May 27, 2008 § Leave a comment


Today, we were thrilled to learn that after 8 long years, the South Carolina Supreme Court has finally reversed the 20-Year Homicide Conviction of Regina McKnight. The unanimous decision recognizes that research linking cocaine to stillbirths is based on “outdated” and inaccurate medical information. NAPW has been working on behalf of Ms. McKnight for nearly 10 years.

Specifically the South Carolina Supreme Court ruled that Regina McKnight did not have a fair trial when she was convicted in 2001 for homicide by child abuse. Through this conviction she became the first woman in South Carolina to be convicted of homicide by child abuse as a result of suffering an unintentional stillbirth.

McKnight was arrested in 1999, several months after she experienced a stillbirth at Conway Hospital . McKnight’s conviction was based on the jury’s acceptance of the scientifically unsupported claim that her cocaine use caused the stillbirth. McKnight had no prior arrest history and even prosecutors agreed that she had no intention of harming the fetus or losing the pregnancy. Nevertheless, upon conviction she was given a twenty-year sentence, suspended to twelve years in prison with no chance for parole. She was projected to be released in 2010.

The medical community has strongly opposed McKnight’s prosecution and conviction. From the beginning, leading South Carolina and national medical, public health, and child welfare organizations and experts have opposed the prosecution and conviction. These organizations—represented by us– the National Advocates for Pregnant Women and the Drug Policy Alliance, with South Carolina counsel Susan Dunn included the South Carolina Medical Association, the South Carolina Nurses Association, the South Carolina Association of Alcoholism and Drug Abuse Counselors, and the South Carolina Coalition for Healthy Families argued in an amicus (friend of the court) brief argued that women do not lose their rights to a fair trial upon becoming pregnant and challenged the state’s evidence that cocaine use or anything else that McKnight did or did not do caused the stillbirth.

In 2002 NAPW with numerous allies challenged the constitutionality of using homicide statutes to prosecute women who experience stillbirths. On appeal, a bare majority of the State Supreme Court upheld the conviction and the new interpretation of the state’s homicide law. The Court held that a pregnant woman who unintentionally heightens the risk of a stillbirth could be found guilty of “extreme indifference to human life” homicide. Under this decision a conviction for homicide is permitted on any evidence that a pregnant woman engaged in activity “public[ly] know[n]” to be “potentially fatal” to a fetus. The U.S. Supreme Court refused to review the decision.

Today’s ruling focused on the question of whether Ms. McKnight received a fair trial and concluded that Ms. McKnight’s counsel was “ineffective in her preparation of McKnight’s defense through expert testimony and cross-examination.” The decision also indicated that the medical and scientific basis for her prosecution and that of other women in the state is based on outdated and inaccurate medical information.

“Significantly, the opinion acknowledges that current research simply does not support the assumption that prenatal exposure to cocaine results in harm to the fetus, and the opinion makes clear that it is certainly ‘no more harmful to a fetus than nicotine use, poor nutrition, lack of prenatal care, or other conditions commonly associated with the urban poor.’” said Susan K. Dunn, South Carolina co-counsel for amicus. “This decision puts Solicitors [prosecutors] across the state on notice that they must actually prove that an illegal drug has risked or caused harm—not simply rely on prejudice and medical misinformation.”

This ruling addressed a petition filed on behalf of McKnight seeking a judicial review to determine whether the person is imprisoned lawfully or should be released from custody. The petition must show that the court ordered the imprisonment based on a legal or factual error. In McKnight, the factual error was accepting a causal link between McKnight’s cocaine use and her stillbirth. The Court held that the legal errors were not calling medical expert as witnesses who could refute that link, failing to investigate the medical evidence the state’s witnesses relied on and that was based on outdated scientific studies, and failing to challenge the court’s confusing and contradictory explanations to the jury of what “intent” Ms. McKnight had to have.

“Ms. McKnight is one of more than 500 women in South Carolina who experience stillbirths each year, and in many of those cases, medicine just can’t determine the cause,” said Brandi Parrish, coordinator of the South Carolina Coalition for Healthy Families and NAPW local ally. “It is a tragedy that Ms. McKnight has been in prison for nearly eight years for a crime she did not commit. Families in South Carolina are not helped by treating stillbirths as crimes and wasting hundreds of thousands of tax dollars to imprison innocent mothers.”

