Tag: hemingway

Growing up, I felt like my mother and I couldn’t be any more different. She is orderly and logical, with a knack for simply doing the next thing that needs to be done. She has strong convictions about what’s right and wrong. On the other hand, I have never been known as neat or organized. I tend to spend more time dreaming, and, although I have strong moral convictions, they’re a little more abstract. I’m the yin to her yang.
Being different from my mom was never a problem, really. Of course, we did butt heads from time to time, but we mostly understood one another and accepted each other for who we are. What I didn’t expect, however, was that time would reveal that I was much more like her than I had ever expected.

I never anticipated that I’d notice myself sounding just like her. I was surprised the very first time I caught a glance in the mirror at my adult face, thinking I had spotted my mother for just a second.

Like my mom and me, mothers and children share a lot, no matter how different they may seem. It’s inevitable. Whether learned from watching them or passed down through genetics, children are destined to inherit certain traits from their parents.
Unfortunately, there are also certain health risks that are more likely to be passed from mothers on to their sons and daughters.

The Science of Inherited Traits

In the nucleus of each cell in the human body, you can find the chromosomes you inherit from your parents. You have 23 pairs of chromosomes, with one half of each pair from one parent and the other half from the other. These chromosomes determine what traits you inherit, like the color of your eyes.

What traits you inherit from which parent really depends on a lot of things. Some genes are dominant, which means they get priority over other genes no matter which parent they come from. It isn’t just physical traits that get passed from parent to child, according to the United Kingdom’s National Health Service. If there are mutations on a gene, those mutations may be inherited by the child. Of course, genetics are not completely to blame: Many conditions are random or caused by environmental factors, according to Erin O’Toole, MS, a certified genetic counselor and the owner of Family Forecast.

“Down syndrome, for example, is a typically random event but does tend to happen more frequently as mothers get older,” she explains. “If a mother or father is personally affected by a genetic condition, a child is typically at increased risk, but this risk would change depending on the condition.”
Additionally, sometimes genetic conditions are simply carried by a parent, who remains unaffected, but they can pass on the condition to their child. And there are some conditions that require both parents to be carriers for the child to be at risk, while others require only the mom or only the dad.

When it comes to physical traits, it’s kind of a toss up whether mom or dad passes on a certain trait. What we do know, however, is that there are a few traits and conditions that are more likely to be passed from mom to child. In some cases, it’s all genetic. In others, it’s about the environment the mom provides during pregnancy and early childhood.

Apple or pear?

One’s body type can be inherited from their mother, according to a study published in the journal BMC Biology in 2014. In this study, they discovered that two specific imprinted genes influence the composition of muscle and fat in the body of mice. And one of those imprinted genes, known as Grb10, was linked to an increased risk of obesity and a glucose intolerance in those mice.

So what does this mean for humans? Scientists believe further research should take place to examine the possibility that maternal genes and paternal genes are working against each other to determine body composition with maternal genes linked to higher body fat.

Just Like Mom

When it comes to fertility in women, a genetic link may exist between mom and daughter. Specifically, the age of mom as she begins menopause might have a correlation with infertility in her daughter.

According to a study published in the journal Human Reproduction, the number of eggs left in a woman’s ovaries decreases more quickly in the daughters of women who enter menopause earlier in life. This is an important aspect of fertility, since we know that egg count and quality decreases as women grow older.

It’s in Our Blood

Women who carry a specific blood disorder might pass that disorder onto their sons. Hemophilia is a clotting disorder that causes abnormal bleeding, most frequently experienced by men. This is a genetic disorder that is carried on the X chromosome. When a mother only has one hemophilia gene, she carries the disorder but doesn’t exhibit symptoms. If she has a son, he will inherit hemophilia from her and, since he only has one X Chromosome, he will experience the symptoms of this clotting disorder, according to the National Heart, Blood, and Lung Institute.

Mental Health Issues

Prenatal depression is believed to be experienced by as many as 23 percent of expecting moms, according to research published by the American Pregnancy Association. Many mothers experience symptoms that go well beyond nervousness about the new baby, experiencing hopelessness, mood swings, and even anger.
[pullquote align=”center”]“Having a parent with a mental health condition does increase the risk for a child, but we are still often unable to determine the extent of the increase.”[/pullquote]
Unfortunately, it is believed that many moms go undiagnosed or untreated. We know that prenatal depression does influence the health of a baby. It is linked to negative birth outcomes like problems with development and lower birth weights. There is also an increased risk for the child developing mental health problems later in life, although research is still inconclusive on how much this risk is increased, according to O’Toole.

“Mental health conditions, including depression, are categorized as ‘multifactorial’ conditions, meaning they are the result of multiple genetic and non-genetic factors,” she explains. “Having a parent with a mental health condition does increase the risk for a child, but we are still often unable to determine the extent of the increase.”

