Planned Parenthood and zeroes out Title X, the nation’s domestic family-planning program. However, women’s access to family-planning services remains in jeopardy as Congress now must compromise on a final CR that will fund the federal government through the remainder of the fiscal year.

Meanwhile, a House Ways and Means subcommittee scheduled a hearing on H.R.3, the extreme “Stupak on Steroids” legislation, for Wednesday, March 16. H.R.3 effectively blocks private insurance plans from covering abortion care in the new health-care system and imposes tax penalties on small-business owners and many other individuals who purchase private insurance plans that cover abortion care. The legislation now has 219 co-sponsors, enough votes to pass the House.

Source:  Naral Pro Choice America

Photo: Wikimedia Commons

Twins are everywhere!

by Jamie Schenk DeWitt

Next time you are walking down the street or jogging in the park, notice how many double or even triple strollers there are.  I was at the park yesterday with my 21-month-old twin daughters and saw three pairs of twin strollers and one set of triplets!  

Based on figures from the American Society for Reproductive Medicine, approximately 30% of couples that undergo ART (Assisted Reproductive Therapy) will give birth to twins versus 1-2 % of spontaneous pregnancies.  

Below are two of the reasons why:

1.  Fertility drugs that are prescribed to patients encourage the ovaries to release more than one egg during ovulation.  

 2. During the embryo transfer of an IVF (In vitro fertilization) cycle, doctors often implant more than one embryo in the womb.  (Ever since the infamous Octomom debacle fertility doctors have been under fire for implanting more than one embryo, but -- needless to say -- depending on the woman’s age,  infertility diagnosis and doctor’s medical evaluation, sometimes it may make sense to implant more than one embryo).  

The first consultation that my husband and I had with our fertility doctor he asked us,   “How do you feel about having twins?”  Spontaneously I responded, “Great!  I would love it.” Our physician went on to inform us that there was a greater chance of having multiples when using assisted reproductive methods.  Because I was so distraught over not being able to get pregnant naturally it seemed like a blessing to get pregnant with one baby, let alone twins.

8 months after our initial visit with our fertility doctor, I was pregnant with twins.  It was one of the most joyous days in my life.  After all of the failed treatments, it felt like a miracle that I was pregnant.  And since being pregnant with twins put me in the high-risk pregnancy category, I was consumed with staying healthy, and the reality of what it meant both physically and financially to take care of twins after they were born did not faze me right away.  Yes, we bought two cribs, two car seats and a double Snap-n-Go stroller (an essential item) in preparation for their arrival.   Yet, the notion that we would have to do two of everything at the same time, -- two diapers, two feedings, and two baths – did not hit me until the morning they were born. Literally, my life changed in an instant. 

The challenges of their first three months, from trying to figure out how to simultaneously breastfeed two babies, to consoling two hysterically crying infants, to learning how to synchronize their schedules, so I could get some sleep at night were tremendous.  I can still remember the first night that I was alone with both of them.  The baby nurse and my mom had left to go back to their respective cities and my husband was working late.  I had successfully positioned both girls on each breast in the football position for their evening feeding.  However, when it came time to give them each a bottle (I had to supplement with formula since I didn’t produce enough milk for two babies) all hell broke out.  They were both crying.   I couldn’t figure out how to hold both of their heads up at the same time to give them their bottles. It was a disaster.  By the time my husband came home, I was bawling.  

Needless to say, I ended up figuring out how to manage that situation, but in the process I felt awful.  It would take several months of trial and error for me to feel like a “mother of twins.” Taking care of my daughters was the most difficult job that I had ever encountered, but with each new challenge that I conquered, I found my voice as a mother.  I learned how to trust myself, rely on the advice of other parents of twins, and use parenting experts in my community.  I also drew incredible strength from observing my spectacular girls grow and develop.  I was proud of who we were becoming as a family and with this newfound confidence, I never shied away from taking them to the park, classes, play dates or the grocery store by myself, which believe me, felt like quite an accomplishment at the time. 

Over the course of the first year I can still clearly remember the comments and looks that I got from other parents or strangers when they would see me out with my twin daughters.  

 “Wow twins!  You’ve got your hands full.”

“Are they twins?  So adorable!”

“Twins!  Two for the price of one.” (If they only knew how much IVF cost)

“A boy and a girl?”

“Are they identical?  Wow, they sure look identical don’t they?”

“You sure have a lot of energy for having two babies.” 

“They must keep you on your toes.”

“Agh twins.” (Insert look of desire) “I wanted twins, but I didn’t get so lucky.  I only have one baby.”

“Agh twins. How’s that going for you?” (Insert look of terror)

“Two babies.  Bet you’re busy.”

“I can’t believe you have twins!”

 Dead silence.  (Insert look at the babies, then look at me. Enough said.)

“Are you enjoying both of them?”

“So precious!”

“Do you have help?”

“Oh my God – Twins!  I could never imagine.”

