September 13, 2007

Mind the Gap

Filed under: Health Care, Family Issues — maha @ 10:33 pm

Fascinating information from Eesha Pandit at Reproductive Health Reality Check:

The Alabama Department of Public Health released a report that shows a link between birth outcomes and health insurance, as reported by the Decatur Daily. The report, by the department’s Center for Health Statistics, examined birth certificates for 60,262 live births, and among other things:

    ▪ Infants born in Alabama in 2005 were more than three times likely to die in the first year if their mothers paid for their deliveries out-of-pocket than those with private health insurance;
    ▪ Infants in deliveries covered by Medicaid were 40% more likely to have low birth-weights and 60% more likely to die than infants with private insurance;
    ▪ White women were more likely to have private health insurance than minority women;
    ▪ Medicaid covered deliveries for nearly four out of every five births among teenage girls and 40% of births involving women ages 20 to 34;
    ▪ Private insurance covered nearly 80% of births among women ages 35 and older; and
    ▪ Nearly all women with private insurance received prenatal care within the first trimester, compared with 74.7% of women with Medicaid.

Now whether Medicaid has merely become a marker for things like education, age, race and economic status, is up to debate. What is clear, though, is the fact that these factors do indeed affect access to reproductive healthcare, and that Medicaid is not a sufficient solution for social inequities.

The simple-minded might read this as an endorsement of private health insurance over “government” health care. In April, Erik Eckholm wrote in the New York Times about a rise in the deaths of babies born to poor and mostly black mothers in southern states — Alabama, Louisiana, Mississippi, North Carolina, South Carolina, and Tennessee. Focusing mostly on Mississippi, Eckholm said Medicaid patients had a difficult time finding and getting to providers.

But social workers say that the motivation of poor women is not so simply described, and it can be affected by cuts in social programs and a dearth of transportation as well as low self esteem.

“If you didn’t have a car and had to go 60 miles to see a doctor, would you go very often?” said Ramona Beardain, director of Delta Health Partners. The group runs a federally financed program, Healthy Start, that sends social workers and nurses to counsel pregnant teenagers and new mothers in seven counties of the Delta. “If they’re in school they miss the day; if they’re working they don’t get paid,” Ms. Beardain said. …

…In 2004, Gov. Haley Barbour came to office promising not to raise taxes and to cut Medicaid. Face-to-face meetings were required for annual re-enrollment in Medicaid and CHIP, the children’s health insurance program; locations and hours for enrollment changed, and documentation requirements became more stringent.

As a result, the number of non-elderly people, mainly children, covered by the Medicaid and CHIP programs declined by 54,000 in the 2005 and 2006 fiscal years. According to the Mississippi Health Advocacy Program in Jackson, some eligible pregnant women were deterred by the new procedures from enrolling.

One former Medicaid official, Maria Morris, who resigned last year as head of an office that informed the public about eligibility, said that under the Barbour administration, her program was severely curtailed.

“The philosophy was to reduce the rolls and our activities were contrary to that policy,” she said.

The outcomes described by Eesha Pandit at Reproductive Health Reality Check speak loudly and clearly — babies born to women who are cut off from decent health care are at greater risk. Eckhold continues,

Whether the rises continue or not, federal officials say, rates have stagnated in the Deep South at levels well above the national average.

Most striking, here and throughout the country, is the large racial disparity. In Mississippi, infant deaths among blacks rose to 17 per thousand births in 2005 from 14.2 per thousand in 2004, while those among whites rose to 6.6 per thousand from 6.1. (The national average in 2003 was 5.7 for whites and 14.0 for blacks.)

That racial discrepancy has a lot to do with why the overall infant mortality rate in the United States is high compared to other industrial first-world nations. Eesha Pandit writes,

In a report from Save the Children released this May, entitled State of the World’s Children, 125 nations were ranked according to 10 gauges of well-being — six for mothers and four for children — including objective measures such as lifetime mortality risk for mothers and infant mortality rate and subjective measures such as the political status of women. Among industrialized nations, the US was second to last (ranked only above Latvia).

See also: “Haley Barbour, Baby Killer,” “At Least We Beat Latvia.”

Infant mortality in the U.S. has been relatively high for many years. Yet most Americans either don’t know this or dismiss the statistics as fake. We do have The Best Health Care System in the World™, after all.