For parents who are concerned because of their own mental health background, she suggests a discussion with child’s pediatrician so both parents and doctor can be on the lookout for symptoms and discuss early intervention if needed.

A Scary Cancer Gene

Certain mothers pass a high risk of breast cancer on to their daughters. Specifically, there are two gene mutations that are increased with a higher likelihood of developing breast cancer and ovarian cancers
Certain mutations of the genes BRCA1 and BRCA2 are passed from mother to daughter and are responsible for an estimated 20 percent of hereditary breast cancers and 15 percent of ovarian cancers, according to the National Cancer Institute.
Of all the women who inherited the BRCA1, between 55 and 65 percent will end up with breast cancer. This is a staggering number when you consider that 12 percent of the general population of women are diagnosed with breast cancer. When it comes to the BRCA2 mutation, around 40 percent of women who inherit this mutation go on to develop ovarian cancer.
The good news is that the mutations are not common, so only those with a family history of women being diagnosed with breast cancer or having already tested positive for a specific mutation need to receive testing genetic testing.

When should I have genetic testing?

For expecting mothers, it is important to understand that passing on genetic conditions is not a common experience. Most mothers experience healthy pregnancies and give birth to healthy children.
[pullquote align=”center”]Would I want to know in advance if I were going to have a baby with a genetic condition?[/pullquote]
However, it is always it a good idea to understand if you have risk factors for passing on a genetic condition to a child. Although O’Toole suggests genetic counseling to all mothers, she says there are specific clues that a mom should definitely have genetic screening.

“Being over 35, having a family member with a genetic condition, or having a history of a poor pregnancy outcomes are all reasons to consider genetic screening,” she explains.
Additionally, she believes all moms who may conceive or are currently pregnant should spend time asking themselves hard questions about what they want to know about their unborn child and how those answers will influence her choice to have genetic screening.

“Asking questions like, ‘Would I want to know in advance if I were going to have a baby with a genetic condition? Would this information change how my family and doctors prepare for the birth and newborn period? Would I consider ending the pregnancy or creating an adoption plan?’ can help you decide if you want to explore your testing options more with your doctor or genetic counselor.”
And, for women who are dealing with anxiety about their pregnancy, a genetic screening that reveals that mother is low-risk can be the reassurance she needs to enjoy her pregnancy without the overwhelming fear of the future of her baby’s health. Knowing her baby has a low-risk of inheriting a life-changing condition just might mean less time worrying and more time daydreaming about whether they’ll get mom or dad’s eyes.

Based on the most recent data available, the United States Children’s Bureau reported in 2016 that nearly 120,000 children were adopted in the U.S. in 2012. And according to the last U.S. census in 2010, almost 2.5 percent of all children in U.S. households were adopted—or about 1.5 million out of 65 million total children.
We adopt infants. We adopt adults. We adopt children from the foster care system. We adopt babies from scores of countries all around the world.
As the facts, figures, and the multifarious forms of adoption suggest, adoption—a process in which “children become full and permanent legal members of another family,” as the USCB defines it—is incredibly widespread in the U.S.

And yet some common myths about adoption still hang on. Some are naive, stemming from confusion about who is allowed to adopt or how much adoptions cost. Others are more nefarious, involving judgments we make about mothers who relinquish their children for adoption or stigmas adoptees unwillingly bear.
Let’s debunk some of these stubborn and insidious myths for a clearer picture about the process of—and, more importantly, the people involved in—adoptions.

Myth 1: Only married, heterosexual homeowners can adopt children.

A slew of misconceptions surround who is allowed to adopt in the US, with many people thinking only traditional families are eligible. As the USCB explains of domestic adoptions: “Most people are eligible to adopt, regardless of whether they are married or single, their age, income, or sexual orientation.”
What’s more, single-parent households accounted for one-third of all adoptions in 2011. Prospective adoptive parents also don’t have to own their own homes, nor does having a disability necessarily disqualify them from adoption.

The legality of same-sex adoption is a more recent phenomenon, the culmination of decades of legal battles finally recognizing the rights of same-sex couples to adopt. Yet in some ways, the battle continues. After the U.S. Supreme Court ruled that same-sex marriage is a fundamental right protected by the constitution in 2015, a federal district court struck down a ban on same-sex adoption in Mississippi in 2016, making same-sex adoption legal in all 50 states. Ironically enough, UCLA’s Williams Institute found in 2013 that it was Mississippi which had the highest proportions of LGBTQ parenting in all of the U.S., with 26 percent of its LGBTQ couples raising biological, adopted, or stepchildren.
However, some states—most recently Alabama—have passed laws allowing faith-based adoption agencies to turn away LGBTQ couples on the basis of their religious beliefs.
For domestic adoptions in the U.S., eligibility comes down to an assessment called a home study. Basically, adoption agencies are looking for a loving household that will care for the adoptee—and yes, research shows that adoptive parents love their adopted children just like their biological ones.
International adoptions—commonly called intercountry adoptions—can come with a different set of restrictions. To adopt from China, for example, a parent has to be 30 years old, among other criteria. Many countries don’t permit adoptions by LGBTQ parents. A few countries, like Russia, currently don’t allow for adoptions to the U.S.