“She looks so much like you.” (Pointing to the daughter who looks exactly like her father)

“They are so adorable.  You must get sick of hearing that?  They sure must keep you busy?  Okay I’ll leave you alone.”

“A boy and girl?  No.  Two boys.” (One is dressed in purple and the other in hot pink.)

 “You are so lucky and blessed.”

“That’s a lot of work.”

“Do twins run in your family?”

So whether you are taking care of one baby, two or three babies, motherhood is a journey and not a destination. Enjoy the ride because it all goes by so fast!   And just realize that if you need fertility treatments, know if you are willing to have a multiple birth, and know all the facts, both medical, emotional, and practically speaking. 

 Even though we did not plan on having twins when we began our fertility treatments I have learned from my own experience, as well as that of other mother’s of twins that the question of whether or not it is safe to have multiples is one to be taken very seriously. There are tremendous risks to both mother and babies when someone attempts to have a multiple pregnancy and you should make sure that you discuss this in depth with your doctor prior to conception being attempted.. 

 According to the Society for Assisted Reproductive Technology (SART).  the objective of infertility treatment should be the birth of a single, healthy child.  Multiple gestations, meaning twins or greater, can pose significant health concerns.  These include but are not limited to:

• Increased Rates of Miscarriage
• Increased Rates of Fetal Death, Even After Birth
• Cerebral Palsy:
• Increased Levels of Nausea, Heartburn and Vomiting during Pregnancy
• Pre-eclampsia (High Blood Pressure)
• Gestational Diabetes:
• Placenta Previa
• Heart Problems, Including Heart Attack for the Expectant Mother:
• Increased Need for Partial or Complete Bedrest, and Limited Physical Activity:
• Emotional Issues, including the possible need for Mutifetal Reduction
• Increased Rates of Caesarian Section Delivery
• Complications after Birth such as Development Delays or Autism

A sobering, and partial list.  It is important to note that not all twin pregnancies are problematic, many like mine, only posed temporary challenges that we as a family were able to overcome.  The American Fertility Association will be publishing several significant commentaries on this issue during 2011, as well as a fact sheet and video on elective Single Embryo Transfer, later on this month.  In depth information on all aspects of mutliple birth will be covered.

Miscarriage and the Sense of Personal Failure

by Kim Kluger-Bell, MA, LMFT

Lisa Ling, the former View host, revealed this week that following a miscarriage at 7 weeks into her first pregnancy she felt like a failure, and that she also felt very isolated and alone because no one talked about it. For this reason, she is speaking out and has created a website where women can anonymously share their experiences with miscarriage called Secret Society of Women.

 Ten years ago, when I wrote “Unspeakable Losses: Healing from Miscarriage,Abortion and Other Preganancy Losses” I felt exactly the same way. The silence surrounding miscarriage only makes you feel more freakish and alone. Here is what you need to know about miscarriages:

 Miscarriages are Common

 Approximately one in 5 pregnancies in the US end in miscarriage every year. That means hundreds of thousands of women experience miscarriages every year. And most of those miscarriages occur in the first 12 weeks of pregnancy. In fact, your chance of miscarrying after that time is only 3%.

 Having One Miscarriage Doesn’t Mean You’ll have another

 Most miscarriages, however, are usually random and isolated events. Having one miscarriage only slightly increases your odds of having another one.

 The Emotional Impact can be Devastating

 For many women, the attachment to the child she is carrying begins at the moment she knows she is pregnant. That is when we begin dreaming about the baby we are carrying and imagining how our lives will change in only nine short months. Few of us hold back our excitement due to fears of a first trimester miscarriage. Instead, we start taking extraordinarily good care of ourselves—eating right, getting plenty of rest and avoiding alcohol, caffeine and tobacco products. When a loss takes place despite all of these preparations, you can feel like you did something wrong. Even the word—miscarriage—seems to imply that you did not carry your baby properly.

 It is Not Your Fault

 In many, if not most cases, the cause of your miscarriage will never be known. Again, most miscarrages are random and isolated events. Doctors now believe that at least 60% of miscarriages are caused by chromosomal abnormalities in the developing embryo or fetus, and that another 10% are caused by various uterine abnormalties (most of which can be corrected with surgery). The remaining 30% of miscarriages may be cause by immunological factors, infections or environmental factors (including smoking and heavy alcohol use).

 Recovering from Miscarriage Takes Time

 It is often more difficult to recover emotionally from a miscarriage than it is to recover physically from one. Even if you had to have a D & C, the emotional fallout from a miscarriage can stay with you for months afterward. Guilt, shame, sadness, anger, and a feeling of powerlessness are very common emotions. So is a sense of generalized anxiety and the fear of another loss. It is not uncommon, especially if you are not able to become pregnant again quickly, to have an ongoing awareness of  how far along in the pregnancy you would have been if the loss had not occurred. Many women feel particularly grief-stricken around the time of the due date of that pregnancy. Miscarriage is a traumatic experience—it takes time to heal from a trauma of any kind.

