Fish or cut bait

As I listened to oral arguments in a case before the Supreme Court concerning Mifepristone, one of two drugs often used in combination, and commonly prescribed by doctors to facilitate abortion, I felt a mix of emotions:

Anger at the thought that denialist doctors and dentists had wormed their way onto the high court’s docket to pitch a case that could force all doctors to abandon evidence-based, and in some cases emergency, medical care to human beings they deemed to be unworthy of the standard of care all doctors take an oath to uphold.

Disbelief about what I was hearing from the counsel for the plaintiffs, who was trying to underscore the harm her clients could endure from merely the thought that they might one day, though some extreme circumstance wherein an anti-choice dentist might be the only medical professional available to treat sepsis in a pregnant woman, have to decide whether the patient had sought an abortion or it had happened spontaneously. 

And, finally, a minor amount of relief that at least some of the ideologues on the bench weren’t biting at the line they’d been cast. 

But even that feeling is fleeting. 

The regulars of this particular fishing trip signaled with their questions how these so-called doctors might one day better land a whopper. Specifically with an antiquated law that governs the mailing of medications. 

Isn’t it enough that guardrails for a doctor’s firmly held beliefs have already been erected?

How many women will die before we acknowledge that that live birth is as rare as pregnancy loss is common? 

Must we continue to endure the chipping away of healthcare autonomy with legal maneuvers bathed in bad faith? Must we suffer the most invasive procedures when the least invasive ones have been standard care for decades?

We must, evidently, because what they are saying the the court is that they do not want to provide the standard of care to anyone they believe is having complications from a pregnancy loss they don’t consider acceptable, or can’t confirm was not the result of human intervention.

As the plaintiff’s attorney dodged one question in particular, it seems her clients might fear complicity so much that they wouldn’t be willing to hand a bottle of water to a non-religious colleague, let alone perform standard procedures to clear the patient of non-fetal tissue for the prevention of infection or death.

Can we truly believe the harm to a practitioner’s soul would in any way match the harm done to the women they would discriminate against by denying emergency medical care? 

In so many of their claims, it seems ensuring that souls endure the most suffering as they experience this “right to life” is the central, though unstated, goal.

I do not believe the majority of us want the sea change in healthcare these fringe doctors are angling for. Nor would we accept such Sisyphean impediments to any other forms of life-saving treatment should our doctors decide the way we consumed food, drank alcohol, or didn’t belong to a church meant we weren’t deserving of righteous care.

And while I am certain these doctors will one day be startled to face a Creator who doesn’t share their belief that using “God-given” talents to deny life-saving care was what she intended, I don’t for an instant think this litigious minority should force the rest of us to turn the other cheek.

At least not when we still have a vote.

-- 

Siobhan Connally
writer, photographer, keeper 

Unexpected flash

 “Oops!” 

I had trained my camera on my husband. He had been lying in bed beside me, head propped up on a pillow while our black cat draped herself over his shoulder like a scarf. I hadn’t hidden the camera, but I had every intention of being furtive in this particular photographic pursuit for posterity.

The room was dark except for their faces, which were illuminated by the word puzzle he was playing on his phone.

The flash had given me away.

My husband laughed at my predicament more than his own.

I had intended to quietly record a different moment in our lives. 

Not just the one in which a sweet feline affectionately paws for his attention, but more pointedly that this serene moment is happening with wires and monitors taped to his face, torso, and index finger. 

Here we are finding a new-age way to fight the dying of the light. 

So many of our stories overlap. Husbands and wives, and parents and children. … That they do is not surprising. But what is often shocking to us is how our shared experiences often diverge.  

A month ago, when he was trying to schedule this sleep test, I was sitting in a waiting room waiting for someone to call my name so that I might be screened for new and more frightening diagnoses.

Instead, his doctor’s office called my phone looking to track down his preexisting conditions, leading me into a testy exchange in which I enquired as to why they had called me instead of him. 

They didn’t think they needed to let me know they were having trouble reaching him. They definitely didn’t think that they needed to remind me I was next of kin.

For better or worse, our stories are all jumbled together. 

For example, the time I took a three-year-old and a five-week-old (by myself) to Maine (while he worked) and the newborn spent four-and-a-half of the six-hour drive crying inconsolably. When I tell the story, I feel like its hero, having survived the arduous journey. But he only hears only that he is a zero for not even playing a minor role in such a major undertaking.

When he tells the one wherein I broke up my relationship with vegetarianism to feast on a foil-wrapped plate of airline chicken, I remind him that is essentially my story and his experience of it mocks me.

 

Not that I mind exactly. 

But he knows what I mean. 

Even these little vignettes can have so many perspectives it can be difficult to focus on the ones from other vantage points. 