Megan Caporicci, a teacher in Tustin, California, had already had was originally interested in adopting from China when she adopted her daughter over 12 years ago. As she tells HealthyWay, she and her husband already had two sons and were interested in a baby girl. Their research pointed them to China—whose former one-child policy and cultural favoritism of boys indeed led to the international adoption of tens of thousands of infant girls from the country over recent decades.
“I wasn’t 30 yet. I was 28, maybe 29, and you had to be 30 to adopt [in China],” Caporicci says. “Every country has specific rules: how long you are married, whether you are married, ethnicity, how much money you make.” The Caporiccis went with South Korea instead, where they were eligible.
If you’re interested in adoption from a specific country, first heed Caporicci’s example and consult each country’s policies.

Myth 2: Adoption always costs a fortune and takes forever.

Assumptions about the expense and length of the process may deter some prospective parents from adopting. Again, we have to distinguish between domestic and intercountry adoption. We also have to distinguish between the means of adoption, i.e., through an adoption agency or through an independent adoption attorney, as well as differentiate the age of the adoptee.

Each year, the Adoptive Families magazine conducts a cost and timing survey. According to their 2016 report, the average cost of adoption from foster care—which happens when “children in out-of-home care cannot be safely reunited with their birth families,” explains the USCB—was approximately $2,800 in 2014–15. This included the home study fee, documentation, and paperwork processing costs, attorney fees, and travel expenses.
Many families, though, actually reported ultimately paying $0 for adoption from foster care and were receiving an average of about $850 in monthly subsidies from the government. By adopting from foster care, families can claim the adoption tax credit, receive health coverage through Medicaid, and even get support with college tuition in some states. Timewise, nearly 50 percent of respondents said it took zero to six months for the adoption placement to take place.
The average age of a child adopted from foster care is 7.7 years old, according to the Adoption Network Law Center. But a great many parents want to adopt a child from birth or infancy—which does become significantly more expensive. The 2016 Adoptive Families survey finds that for newborn adoption in the U.S. in 2014–15:

• Adoption through an agency cost an average of just over $41,500, with 62 percent of families matched with a child within one year of application. Nearly $17,000 of the total costs went to agency fees.
• Adoption through an attorney cost an average of just over $35, 500, with 67 percent of families matched with a child within one year. About $13,000 went to attorney fees.

Cost and timing for intercountry adoption varies. Adoptive Families provided a breakdown for three of the top countries American families adopt from in 2014–2015:

• China: average cost of about $36,000, with 75 percent of families matched within six months for its “Waiting Child” program, which supports children with special needs. Adoption of a “Traditional Child” has a considerably longer wait. About 70 percent of families adopt a child younger than five.
• Ethiopia: average cost of just over $38,500. Fifty six percent percent matched within one year, and 78 percent adopted a child younger than six.
• South Korea: average cost of about $46,000. Fifty six percent matched within one year, and 100 percent of families adopted a child younger than five.

Remember, these costs are averages, and the adoption process is complex—plus, we’re dealing with human beings here, who want nothing more than a good home.
For the Caporiccis, the “total cost was about $17,000, including travel,” Megan shares. “From application to actually finalizing, it was almost two years. But from application to baby in arms was one-and-half years.”

They also elected for adoption from South Korea not only because their age and martial status met the country’s requirements, but the total travel time was less. South Korea was closer than other places they considered, and the agency only required one trip that lasted only about four or five days. “For us, having young kids, it wasn’t easy imagining leaving them for months at time,” says Caporicci.

Myth 3: The biological mother can come back at anytime and take her baby.

While we appreciate the feelings of anxiety and uncertainty that can surround the adoption experience, a biological mother can’t simply change her mind and reclaim her child.
Before a child goes up for adoption, the birthparent has to consent to terminate all parental rights in a court of law. Only in very limited circumstances—usually in cases of fraud or duress—can a birthparent revoke that consent. After the child has been placed into a new household for a period of about six months, a judge issues an adoption decree at the end of what’s called the finalization process. The decree makes the adoptee the permanent, legal child of the adoptive parent(s). In other words, the adoptee is their child under law.