It’s true that some of the problem with our infant mortality rates can be attributed to different standards in what’s considered a live birth. In a small percentage of births, a birth that would count as a live birth by U.S. medical standards would be considered a stillbirth in other countries, and thus would not count as an infant mortality. But my understanding is that when these births are taken into account, the U.S. doesn’t move up much. What’s really cranking up the death rates of U.S. babies is the high infant mortality rate among the poor, especially the poor and black, in the United States.

There are also significant differences in infant mortality rates among the states. According to a recent release from the Center for Disease Control:

Three years of data (2002-2004) were combined to get specific estimates of infant mortality rates by state, race and Hispanic origin. For the three-year period there were significant differences in infant mortality rates by state, ranging from a rate of 10.32 [per 1,000 births] in Mississippi to 4.68 in Vermont. For infants of non-Hispanic black mothers, rates ranged from 17.57 in Wisconsin to 8.75 in Minnesota. For infants of non-Hispanic white mothers, the infant mortality rate ranged from 7.67 in West Virginia to 3.80 in New Jersey.

As I wrote here, American hospitals generally provide excellent care for newborns. But too many American babies are born prematurely, or with low birth weight or other preventable problems. And many of these problems can be traced to a lack of basic prenatal care.

Today UNICEF declared that the rate of child mortality worldwide has dropped considerably. Happy news. A table showing rates by country 1960-2005 shows a slight drop in deaths of children under 5 in the U.S. also. But all of the western European nations on the list have lower rates, as do Australia, Canada, Cyprus, the Czech Republic, Japan, South Korea, New Zealand, Singapore, and Slovenia. Shit, people, we don’t even beat Slovenia.

Spotlight

March 7, 2007

Flexible Lives

Filed under: Republican Party, Family Issues, American History — maha @ 9:41 am

Following up this post from Sunday — Harold Meyerson has a must-read column about The Decade That Destroyed Family Values in the Washington Post:

As conservatives tell the tale, the decline of the American family, the rise in divorce rates, the number of children born out of wedlock all can be traced to the pernicious influence of one decade in American history: the ’60s.

The conservatives are right that one decade, at least in its metaphoric significance, can encapsulate the causes for the family’s decline. But they’ve misidentified the decade. It’s not the permissive ’60s. It’s the Reagan ’80s.

(I am reminded, once again, of the definition of pseudo conservative — “The pseudo conservative is a man who, in the name of upholding traditional American values and institutions and defending them against more or less fictitious dangers, consciously or unconsciously aims at their abolition.” — Theodore W. Adorno)

In Saturday’s Post, reporter Blaine Harden took a hard look at the erosion of what we have long taken to be the model American family — married couples with children — and discovered that while this decline hasn’t really afflicted college-educated professionals, it is the curse of the working class. The percentage of households that are married couples with children has hit an all-time low (at least, the lowest since the Census Bureau started measuring such things): 23.7 percent. That’s about half the level that marrieds-with-children constituted at the end of the Ozzie-and-Harriet ’50s. …

… Over the past 35 years, the massive changes in the U.S. economy have largely condemned American workers to lives of economic insecurity. No longer can the worker count on a steady job for a single employer who provides a paycheck and health and retirement benefits, too. Over the past three decades, workers’ individual annual income fluctuations have consistently increased, while their aggregate income has stagnated. In the brave new economy of outsourced jobs and short-term gigs and on-again, off-again health coverage, American workers cannot rationally plan their economic futures. And with each passing year, as their level of economic security declines, so does their entry into marriage.

Yet the very conservatives who marvel at the efficiency of our new, more mobile economy and extol the “flexibility” of our workforce decry the flexibility of the personal lives of American workers. The right-wing ideologues who have championed outsourcing, offshoring and union-busting, who have celebrated the same changes that have condemned American workers to lives of financial instability, piously lament the decline of family stability that has followed these economic changes as the night the day.

American conservatism is a house divided against itself. It applauds the radicalism of the economic changes of the past four decades — the dismantling, say, of the American steel industry (and the job and income security that it once provided) in the cause of greater efficiency. It decries the decline of social and familial stability over that time — the traditional, married working-class families, say, that once filled all those churches in the hills and hollows in what is now the smaller, post-working-class Pittsburgh.

Problem is, disperse a vibrant working-class community in America and you disperse the vibrant working-class family.