The medical and public health groups also raised concerns about the consequences of South Carolina ’s policy of arresting pregnant women who experience drug problems. In their brief, they cited the fact that threatening pregnant women with jail time deters them from seeking prenatal care and other vital services, as has been the case in South Carolina since the Whitner ruling in 1997 that originally permitted prosecution of pregnant women under state child endangerment charges.

Ms. McKnight is represented on the petition by C. Rauch Wise of the American Civil Liberties Union of South Carolina Foundation, Inc., and Matthew Hersh and Julie Carpenter of the law firm Jenner & Block for the DKT Liberty Project.

racism and infant mortality

May 21, 2008 § Leave a comment

Disparities In Infant Mortality Not Related To Race, Study Finds

ScienceDaily (Jul. 31, 2007)The cause of low birth weights among African-American women has more to do with racism than with race, according to a report by an associate professor of pediatrics at the University of Illinois at Chicago.

In a report published in the July issue of the American Journal of Public Health, Richard David says the quest for a “pre-term birth gene” that is now underway will be of no value in explaining low birth weights.

David is the report’s lead writer and co-author with James Collins Jr., professor of pediatrics at Northwestern University. David is affiliated with John H. Stroger Jr. Hospital and Collins with Children’s Memorial Hospital.

They compared birth weights of three groups of women: African American, whites and Africans who had moved to Illinois. Most African-American women are of 70 to 75 percent African descent.

“If there were such a thing as a (pre-term birth) gene, you would expect the African women to have the lowest birth weights,” David said. “But the African and white women were virtually identical,” with significantly higher birth weights than the African-American women, he said.

The researchers did a similar analysis of births to black Caribbean women immigrants to the United States and found they gave birth to infants hundreds of grams heavier than the babies of U.S.-born black women.

For black women, “something about growing up in America seems to be bad for your baby’s birth weight,” David said.

Another argument against a genetic cause is that children of American black women rate higher for all the major causes of death in the child’s first year.

“Genetic diseases pop up at random in different (racial) populations,” David noted. “But one group is taking all the hits. If this were a genetic problem it wouldn’t fit that pattern.”

Moreover, birth weights are not static but change in every population and from one generation to the next. Genetic shifts, however, “take place over thousands or tens of thousands of years,” he said.

One reason African-American mothers have babies who weigh less at birth is that they are at greater risk for such conditions as high blood pressure and preeclampsia.

Also, minority women are subject to stress caused by perceived racial discrimination, the researchers said.

David and Collins spoke with black women who had babies with normal weights at birth, comparing them with black women whose babies’ birth weight was very low — under three pounds.

They asked the mothers if they had ever been treated unfairly because of their race when looking for a job, in an educational setting or in other situations.

Those who felt discriminated against had a twofold increase in low birth weights. And for those who experienced discrimination in three “domains,” the increase was nearly threefold.

In David and Collins’ study of black women who gave birth in two Chicago hospitals, 16 percent said their partner was in jail during the pregnancy.

“We interpreted this finding as another indicator of stress, but one caused by institutional rather than interpersonal racial discrimination,” David said.

disadvantage inequality and social policy

May 21, 2008 § Leave a comment

So a few months ago I was having a conversation with white mother and daughter about why infant mortality rates are so much higher in the states than in other countries.  The mother said that she thought it was because in the states so many middle class women are having children after 40 years of age.  I said that I thought it was related to the extensive poverty throughout the US.  Ever since then I have been keeping my eyes out for connections between race, poverty, culture, and infant mortality, mother health, etc.

So today a few selections from

Disadvantage, Inequality, And Social Policy

But what if policies that most enhance population health and increase disparities also bring large increments of improved health to those who are most disadvantaged? It is reasonable to accept disparities if the health of all groups is enhanced.

This dilemma is illustrated by examining progress in reducing U.S. infant mortality between 1950 and 1998.9 Black infant mortality in 1950 was 43.9 deaths per thousand live births, 64 percent higher than the white rate of 26.8. By 1998, black infant mortality fell to 13.8 deaths per thousand compared with a white rate of 6.0, a disparity of 130 percent.10 In every five-year period since 1965, more black babies than white babies were saved per thousand live births. A comparison of deaths in 1950 and 1998 indicate a reduction of 20.8 deaths per thousand live births for whites and a 30.1 reduction for blacks, an absolute change that favored blacks 50 percent more than whites. Ironically, this occurred while the magnitude of disparities in infant mortality increased, with the exception (discussed later) of the period 1965–1975, when blacks gained relative to whites.