Contact between adoptive families, adoptees, and birthparents is a complex matter, involving issues of birthparent privacy and adoptees’ right to certain information, like their medical history. In closed adoptions, there is no contact between the two households, and no identifying information is shared, whereas open adoptions, which are increasingly common in the U.S., allow for various degrees of contact and identification between the birth and adoptive families.
The Caporiccis, for example, went through a closed adoption with their daughter, as is common for intercountry adoptions. She says there was some information required for each family to report to the adoption file, while other information was completely optional to share, such as birth name and family interests.
As we’d expect, views vary on the pros and cons of contact, as they do on the risks and benefits of an adoptee reuniting with their birthparent. One thing is for sure, though: It’s normal for adoptees to be curious about meeting their birthparents—and it doesn’t mean they love their adoptive parents any less. It’s also a very personal choice for whether or not an adoptee seeks out a reunion.

Thomas Kelly, now an attorney in Cleveland, was adopted after birth in 1948 from the Father Baker Home in Lackawanna, New York. He was very open about the subject of reunion. His thoughts reveal just how unique each adoptee’s experience is, and are worth quoting at length:

I am certain that at some time or another, every person who is adopted has some level of desire to find the biological parents, to see what they look like, to discover why they chose to place the child for adoption. It’s easy for … an adopted child … to fall into the trap of, “Was I not good or not good enough?” or “I must be less valuable because my parents didn’t want me.” Self-pity clouds judgment, and it’s a minor form of selfishness. But we are all prone to it. … I am forever grateful to them for their decision to choose me and their lifelong love and concern for me. I had also decided long ago that the decision made by my natural mother (most likely without the involvement of the father) to place me for adoption was also a great gift and a great sacrifice that I should honor and that I should not disturb her life, which I hope was happy and fulfilling.

Megan Caporicci says her daughter, now 12, hasn’t expressed any interest in reuniting yet. But as for talking about adoption with daughter, she says, “All families are different.”
“The message in this day and age is you talk about it from day one. It was known as long since we could talk … don’t need to put a magic cover on it.”
In addition to her birthday each year, the family celebrates her Adoption Day, marking the date when she officially joined their family.

Myth 4: Foster children are broken, and adopted children are doomed to attachment issues.

Aggressive, troubled, damaged: These are some of the toxic labels cast on foster children, perhaps due to stereotypes of such youth being “shuttled from home to home” or because of some notion that they are delinquents or runaways.

Truth is, most foster children enter into special care because of abuse, neglect, abandonment, and death. Like all of us, foster children want love, care, and stability. Being in foster care is no doubt disruptive, confusing, and challenging, so let’s dispel the myths that foster children are broken.
Casual jokes and everyday remarks, meanwhile, shame adopted children as “looking different from their family” or “being unloved by the parents.” Some of us may assume that adoptees are destined to struggle with forming trusting, meaningful relationships for all their days. The experience of adoption entails seriously grappling with identity—something we all do. But that doesn’t mean adoptees don’t go on to live happy and fulfilling lives.
Kelly writes of his experience: “I was about five or six years old when I first heard the word ‘adopted.’ Some kid had told me I was adopted; how he knew, I never discovered, but it seemed from how he had said it that it was not something to be proud of or happy about.” His parents later explained his adoption to him at home, but in a manner that has always made him feel “chosen” and “special,” he shares.
Fortunately, thanks to the “grace and dignity” his parents always brought to the topic, Kelly writes “being adopted did not come with any stigmas” or “cause me any setbacks as I grew.”

Society has become indeed more open about adoption in the intervening decades. For her part, Caporicci says that her daughter “knows it’s a button she can use”—that she’s not her birthmother. When upset, her daughter will voice complaints like “Well, you’re not my real mom!” or “I wish I had my real mom!” Caporicci doesn’t react and instead acknowledges the reality that she’s her adoptive mother who does everything she can to love and support her.
And yet, “she’s so strong that she blurts it out there,” Caporicci continues. Her daughter will announce when she starts a new school, “I’m adopted.”
“It took her longer to realize she had a birth dad—the mom and the belly is such a permanent figure.” She recounts with a laugh when her daughter declared her discovery to her father: “‘Did you know I had a birth dad, dad?'”
Caporicci is quick to add, though, on a more somber note: “I feel like it would be not fair for me to say she doesn’t struggle … I think that there’s more details that I don’t know that she struggles with … that she probably can’t even verbalize.”

Before adopting her daughter, the Caporiccis lost a son and learned they were carrying a genetic disease. “I do know a huge loss on my end. I do know she went through a loss, too.”

Myth 5: Birthparents give up their children because they don’t love them.