Like the stories I tell out of earshot of my kids … the ones that recount cutesie quirks like toddler mispronunciations and silly dances. Youth offers its own richness of embarrassments, they don’t need me laughing about my memories to make them feel foolish. 

It seems like it should be a simple thing, knowing where a story will go … even when it seems straightforward. But it's not always so. Often it’s the unexpected flash that sheds light.

Car talk

 While she packs the car, I check the weather. Though it won't change our path any, my heart is lighter knowing we won’t have to contend with snow or rain. 

Spring break seemed to sneak up on us this year, and now it’s over. 

At least it is over for our college student.

The days off from her school never align with the days her brother receives from her old alma mater, still, we manage to make the most of her time.

We binged on her presence. From family meals to family marathons in front of the television, watching all of the one-hour shows that she’s denied herself until we could all sit side-by-side on the same couch. 

Her life, she notes not unhappily, resembles the outward contours of adulthood. 

She has done all the dutiful things time doesn’t permit during her regular semester. She’s scheduled appointments with doctors and dentists. She’s managed to squeeze in a shift or two of waiting tables to free up some extra income. She meets up with a friend, and takes her brother to school, just like in the old days when she was a kid. 

This time is such a gift. Each minute is precious for its rarity, though I must admit I have not conferred the mantle of adulthood to my firstborn, most likely because our first moments together feel more like recent memory than ancient history. 

I pull out of the driveway and turn right. I follow instructions the map reader calls out, though I think I have driven the route enough times to remember. But I may never put trust in myself when technology so freely offers the comfort of assurity.

No one likes getting lost except in thought or conversation. Neither of which I would expect as we make this commute.

Especially once she asks if she can play music. 

I imagine our conversation will ebb now. I will ask “Who’s singing,” and she will answer a name I do not recognize nor can retain long enough in my memory to retrieve if the song shuffles back within the hour. 

Soon, I was surprised to be wrong. The volume stays low while she directs lines of thought my way. 

Each thought intersects another, knitting the strands of news, secrets, and ideas into a nubbly cloth. Overall, I feel the warmth of her trust. 

I’d like to tell her, but she starts another ride down memory lane. We are back in the car, me driving while she and two friends in the back seat dish about about their lives.

They speak as if we are not merely divided by a generation or two but by an invisible soundproof partition.

Oh, how I love the commute. How a car can’t seem to contain or corral any particular audience. 

Hours pass like minutes. 

By the time we arrive at our destination, we are quiet. I circle the block and cross my fingers, hoping the parking gods will smile down on me so that time can stand still long enough for me to help her ferry bags of books and clean laundry up five flights to her dorm room.

Alas, I must double park and wait for her to complete the circuit twice so as not to risk the inconvenience of a tow.

Finally, she is back and ready for hugs and “see ya next time.”

She knows how much I hate goodbyes. 

Keeping women in the picture

In the big picture, we want to take maternal health seriously. We want to minimize harm to our nation’s pregnant and postpartum patients. And through laws like Paid Family and Medical Leave, we have helped to ensure parents can afford to welcome and care for the new lives they labor into the world.

But what happens when that picture never develops? 

For women like Cassidy Perrone, who delivered her daughter, Olivia, stillborn in 2022, the tragedy is compounded by flaws in the system designed to support them as they recover and try to care for themselves and their families. 

Perrone, the primary breadwinner, learned after the birth that she was ineligible for Paid Family Leave. 

In New York pregnant people who experience stillbirth are currently excluded from receiving Paid Family Leave (PFL), despite their partners being eligible. In some instances having their approved cases revoked after they suffer a fetal loss.

This is why PUSH for Empowered Pregnancy (PUSH), a group of parents and medical providers advocating for those who have experienced stillbirth, is convening in Albany this coming week to call for legislation that would bring awareness to the need for more equity in how paid family and medical leave benefits are determined.

Since PFL is intended for bonding with new babies, caring for ill family members, or managing issues arising from military deployments, a postpartum patient who suffers stillbirth becomes ineligible to obtain PFL because they are no longer categorized as caregivers. Instead, postpartum patients must rely on Temporary Medical Disability Insurance, which pays considerably less as they recover. 

In New York state, temporary disability offers roughly 50 percent of workers’ wages but caps the benefit at a legal maximum of $170. In comparison, PFL offers as much as 67 percent of the claimant’s usual wages.

The disparity, like all disparities in maternal health, disproportionately affects under-resourced families of color, who are more likely to be forced back to work during the most dangerous postpartum weeks.

Women who experience stillbirth are also almost five times as likely to suffer severe maternal complications compared to those who deliver living infants. And experts indicate that using best practices, at least  25% of US stillbirths may be preventable. 

