A few news items of note:

Great press coverage in the Seattle Times yesterday about a program near and dear to my heart -- the Birth Attendants of Olympia, WA, are a dedicated group of doulas and childbirth educators who provide education and doula support to incarcerated women who are pregnant and mothering their babies.

and from the CDC, we find that the increased cesarean rate is in fact, creating more preterm births. Here's the MSNBC link to the story and some selected quotes:

"Researchers at the U.S. Centers for Disease Control and Prevention and the March of Dimes compared single births — not twins or other multiple births, which are at an increased risk for pre-term birth — in 1996 and 2004. The rate of premature births rose by about 10 percent in that period, they said.

The number of premature births rose from 354,997 in 1996 to 414,054 in 2004, the study published in the journal Clinics in Perinatology showed.

"When one looks at the numbers carefully, there was an increase of 60,000 who were pre-term, and 92 percent of them were by Caesarean section," Fleischman said."

and

"The increase in pre-term births is really being driven by the Caesarean section rate, and really demands good research to sort out what percent of those are not medically indicated deliveries," Fleischman said in a telephone interview.

"My gut tells me its significant, but I can't give you an estimate and a percent," Fleischman added."

Finally, something you don't see every day: Photographs ofa woman's cervix every day through her cycle. It is an amazing sight. Check out My Beautiful Cervix

This summary is not available. Please click here to view the post.

In the News....
attendance at childbirth education classes has dropped. It has been my first time being interviewed and quoted by a reporter. The USA Today article has been my 15 minutes of notice and has been gratifying. It has also renewed my commitment to get more of my writing published. Tracing this news story throughout the media channels has been interesting too.

Here's a little something about male doulas in Canada. Unfortunately for doulas, when someone like Vince Vaughan comes in to define who and what a doula is to the mass market, they may be in for some troubles. (as in, do you think that film Klingendorf's Tribe was of benefit to cultural anthropologists? ) The public comments were interesting. Many equated the impact of a male doulas to that of doctors in terms of their right to be physically close to a birthing woman. Only occasionally did someone recast the doula's role as emotionally, physically supportive, not clinical. Whereas physician are trained to emotionally detach, doulas typically cathect with their clients. Additionally, some men expressed concern and discomfort around the notion of another man seeing one's wife during this intimate process --- and it's true that many men have experienced this, with male doctors. I wonder how men respond when the women they are with are treated roughly by doctors--any studies about that?

Men and reproduction ... men and childbirth education. In the classes we observed during the course of our research on childbirth education, men were clearly the primary audience for the educators. More on those findings soon.

Surrogacy outsourcing to India ....
This week Judith Warner wrote her column on Outsourced Wombs, generating over 150 comments. Mine, however, was not published, even after I submitted it twice. So I decided to blog it.

I was interested in the variety of responses to the idea of presumably infertile American women contracting with Indian women to be gestational carriers (no genetic connection). Folks raised issues of exploitation, the free market, empowerment and entitlement. Strong opinions and feelings characterized most postings. As a sociologist studying reproductive practices, experiences and meanings, I am fascinated by the discussion.

Along with many posters, I agree we need to know more about what is actually happening, how it is experienced by the Indian women, their families and the US couples. From my knowledge of surrogacy (and ivf methods), it seems we have the practice of wealthy white educated American women (who undergo treatments to extract their eggs, presumably) and their husbands providing sperm to create a viable embryo. They pay desperately poor uneducated women to inject a range of drugs to their bodies in order to accept the implanted embryo (which may/not cause long term health damage to both the surrogate and the adopting mother). The surrogate is then implanted with a fertilized embryo and will carry a pregnancy to term (~ 40 weeks +/- 4); assume long term risks associated with pregnancy and birth; manage a postpartum without lactating, by use of drugs to suppress milk production (unless she will be expressing the colostrum and early breastmilk for the baby's optimal development; deposit check in bank and then what?

The babies will leave an environment and experience they have come to know in that 40 weeks, and be taken into one with new smells, rhythms, sounds and emotions. If they are treated like most babies born in America, they will be provided suboptimal nutrition (manufactured formula); probably less than optimal skin-to-skin contact and baby wearing, unless supplemental nursing systems are utilized by the new mother; possibly impacted by adopting mother's employment status--how much maternity leave does she have, if any; or is she resourced enough to not need to work for income for some months? The babies are nurtured, loved, indulged, and treasured. Their lives are worth the cash paid for them, $6K, plus the travel expenses, $6K, plus whatever else is laid aside for their immediate and future expenses. How much money do these parents put into the nursery? clothing? toys? How many of these purchases are 'essential' to baby's developmental needs and how many are 'optional' or 'culturally determined needs'? What is the value of this child compared to the previous child born of the same woman? Socially? Morally? Economically? Politically? Hard questions.

The western women will have a baby. They will have demonstrated their right, and ability to have a baby, via a network of new relationships and technologies and economies.

Some questions I have (which were not answered in the Marie Claire article on the same topic last year).
On average, how many attempts does it take to be impregnated? What health consequences are faced with this process?
How many attempts until the presenting surrogate is rejected? What compensation does she receive?
How are labors managed? How many cesareans are performed?
How do women plan to spend the the money they receive? How _does_ it get spent? How will their new found wealth be viewed in their own communities? Where are the blogs in low income India on this topic?
How do the contracting couples relate to the baby? What are the long term health consequences for surrogates and the infants they produce?

Clearly many folks posting have strong moral, ethical, economic, political views on the practice. Also clear is that in the US and Indian cultures, a free market mentality rules, in contrast to several European countries where such transactions are illegal. Where is the social science and medical research showing us what these practices are and what they mean in both cultures? Where is the funding for this type of research and its dissemination in useful, relevant, and trustworthy venues to the greatest number of people?

This is a new social experiment. wow.