Which leads us to the final area of adoptions myth: What kind of a mother bears a child and then gives it up for adoption? Some have pictured such a mother as an irresponsible teen, a promiscuous woman, or a selfish person who just doesn’t love their child.
But mothers do not take the decision to relinquish their child for adoption lightly or easily, and the reasons that motivate them are often very serious and painful.
They include age, with some underage mothers and their parents wanting the child to grow up with parents who are ready, prepared, and able for childrearing. Inconsistent employment, challenges to stable housing, and single parenthood compel other mothers to relinquish their child, according to Cosmopolitan.

Some mothers choose adoption because their child has severe disabilities they are unable to properly care for. Other mothers choose adoption because their child was conceived as the result of sexual violence. And in some countries around the world, poverty or other extreme hardships lead to adoption.
The decision is ultimately driven by an intense desire for their child to have a better, happier life in the care of an adoptive family.
The adoption process has enough challenges and trials. We don’t need any myths piling on guilt, shame, or other bogus judgments.
And we don’t need any myths obscuring the joys, the opportunities, the beauties, the blessings of adoptions—how “amazing and wonderful” it can be, as Caporicci puts it.
Or as Kelly concludes: “For many years I have said that I am the most fortunate man I have ever known. And much of my good fortune is the direct result of adoption. I am grateful to the woman who bore me, the good people at Father Baker’s who cared for me, and forever grateful to [my parents] for my life.”

When kids or parents normally complain about homework, it’s mainly because of either the quantity or the difficulty. One only has so much time in the day to plow through their studies.
But people occasionally get upset about homework for different reasons. Not because it’s too time consuming, but because, in their eyes, it blows beyond the boundaries of good taste.
This is usually not the intent. Controversy is something lower education tends to avoid like the plague. Inciting it can prove perilous for the employment of any teacher, be they well meaning or not. But controversy arrises with homework more than you might think.
Sometimes a child comes home with an assignment so bizarre, incendiary, and insensitive that one it’s a wonder how it was ever assigned in the first place. Perhaps it’s too sexually provocative or racially charged, or maybe it presents moral dilemmas that children simply aren’t mature enough to fully comprehend. A teacher should try to preserve a child’s innocence as long as possible, some say, not offer a preemptive assault on their sensibilities.

We need to play devil’s advocate here, while proceeding with caution: It’s not always a negative to get an assignment that diverts from convention. Sometimes homework provokes intense feelings because a teacher is asking important questions designed to broaden their students’ horizons.
So why do some teachers give out homework that could result in being reprimanded at best and fired at worst? Let’s take a look at some of the most prominent examples of homework assignments that went very, very wrong—either because of poor taste or offending the sensibilities of overprotective parents.

Slavery Math

“Each tree had 56 oranges. If eight slaves pick them equally, then how many would each slave pick?” Could you imagine seeing that loaded question on your child’s math homework? It was a real eye-opener for parents of third graders at Beaver Ridge Elementary School in Norcross, Georgia.
The question appeared on a 2012 cross-curricular activity that mixed basic math questions with a reading assignment about abolitionist Frederick Douglass. And it got worse. Another question read: “If Frederick got two beatings per day, how many beatings did he get in one week?”
 

So why would any teacher think about including slavery into a math question? Gaye Lynn Seawright, assistant superintendent at Valley Mills Independent School District in Waco, Texas, says, “When people send home questions like that, that are in poor taste, what that tells me, as an administrator, is that they need a mentor teacher. They don’t have enough experience in the classroom or in the community.”
While it’s important to learn arithmetic and American history (both the good and the bad), mixing them together takes things out of context. Seawright also emphasizes that anytime a teacher is teaching about a sensitive topic, it’s important to “change the verbage to reflect a more neutral type of environment.”

How comfortable are you?

This outrageous questionnaire got a teacher in Hernando, Florida, fired. And it’s not hard to understand why.
It was a list entitled “How Comfortable Am I?”, and it included provocative questions that had students rate how they might react to certain social situations. Those situations largely revolved around issues of race, gender, sexuality, and those with disabilities.
In an interview with ABC news, Jennifer Block, mother to a 12-year-old student, said she was offended by the questions, including “How comfortable are you if you see a group of black men walking to you on the street?”, adding, “That’s completely inappropriate. In no world, whatsoever, is that okay to question a child on.”

In the same segment, student Tori Drews was equally outraged by the questions: “I thought some of them were racist. I thought some of them were sexist. I thought it was completely intolerable.”
So why would a teacher assign such potentially inflammatory homework? Did the instructor have good intentions by trying to teach about tolerance? Was it designed to help students confront their on biases, or was the instructor forcing their own bigoted views on their students?
Seawright says no matter the intent, teachers walk a very fine line venturing into such sensitive territory, as there can be blowback from “preaching in a classroom and trying to make your own philosophies to be the kids, because that’s the parents job. You’re just there to teach the content and make sure they pass the class and they grow up with good standards and they have open minds to learning.”