 It is important to be gentle with your self and find people to talk to who are compassionate and will not judge you for the intensity of your feelings. It is also important not to blame yourself, or to isolate yourself too much. It may be impossible to spend much time around pregnant friends or those with babies or young children, but if you don’t have people in your life who are willing to share their own experiences of pregnancy loss with you, there is a large group of people out there who have been through a miscarriage, and there are many on-line resources and books available to you that can help you feel less alone.

 Websites:

• Facebook page, “Whisperers”
• www.nationalshare.org
• www.missfoundation.org

 Books:

• Empty Arms by Pam Vredevelt
• Empty Cradle, Broken Heart by Deborah L. Davis
• Unspeakable Losses by Kim Kluger-Bell
• Miscarriage: Women Sharing from the Heart by Marie Allen, Shelly Marks

Kim Kluger-Bell is a psychotherapist and marriage and family therapist in private practice in Berkeley, California. She specializes in helping individuals and couples heal from such reproductive crises as infertility, pregnancy loss, and abortion. She lives in Albany, California, with her husband and son.

 

 

Tis the season to feel guilty. Past abortion history and current infertility issues.

by Corey Whelan

"Dealing with infertility after an abortion is fraught with complexities, surrounding feelings of guilt and  anxiety about whether one's last chance to have a baby may have been squandered.  Some patients feel that the pain of infertility is their divine, and justly deserved, punishment". - Joan Winograd, L.C.S.W.

Despite the fact that the overall rate of abortions in the United States have declined, the CDC reports that in 2006 (the most current data available) 846,181 recorded abortions were performed in this country. 

Current data also indicates that one in 136 women (about two million annually) are currently under a doctors care for infertility.

Staggering numbers aside, it might be assumed that these two seemingly separate populations of women do not overlap.  However, many women who have a past history of one or several abortions  will at some point during their reproductive years find themselves in the unfortunate position of not being able to conceive a baby.  Advanced maternal age, pelvic inflammatory disease, endometriosis, polycystic ovarian syndrome, premature ovarian failure, and other diagnosis unrelated to abortion will often be found as the reason why conception is now a challenge.  What won't be found, most of the time, is a link between past abortion history and current infertility.  Simply stated, rarely does a link exist. 

According to Long Island based reproductive endocrinologist  Daniel Kenigsberg, M.D., "Previous abortion is not often a problem for future fertility.  As with any medical procedure, there are complications (of abortion) that can occur, such as infection, or scar tissue formation.  Fortunately, both are very infrequent.  One aspect often overlooked is that previous cervical dilation, which is necessary for the abortion procedure, may predispose the woman involved to cervical weakening, which can lead to premature delivery or even midtrimester pregnancy loss.  If you have had an abortion, please tell your doctor, and make sure that your cervix is evaluated frequently during your pregnancy."

Despite clear evidence to the contrary, women experiencing infertility who have a past abortion history often blame themselves and believe that their current situation was created by their past choices.

The Infertility and Adoption Center's Executive Director, Joni Mantell, L.C.S.W., asserts that lowered self esteem may often be to blame.  Says Mantell, "Human nature is to seek cause and effect.  It is not uncommon for women who have had abortions prior to infertility to think that there is a causal relationship to all of this, even though in most cases medical evidence does not exist."

She goes on to state that "the mindset of a woman suffering from infertility is often one of great shock, disappointment, fear about whether they will ever be able to have a baby, and often loss of self esteem, because they cannot in fact do what they always thought was an essential part of their role as a woman.  Lowered self esteem is in fact, fertile ground for self blame.  Women may look back over their past,  to try to figure out where they went wrong.  This may be part of our human need to find rational explanations for the ills that befall us, or conversely, may actually be a form of self punishment, fueled by guilt about the prior abortion and also about not being able to conceive currently".

These feelings may be confusing to many women experiencing them, since the most common emotion experienced immediately after an abortion is performed is relief.  However, according to Ms. Mantell, "Women may not have been aware of their feelings of prior guilt.  Infertility can bring this emotion closer to consciousness, and  with it a painful realization to confront at an already highly charged, stressful time.  Renewed grief about the baby that could have been born, yet was instead aborted, may need to be worked through on a deeper level.  These feelings would be occurring simultaneously along with the raw, immediate experience of pain and loss resulting from infertility".

Safe, legal abortion does not cause infertility in women.  If you have had one or more abortions, you should talk to your gynecologist honestly about your past medical history and your concerns.  If you are unable to conceive without the additional support of a reproductive endocrinologist, you have the right to acquire that support.   If you feel that you would benefit from seeing a therapist, you should do so.  Most IVF centers have highly competent therapists on staff who are ready to support you. 

Your reasons for having had an abortion are your own.  No matter how you currently feel about that past choice, it is important to acknowledge that your choice did not result in infertility.  

Reprinted with permission from Examiner.com