If the derivation from Link and Phelan is correct, overall efforts to improve population health through new technological changes such as preventive screening, modifying smoking and other substance abuse, increasing exercise, improving nutrition, and many more may well increase disparities. Such initiatives, however, might improve the absolute health of disadvantaged groups more than would initiatives directed specifically at reducing health disparities.

so i guess we should just be grateful that a rising lifts all boats.

in this article David Mechanic makes a false dichotomy.  He posits the question as: Should we aim for overall health improvement or should we put our resources into targeting vulnerable populations even if it at the loss of white or more financially well-off communities.  Yet he does not show us when has targeting vulnerable populations ever led to less healthy communities of privilege.

He goes on to say: Interventions may improve population health without increasing disparities if directed at problems that are much more prevalent among disadvantaged groups and that offer a relatively simply executed and efficacious remedy….

and ends the article by saying:

Reducing health disparities is a complex task involving important considerations as to how to achieve the largest gains for disadvantaged persons from the investments made. The irony is that some of the largest gains possible for disadvantaged persons through population initiatives may have the effect of increasing disparities because of the dynamics of advantage. Health disparities impress many of us as fundamentally wrong and undesirable, but a compelling case could be made for policies that maximize population health at the cost of disparities when they provide large life and health benefits to disadvantaged groups as well as to others.

Strategies to redistribute income to the poor will remain contentious, although there is strong support for policies that help persons to attain health insurance and medical care access and for helping workers achieve a livable wage. Most thoughtful persons also understand the importance of maintaining a reasonable safety net for persons with disabilities and persons who are homeless, sick and uninsured, or temporarily down on their fortunes. Disagreements continue on how to respond to the more long-term welfare population who exhaust their eligibility. However this issue is resolved, there is much to be said for aggressive policy efforts in areas such as education, where positive outcomes can be expected and where there is much public support.

So it looks like  the dynamics of advantage are at work not only in current health care policies.  But also in future visions of US healthcare.  For example health care initiatives are limited by how much public support there is for the initiative.  And the public is not going to support a policy which readjusts these dynamics of advantage toward white folk.  It is easier to get support for initiatives which allow for some improvement in the health of vulnerable communities without changing the fundamental disparity between rich and poor white and colored.

sexuality and sex education

May 18, 2008 § Leave a comment

great series of thoughts on sexual apostasy. i am not sure if i agree with her characterization of progressive sex education. i never got to take that class in high school. my sex education was considered rather progressive. we were told what sex was, how to be safe while doing it, and sexual morality comes from the home. but then i am old.

but i love the reference to the puritans.

I don’t think teen and young adults should NEVER have sex, ever. But they could NOT have sex until, you know, long-term relationship time rolled around. I mean, the idea of emphasizing celibacy for a period of time until one enters into a long-term relationship is honestly never a part of any sex education i’ve seen advocated by either right-wing people or left-wing people.

Altogether too many liberals find it being problematic that sectarians focus on sexual sin to the exclusion of other sins. But it’s problematic to err in the other direction and think that always choosing the option to have sex is ‘better’, which is the subtext you get from the other side. Plenty of people who are given to natural celibacy or asexuality, or even people who do want to wait and only have one partner for their own reasons often, often, often are considered strange and weird for not choosing the option to have sex.


Also, and this is key, we now live in a society that does not understand why the aggressively anti-gay whatnot is just as much a symptom of endless indulgence as aggessively pro-gay. People feel free in this culture to indulge it all, be it tolerant support or intolerant dislike or outright hatred. It is an unintended consequence, but there it is.

The Puritans were so much more rational about it all. Wives and husbands were to please each other in bed and premarital sex was strongly discouraged, but you weren’t reviled if you had sinned that way because everyone sins and sexual sin wasn’t broken out and considered ‘worse’ than other sins and specific sexual sins weren’t judged as uniquely awful (like the current sectarian gay-hate– Puritans would have recognised that behavior as distinctly unChristian and rebuked it accordingly). But history is written by those who overthrew them, so the word has come to mean almost the opposite of what Puritans actually thought and believed, especially (though not limited to) sex.

birth, american way

May 17, 2008 § Leave a comment

birth, the american way

id like to see the movie…

black women mental health needs unmet

May 17, 2008 § Leave a comment

from womens enews

By Shauna Curphey

black women mental health needs unmet

But mental health problems are not confined to low-income women. African American women higher on the socioeconomic ladder experience their own set of pressures, especially in the workplace, where they feel they are often treated as if they do not deserve to be there, said Morrow. As a result, black women struggle with a pressure to out-perform others just to gain acceptance. She used her own career as an example.