Fat Shaming Children

As adults, it’s easy to forget just how sensitive children can be about their physical appearance. A 2015 study by Common Sense Media shows that one-third of boys and over half of girls as young as 6 to 8 years of age are unhappy with their body weight. And by age 7, one in four children have tried some type of dieting program.

In other words, fat shaming can have a devastating effect on kids who already have body image issues. It’s too bad that some teachers didn’t get the memo—namely, teaching staff in Bellevue, Kentucky.
Third graders were assigned an essay about the Great Depression that featured the insensitive multiple choice question “A very fat child probably…” The most egregious possible answer was “had trouble sharing a seat.”
One parent took to social media to declare how upset she was that her child was exposed to such insensitive material.
In response to her outcry, the school board apologized, stating that the essay, designed for reading comprehension, was sent home without any of the teaching staff aware of the potentially offensive material.

You may be asking, “How could an entire teaching staff not know what’s contained in their teaching materials?” Seawright says that teachers who make these types of reckless errors often lack experience due to only learning the bare basic requirements for their position: “They pay like $2,000 and spend a few months taking online courses, and then they get a job. … So that’s where a lot of your mistakes are made.”
She says that while an online teaching course covers all the major qualifications, it misses nuances which can result in a teacher who is “not attuned to the community, or the age of the kid, or what developmental state the kids are and what’s appropriate for them, because they don’t have a lot of experience.”

White Privilege

In 2016, a controversial homework assignment for students at a high school in Aloha, Oregon, drew polarizing reactions from some parents. The assignment in question was a survey which challenged students to identify if they had benefitted or been harmed by white privilege, a theory stating that white Americans benefit from a social hierarchy that discriminates against minorities.
[pullquote align=”center”]It’s a huge topic and it needs to start somewhere. If it doesn’t start now, it’s not going to start.[/pullquote]
Questions included hypothetical scenarios like, “I can go shopping alone most of the time, pretty well-assured that I will not be followed or harassed,” or “If a police officer pulls me over, I can I can be sure I haven’t been singled out because of my race.”

In an interview with a local news station, parent Jason Schmidt was angry with his son’s assignment. “I think he should be learning actual education and not be a part of some social experiment or some teacher’s political agenda,” he said.
This survey wasn’t met entirely with criticism, however. In the same news segment, Sarah Rios-Lopez countered, saying, “I want [my daughter] to have opinions. Whether it’s for or against, you have to create those, but you can’t without good information, so I applaud teachers getting out that information. … It’s a huge topic and it needs to start somewhere. If it doesn’t start now, its not going to start.”
In response to the news coverage, school officials elucidated on why students were given the assignment, saying it was to help them engage in a civil manner on matters regarding race, sexuality, and religion.

It’s worth noting this study has been distributed to various school districts ever since it was first published in 1988. While it may make students (and parents) uncomfortable, it’s clearly designed to start a dialogue…but some parents aren’t interested in their children joining the conversation.

Teaching Taboos

A 2010 homework assignment assigned to middle schoolers in Greenwich, New York, raised major eyebrows from some parents.
Gary Cella became incensed after he found his 11-year-old daughter’s reading assignment contained numerous racial and sexist slurs, telling a local NBC affiliate she felt “as a parent of a seventh-grader that words that start with the letter ‘F’ and are four letters in duration and that words that start with letter ‘N’ and are six letters in duration are inappropriate.”

When Cella reached out to the school principal, he was told the assignment was intentionally provocative. It was done in conjunction with the American Library Association‘s Banned Books Week. The reason it was assigned? To make students understand (and discuss) why certain classic books are deemed offensive or taboo.
[pullquote align=”center”]It is not a question whether or not the content is offensive —of course it is—but it is the intent of why the content is being given to students …[/pullquote]
Matt C. Pinsker, JD, a professor at Virginia Commonwealth University, says teaching students about free speech is important: “I teach constitutional law, including the First Amendment’s right to free speech and the Fourteenth Amendment’s equal protection clause to combat racism. To understand the law on free speech and equal protection, I have my students read U.S. Supreme Court decisions and do practice problems, many of which arise from speech uttered by some of the worst people in this country.”
“Of course,” he adds, “what those people said is offensive, vulgar, vile, and absolutely disgusting. However, just like a doctor cannot learn medicine without seeing naked people, there is no way to learn constitutional law about free speech and equal protection without reading these important Supreme Court cases and going over real-world examples.”