Since the 1940s, improvements in maternity care have resulted in a dramatic reduction in the occurrence of stillbirth; however, more recently, the decline has slowed or halted. In 2020, the latest year statistics are available, the CDC reported about 21,000 stillbirths in the United States. According to the National Institutes of Health, there are approximately 1,400 stillbirths in New York State each year. 

 

“New York’s current Paid Family Leave law forces parents of stillborn babies to make the awful choice between a paycheck and taking time to safely recover during the early postpartum period – a critical time in maternal health when moms are at significantly higher risk of life-threatening medical complications,” says PUSH Executive Director, Samantha Durante Banerjee. 

“This puts these families in an even more precarious situation, literally being forced to choose between their physical and financial health. And it's only exacerbated by the fact that it is totally unexpected, happening in the immediate wake of an immense trauma, and at a time when this family is grappling not only with the loss of a child but also significant financial impacts (funeral and burial expenses, autopsy and testing which often is not covered by insurance after stillbirths, mental health support, etc.) that come along with this devastation,” she said.

“Mothers need at least six weeks to recover physically from pregnancy loss, not to mention to recover emotionally. There have already been too many close calls where mothers with no choice return to work too soon and risk their health. We need a solution now – before a New York mother loses her life,” urges PUSH Policy Director Allie Felker.

PUSH is asking Gov. Kathy Hochul to fast-track legislation that would grant the birthing parent 12 weeks of paid time off regardless of whether labor resulted in a live birth.

Honestly, I don’t know whether PFL is the best vehicle by which to do this or if medical disability should rise to meet the realities of our times since the consequences of lost wages can wreak havoc on all patients and their families. A part of me worries that in either scenario, anti-abortion politicians will always try to weaponize good-faith legislation in their continuing efforts to diminish reproductive rights or dictate to families how they should be configured.   

But I don’t see how we can claim to hold family values in high esteem if we carelessly erase the value of a woman’s financial contribution to her family or the realities of her continued caregiving role even as she convalesces. 

Twelve weeks is a small price to pay if it keeps women in the bigger picture. It’s simply what’s fair. 

——-

 PUSH for Empowered Pregnancy (PUSH) will gather outside the Governor’s Executive Mansion (138 Eagle Street) on Thursday, March 14, 2024, at 2 p.m. 

Divine spine

The conversation was heading in an awkward direction, as conversations about religion and politics often do. 

My mouth was ready to cast off a sentence, which might have amounted to “I’d rather see a church burn than spill a single drop of this-here coffee,” when I managed to reel it back inside. 

A brief chortle, however, propelled me toward ephemeral damnation.

“Do you go to church?”

“No,” I had to admit. “And because I am a lapsed Catholic, I feel the need to verify just how much thought I’ve put into disbelieving.”

He waved me away, not wanting to waste his time with any of my religious meanderings. 

It’s just that he KNEW and I didn’t.

And from here until the end of the session, he would bestow upon me the healing miracles that God bestows … if you are saved.

As he tells me his story … a short one that starts with sitting on a bench in church, praying for nothing in particular, and receiving the shock of feeling a dodgy vertebrae in his lower back shift a whole quarter inch to the right, falling back into place like a puzzle piece, smoothing out the pain he had hardly acknowledged.

The way he described it, was as if the whole congregation felt the godly adjustment. 

He paused long enough for me to pay respects to the power of prayer.

It was in earnest that I replied: I’m so glad for you.

No one could have been more surprised than I was that the spirit had, in fact, moved me.

Even amidst the suspension of disbelief, I couldn’t suspend the feeling that however someone finds true peace, it’s personal.

Not my place to throw a wrench in the works.

Which is where another “holy lecture” found me a few years ago as I stood with a sign in a sea of protesters unmoored by a Supreme Court decision that had overturned the civil right of women’s body autonomy bestowed by Roe Vs. Wade. 

This voice at the lectern, a woman, had called upon her Christian faith and waited a minute as the gathered crowd exhaled a collective groan.

“Now I know what you are thinking. You’ve heard a lot of people of the faith tell you they believe in the right to life, but they do not. If they believed people should have the right to life they’d make sure people also had the right to live it.” 

She preached about how the righteous would be against the taking of lives through judicial and extrajudicial means. They would be against guns, and wars, and hatred. They would be interested in feeding the poor, and housing the homeless. If they wanted healthy, happy babies they would make policies to ensure those babies’ parents were cared for, too. There would be real benefits, not just bootstraps. It takes backbones, too.

I noticed then how the crowd had hushed. And I felt a calm come over me.

I felt my spine tingle.

Like a puzzle piece slipping effortlessly into place.