“I had to be at the top of my class,” said Morrow in a phone interview, “I was always seeing myself being compared and competing with this white ghost . . . These issues play out in the lives of black folk. It is impacting how they feel about themselves and it is impacting their physical and mental health.”

Sixty percent of African American women have symptoms of depression, according the national study conducted for the Black Women’s Health Imperative. In addition, research indicates that the stress in the lives of African American women contributes to poor physical health. Stress related to racism may underlie the poor diet and resulting obesity among black women and may be associated with the high prevalence of high blood pressure and diabetes, according to the Women of Color Health Data Book.

Lack of insurance also contributes to the low percentage of black women who seek mental health treatment. Nearly one in four African Americans is uninsured. Even among those who have coverage, mental health may not be included in the policy or the cap on covered expenses may be low. But better insurance coverage alone is not enough get more women to seek help. African American women also struggle against the stigma associated with mental-health treatment.

breast feeding rate highest in decades

May 17, 2008 § Leave a comment

Breastfeeding Rate Highest In Decades; Black Women Have Most Significant Increase, Report Finds

The number of new mothers who breastfeed their infants during the first months of life has increased to 77%, up from 60% in 1993-1994, with the sharpest increase among black women, according to a CDC report, the Associated Press reports (Stobbe, Associated Press, 5/1). The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists recommend that women breastfeed their infants exclusively until six months of age and breastfeed as a supplement to baby food until age one. Research indicates that formula-fed children have higher risks of ear and respiratory infections, obesity, diabetes and cancer, according to the New York Times.

The report, which is part of the National Health and Nutrition Examination Survey, is based on data collected in 2005 and 2006 for 434 infants. Researchers found that 65% of black women breastfed, up from 36% in 1993-1994 (Harris, New York Times, 5/1). Historically, black women have had lower breastfeeding rates than other groups, according to Former U.S. Surgeon General David Satcher. Mexican-Americans had the highest overall breastfeeding rate at 80%, which increased from 67% in 1993-1994. Among whites, 79% breastfed in the latest survey, up from 62% (Associated Press, 5/1). Researchers also found that 57% of low-income women breastfed and that 43% of women under age 20 breastfed.

Satcher said, “It was very impressive that when it comes to beginning to breastfeed, [black women] have had the greatest progress” (Associated Press, 5/1). According to the Times, the increases can be attributed in part to campaigns by medical and governmental groups to educate women about the benefits of breastfeeding. Breastfeeding experts said that the findings are positive but stressed that breastfeeding rates at age six months have remained stagnant. The current report did not examine rates at age six months (New York Times, 5/1).

a bit chiropractry

May 7, 2008 § Leave a comment

A chiropractor in Eugene, Oregon, recommends the following technique for relaxation and ease of back labor. With the woman positioned on hands and knees, or in any forward-leaning position she finds comfortable, the midwife stands next to her at the waist, cephlad to pelvis (facing away from the woman’s head). She puts pressure with the heel of her hand on the posterior aspect of (behind) the sacrum and applies downward pressure to the sacrum in a caudad direction (away from the woman’s head). He states that from a chiropractic and neurologic view, this technique is more beneficial than applying pressure to the sacrum in an upward or directly inward direction while positioned behind the woman.

~ Douglas Carlstrom

wide racial disparities in reproductive health

May 3, 2008 § Leave a comment

A United Nations committee has expressed concern about “wide racial disparities” in sexual and reproductive health in the United States.

Not only did the Committee recognize the need for the U.S. to take action to address racial disparities, it rejected the government’s argument that the poor health outcomes arose from behavioral choices rather than government policy choices that fail to address American citizens’ human right to adequate reproductive health care. In order to address these needs, the Committee recommended that the U.S.: (1) improve access to pre- and post-natal care, including by eliminating eligibility barriers to Medicaid, (2) facilitate access to contraceptive and family planning methods, (3) provide adequate sexual education aimed at the prevention of unintended pregnancies and STIs.

May 2, 2008 § Leave a comment

so i caught this blog post….yeah, i went fishing…and i loved it…reminds me of being preggers in palestine…i think that it is important to have a diversity of ideas (and no i am not just saying diversity in terms of race and ethnicities…) and experiences of pregnancy represented.  hwne we ignore all of the diferent ways that pregnancy is experiencd in the staes we cheat ourselves of what dows it mean to live here with reproductive organs (to get technical)…

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