In instances like these, he notes it’s about getting students prepared for life beyond the classroom. “It is not a question whether or not the content is offensive—of course it is—but it is the intent of why the content is being given to students and that it is done so in a professional manner which is reflective of the real world … .”

Pass or fail?

So, as we’ve covered, when homework causes social outrage, it falls into one of two categories: poor judgment by a teacher or something intentionally designed to push the envelope. Something ill-advised, or something intended to develop a grasp on complex societal issues that well-worn textbooks don’t cover. It’s clear, then, that the most important quality, for both teacher and parent, is the ability to discern between the two.
Seawright says there will always be instances when homework assignments touch a raw nerve, because, in the end, “Everyone comes from different backgrounds. Everybody’s interests are different. Everyone’s political and religious views are different.”

She adds that when approaching such sensitive topics, it’s possible to teach the concepts while being conscious of the age of the child and proceeding with caution.
“I’m for keeping the innocence in the classroom for the kids. I think there’s so much out there right now, and part of what some teachers are missing is that kids grow up so fast.”

In 2012, Heather Beckius developed gestational diabetes while pregnant. Like other forms of diabetes, gestational diabetes affects cells’ ability to utilize glucose properly. The condition can lead to elevated levels of blood sugar, which can impact the health of both the mother and the baby, according to the Mayo Clinic.
Since she had this condition, the doctor performed a nonstress test—a simple procedure completed during pregnancy to evaluate the baby’s health. During the test, the fetal heart rate kept dropping. The doctor followed up the nonstress test with an ultrasound, which showed a sizable spot on the unborn baby’s brain.
The spot would later be identified as a brain bleed or a stroke. Although Beckius was going through a very challenging situation, she says, “All of the doctors were very supportive. They tried to prepare me for the very worst—my baby not surviving—and, at the same time, they told me that the brains in babies have a great tendency to rewire themselves.”

Thankfully, Beckius’s story has a happy ending—she gave birth to a “miracle” baby boy. But the circumstances surrounding her pregnancy underscore the importance of the accessibility of maternal healthcare, from prenatal to postnatal, so that all mothers can receive the quality of care they require and reduce the risk of pregnancy-related complications.

What is maternal health?

The World Health Organization defines maternal health as “the health of a woman during pregnancy, childbirth, and the postpartum period.”

For many women, pregnancy and childbirth are a joyous and anticipatory experience. For others, however, this period can be marked with adversity, mental or physical health issues, and worst case scenarios—even in the United States. In fact, WHO reports:

• From 1990 through 2013, the maternal mortality rate in the U.S. increased from approximately 12 to 28 per 100,000 births.
• Currently, the United States has a maternal mortality rate higher than other high-income countries and countries like Iran, Libya, and Turkey.
• Nearly half of all maternal fatalities in the U.S. are avoidable.
• Approximately 1,200 women in the U.S. experience fatal complications during pregnancy or childbirth each year.
• Each year, almost 60,000 women endure complications that are near-fatal.
• Data from 2012 showed the upward trajectory of maternal complications and the mortality rate continued—even though the U.S. spent more than $60 billion on maternity care.

With that said, modern developments in maternal healthcare give women a much brighter outlook than they had in years past. Figures collected by Our World in Data show that the U.S.’ maternal mortality rate didn’t fall below 400-in-100,000 until 1940.

How was maternal medicine practiced back when?

Mary Jane Minkin, MD, a clinical professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at Yale and a private practice physician in New Haven, Connecticut, began medical school at the Yale School of Medicine in 1971. She delivered her first baby during her obstetrics rotation in 1973. With more than four decades of experience with women throughout pregnancy and childbirth, Minkin has seen some changes in maternal healthcare.
Minkin says the first significant advancements for obstetrics, gynecology, and maternal health occurred in the early 1970s. One of the primary areas of progress Minkin mentions is in early pregnancy detection. “When I started medical school, we literally had to wait for the rabbit to die to see if someone was pregnant,” she recalls.

The phrase “the rabbit died” was created between the 1920s and ’30s. To see if a woman was pregnant, physicians would inject urine from their patient into a rabbit. If the urine contained the pregnancy hormone hCG, it would cause the rabbit to ovulate and verify if a woman was pregnant.
Unfortunately, this method came at a tremendous cost to the rabbits—their lives! The rabbit’s ovaries couldn’t be seen without an autopsy or surgery to remove the ovaries; the latter was typically deemed a waste of effort. Eventually, this practice was replaced with home test kits like First Response, which allows a woman to tell if she’s pregnant six days before her missed period.

Another area Minkin cites as one of concern during her early years at Yale was with fetal well-being and the lack of imaging to assess fetal health. These pressing matters helped form the “backdrop for maternal and child health changes,” she says.
Through the decades, the technological developments have led to the invention of fetal monitoring, which allows for the fetal heart rate to be monitored during labor and delivery to determine the condition of the baby.