Sometime during the Reagan Recession, President Reagan made a flip remark about laid-off factory workers. In effect, he said they could “vote with their feet” and move to some other part of the country to find better jobs. He was, of course, oblivious to what “voting with their feet” would do to families and communities.

As I wrote last Sunday, an article by Sharon Lerner in the New York Times discussed declining birthrates in Europe. The European experience suggests that “conservative” social policies discourage women from having children. In a nutshell, “conservative” countries provide little public support for working mothers, so women postpone having children. By contrast, those “socialist” Scandinavian countries that provide subsidized day care and mandate generous maternity leave policies have higher birthrates, because Scandinavian women are less likely to feel they have to choose between work and babies.

The problem with conservatives is that they try to apply pre-industrial models onto an industrial (and post-industrial) world. The “Ozzie and Harriet” family we’ve come to think of as the norm — dad works outside the home, mom stays home and raises kids — is actually a creation of the industrial revolution. Before the industrial revolution, most men worked for themselves as craftsmen or farmers and were not separated from their families by jobs. If a man had sons, the sons probably started working with dad while they were very young and, thereby, spent a great deal of time with him. But the industrial revolution changed that; men left the home and family to work in jobs, and in effect the jobs separated them from their children.

(It speaks volumes, I think, that before the 20th century, when a married couple divorced the father automatically got custody of the children. Sometime in the 20th century the idea that children “belonged” primarily to mothers had taken hold, and the law preferred mothers over fathers. The move to revise divorce laws and favor joint custody in the 1970s was actually a by-product of the feminist movement. Most “Father’s Rights” advocates, of course, still complain that the courts favor women and blame feminism for this, but most of these creatures seem less interested in their children than they are in using their kids to bash their wives and gripe about women generally.)

By the 1950s the notion that raising kids was “women’s work” was firmly entrenched. In fact, I clearly remember that when one of the very early issues of Ms. magazine argued that raising kids was “men’s work,” too — the cover featured a smiling man holding a baby — conservatives of the time were actually outraged. Of course, 20 years later conservatives were wailing about how children needed fathers and complaining that “feminazis” were destroying the American family.

Anyway, shortly after World War II Joseph Campbell began to argue that this exclusion of fathers from family life was creating a faux masculinity, which I wrote about yesterday. For that matter, the faux femininity that Betty Friedan wrote about in The Feminine Mystique was mostly a post World War II phenomenon, you might recall.

The bottom line is that, over the last couple of centuries, the rise of capitalism as the way most money gets made has had profound effects on society in general and families in particular. We’re still trying to figure out how to blend capitalism with a healthy family life. In America and other “conservative” countries, the burden of making the capitalism-family equation work is put on individuals. And this is true even now that, in most families, both parents are separated from their children most of the day. But conservatives worship at the altar of capitalism and are blind to its pernicious side effects, even as families and marriage itself are literally breaking apart under the strain.

I think it ought to be possible to maintain private property rights and free enterprise and all that — well, in fact, it was possible before the Reagan Revolution began dismantling the New Deal. But to make it work, government must do a better job supporting workers and families. Teddy Roosevelt said almost a century ago,

The true friend of property, the true conservative, is he who insists that property shall be the servant and not the master of the commonwealth; who insists that the creature of man’s making shall be the servant and not the master of the man who made it. The citizens of the United States must effectively control the mighty commercial forces which they have called into being.

The Right sees capitalism as the master and workers as capitalism’s servants. And for all their talk about family values, when they have to choose between children and money, money wins every time.

Spotlight

March 4, 2007

What Righties Mean by “Support”

Filed under: Bush Administration, Iraq War, Family Issues — maha @ 2:30 pm

Along with “the troops,” another entity righties claim to “support” is “the family.” As in “marriage” with “children.” So one assumes righties will be disturbed by this story by Blaine Harden in today’s Washington Post:

Punctuating a fundamental change in American family life, married couples with children now occupy fewer than one in every four households — a share that has been slashed in half since 1960 and is the lowest ever recorded by the census.

As marriage with children becomes an exception rather than the norm, social scientists say it is also becoming the self-selected province of the college-educated and the affluent. The working class and the poor, meanwhile, increasingly steer away from marriage, while living together and bearing children out of wedlock.

Does this mean President Bush’s Healthy Marriage Initiative isn’t working? The HMI, you might remember, was George Bush’s cure-all for welfare. Bush budgets carved money out of Medicaid and other “entitlements,” but in 2006 HMI was allocated $750 million ($150 million per year for five years). The goal of HMI is to increase the number of children raised by married couples. (Here is a good analysis of HMI by Emily Amick of Wellesley College.)

The point of the marriage initiative isn’t just to provide children with stable homes, but also to raise families out of poverty. For quite a while righties have noticed that, statistically, poor families are likely to be single-parent families. Therefore, deep thinkers like these geniuses at the Heritage Foundation concluded that if only poor women could be persuaded to get married (like it never occurred to them before) they’d automatically be on the road to the Middle Class. Robert Kuttner explained in 2002:

When the welfare reform program of 1996 comes up for renewal later this year, it will have a new emphasis — wedding bells. The Bush administration wants to spend $300 million of scarce welfare funds to encourage marriage and another $135 million promoting premarital chastity.

Several governors have already jumped the (shot)gun with state programs to promote marriage, not just for welfare recipients but for everyone. Some conservatives, like Robert Rector of the Heritage Foundation, would go further and provide $4,000 bounties for poor people who marry.

But the Blaine Harden article suggests righties were putting the cart before the horse. It wasn’t the erosion of marriage causing poverty, but increasing financial instability causing an erosion in marriage.

Marriage has declined across all income groups, but it has declined far less among couples who make the most money and have the best education. These couples are also less likely to divorce. Many demographers peg the rise of a class-based marriage gap to the erosion since 1970 of the broad-based economic prosperity that followed World War II.

“We seem to be reverting to a much older pattern, when elites marry and a great many others live together and have kids,” said Peter Francese, demographic trends analyst for Ogilvy & Mather, an advertising firm.

Another grim trend for the “family values” crowd — Sharon Lerner writes in today’s New York Times that women in industrialized nations are having fewer children.

To the dismay of pundits and politicians alike, women in industrialized countries and elsewhere have been bearing fewer and fewer children. More than 90 states have fertility rates below the replacement level of 2.1 children per woman, and the trend, which began in the early 1960s, is already leading to fewer workers, graying populations and dire predictions about vanishing peoples.

The Right will tell you this is the doing of those liberal anti-family, pro-Hollywood types. But wait …

Curiously, Europe’s lowest birthrates are seen in countries, mostly Catholic, where the old idea that the man is the breadwinner and the woman is the child-raiser holds strong. Portugal, Spain, Italy and Greece have among the lowest fertility rates in Western Europe. Meanwhile, countries that support high numbers of working women, like Finland, Norway and Denmark, have among the highest birthrates.

And how did this happen?

One explanation is that the more traditional countries face particular challenges when their women do start to work. In these countries, the welfare of the family is still typically seen as the responsibility of individuals rather than of the government, according to Peter McDonald and Francis Castles, who are demographic theorists. And with little public support for working mothers forthcoming, women are likely to think they must choose work or motherhood. At least for now, it seems, many are choosing neither. Statistics show that women in these countries are both less likely to work and less likely to bear children than their counterparts in, say, Scandinavia.

Scandinavia?

In Scandinavia, extensive public child-care systems offer a slot to virtually every child under 5 whose parents work. Do such programs have an effect? Some experts have linked changes in Sweden’s birthrate to paid-maternity-leave policies. And according to Ronald Rindfuss, a sociologist, Norwegian women who live in towns with more day-care slots available have more children and become mothers earlier. The timing of births is important, because lower fertility rates may owe something to the fact that many women inadvertently delay becoming pregnant until it’s no longer biologically possible.

So what about the United States? Immigrants to the rescue —

Looking at America’s fertility rate, which now hovers around replacement level, you could assume that the U.S. has escaped such problems. But in fact, it’s the relatively large families of new immigrants that are staving off a population crisis — and masking the difficulties women face when they try to “have it all.” With a largely hands-off approach to family policy, the U.S. spends far less than other wealthy countries on child care while guaranteeing no paid parental leave. As a result, being an employed parent may be more difficult here than in countries now experiencing even the most severe baby droughts.

In his 2002 TAP article linked above, Robert Kuttner remarked that, on the American Right, having “family values” means being opposed to having government do anything that might actually help families.

With no sense of contradiction, the welfare reformers demand that single mothers work or lose all benefits — so much for Mom staying home. But missing from the equation is high quality childcare, so necessary to reconcile working motherhood, sane family life, and healthy children, whether for single moms or working couples.