Additionally, breakthroughs in ultrasound technology have given clinicians the ability to view the placenta in all locations and positions, diagnose fetal abnormalities more quickly, and provide expectant parents a real-time, color image of the fetus in 3D/4D. Furthermore, advances in amniocentesis created a minimally-invasive procedure for doctors to test for chromosomal abnormalities, fetal lung health, and infections.

A magical moment caught on camera during a 4D ultrasound. A tiny fetus waves to his mommy and daddy. pic.twitter.com/5HYLBqfLzr

— KHOU 11 News Houston (@KHOU) January 12, 2018

These are a few of the ways in which maternal healthcare was practiced in the last four decades and how it has made strides.

What are some ways healthcare providers are working to improve a woman’s experience with pregnancy and beyond?

There’s a growing trend to provide expectant mothers with a comprehensive birthing experience. Vice Chief Medical Officer Michael Moxley, MD, and Department Chair of OB-GYN Miguel Fernandez, MD, are professors at Georgetown University School of Medicine and physicians at Virginia Hospital Center. One way medicine is working to improve maternal health is through a multidisciplinary approach to care.
“We have sought to become more collaborative with our colleagues. Traditionally, medicine has been siloed, with each group acting independently,” Moxley and Fernandez say. “Now, at VHC, we work in teams that include not only doctors and nurses, but administration and, most importantly, patients.”

Besides a more collaborative approach to maternal health, Moxley and Fernandez say medicine is taking cues from the field of aviation to reduce errors. Medical flight simulations, so to speak.
“In the last 10 years, we have started regularly practicing to react for emergencies that rarely happen so that we are better prepared and have better outcomes when the time comes,” they stated.
Furthermore, Moxley and Fernandez aim to cut down on unnecessary C-sections, which increase the maternal risk of having complications during childbirth.

“The statistics indicate after the first C-section, repeat births will be done via C-section 90 percent of the time. Since the risk of complications increases with C-sections, we want to make sure that the C-section is medically needed,” they say. “We follow the guidelines that were created in 2014 by the American College of Obstetricians and Gynecologists—the guideline that made the biggest change was allowing more time for the labor to progress.”

Regarding how healthcare providers are working to enhance a woman’s maternal experience, Minkin furthers the conversation by stating, “The most important advances in maternal and child health actually pertain to getting ready for pregnancy. We know that smoking [and substance use] … are very toxic to the fetus. So we encourage all of our patients to stop taking drugs, stop drinking … , and stop smoking before pregnancy, or limit these as best as possible.”

Additionally, Minkin acknowledges that women with chronic medical conditions—either mental or physical—have better outcomes when they have the opportunity to carefully plan their pregnancies. To illustrate an example, she says, “If a woman has high blood pressure, she should meet with her primary care provider to make sure she has her blood pressure well-controlled and is not taking certain drugs that are bad for babies.”

“Also, we know that if a woman is diabetic, her baby will do much better if mom’s blood sugars are in excellent control before she gets pregnant. A pre-pregnancy meeting with an obstetrician is ideal before a woman conceives to maximize her healthy outcomes.”

Finally, Minkin emphasizes the importance of addressing a woman’s mental health needs throughout her pregnancy. “These days, all women are screened during pregnancy for depression and hooked up with a mental healthcare provider before delivery to minimize the chances of postpartum depression,” she says. “We do know that certain antidepressants are safe to use during pregnancy, and some of these may be prescribed if the woman is suffering from depression.”

Advice and Tips

Although maternal healthcare in the U.S. still has obstacles to overcome, particularly in its accessibility to all women, these are a few tips women can follow to prepare for a safe childbirth and develop a strong patient-doctor relationship:

• Look for a physician who will seek to meet your needs. If you’re unhappy with your current doctor, don’t be afraid to try another one—either within the same practice or a different one. Wherever you go, it’s important you feel heard and valued as a patient.
• If you have pre-existing health conditions, work with your doctor to get those under control before, during, and after pregnancy.
• Your doctor may offer you lifestyle, supplement (like prenatal vitamins), or exercise recommendations. Try to be as compliant as possible with these recommendations.
• If you’re considering a midwife or doula, our experts suggest using a hospital that has midwives or doulas as a part of their birthing team. Or find a doctor who is willing to work with them to give you and your baby the best care possible.
• “One thing that I strongly recommend is that women don’t take advice from a celebrity about medical health just because she is a celebrity,” Minkin says. “You hear all sorts of crazy things put out by folks who really don’t know any medicine!” Instead, focus on creating a reliable social network, so when you have the baby, you have the support you need.