Why is the childcare link missing? Because of conservative ideology: socially provided childcare violates ‘’traditional values'’ and costs public money.

Scholarly assessments of the welfare reform experiment reveal a bitter paradox: The more that single mothers ‘’succeed'’ by getting off welfare and staying in low-wage employment, the more their unsupervised teenage children are placed at risk.

Kuttner brings up the Scandanavian factor:

So if the administration were serious about promoting healthy marriages and flourishing children (and not just throwing a steak to the religious right), it would be pushing several other policies — jobs that paid living wages, high quality child care, paid parental leaves, sex education that includes birth control as well as early teen abstinence, and generous treatment of children who happen to be born to single parents.

Won’t this just reward single parenthood? In Norway, public policy provides all of these supports, yet a higher percentage of kids grow up with both their parents, more mothers are in paid work, and far fewer families and children are poor.

But policies such as these accept the realities of modern family life and they challenge archaic notions of sex roles and traditional values beloved by the religious right. They also cost tax dollars that were just given away to multimillionaires.

So when righties say they support “family values,” this doesn’t mean supporting families and children. It means supporting an idea of “families” and “children.” Real families and children must fend for themselves. Likewise, when righties say they support “the troops,” this does not, in fact, mean supporting the troops. It means supporting an idea of “troops” as part of their idea of glorious victory in the magnificent war in Iraq (meaning a fantasy of Iraq, not the actual place).

And, of course, “support” means a conceptualization of support. It doesn’t extend to concrete support, such as raising tax dollars to pay for body armor, or hospital care, or covering one’s own precious skin with a uniform and going off to fight in Iraq (the actual place).

I hope that’s clear.

Spotlight

June 13, 2006

Oh, those silly kids

Filed under: liberalism and progressivism, Women's Issues, Family Issues, Feminism — fshk @ 5:09 pm

One of the comments to my post about the HPV vaccine mentioned that it was nice to see a “younger” voice on this blog, so that’s what I want to post about now, while the maha-in-chief is still in Washington.

A few links. Sadly, some of these are behind subscription walls.

My mother has said to me that the feminist movement is effectively dead, but, although I think the movement has lost some of its oomph for sure, I like to think it’s still flailing and kicking somewhere. Perhaps on college campuses: Salon’s Broadsheet reports that an organization of anti-feminists is opening up chapters on campuses all over the country:

These young women read Danielle Crittenden and Christina Hoff Sommers, attend conferences key-noted by Ann Coulter and Elaine Chao, spread jittery but false gossip that Lynne Cheney is a donor, and host 80’s dances in honor of Ronald Reagan’s birthday.

Kinda sends shivers down your spin, dudn’t it?

Broadsheet crows that this is a sign that women’s movements are enjoying a “a vibrant, exciting renaissance” among college-aged women. I hope that’s true; certainly when groups emerge to oppose you, it’s a sign that you’re doing something right.

But, so, young people. There’s a vicious cycle at work wherein young people don’t participate politically and therefore their interests aren’t represented or talked about and therefore they don’t want to participate. It means us 20-somethings get slandered a lot for being lazy or entitled.

Young women in particular are left out of the conversation. A friend of mine recently pointed to MoveOn’s most recent campaign as an example. Ten issues were voted on and narrowed down to three big ideas: “Health care for all, energy independence, and restored democracy.” Worthy goals, certainly, but of the ten issues originally presented to us, not one of them dealt with the eroding rights of women — access to abortion and birth control, which you may think is a pet issue, but which I think is key to women’s autonomy and equality, and that’s a hell of a big deal to me. Or equal pay, for that matter. Or better family policies, like access to childcare and better maternity/paternity leave… and these are “women’s issues” in the public discourse, I guess because “family” still falls in the women’s sphere — that’s some progress, eh? All that is right up there with health care for everyone and whatever “restored democracy” means, for me. (Energy, too, insofar as I’d like for us to find sustainable and renewable alternatives before we all bake, but I don’t own a car, so “gas prices are too high” is not really a motivation for me to advocate anything.)

Ah, but how do you get those pesky kids to vote?

One last link, while we’re talking about gender issues: Everyone’s favorite cabbage argues that girly books make boys not want to read. And we’re back on the whole “male and female brains are wired differently and so boys and girls excel in different subjects” nonsense debate. Last I checked, Brooks was not a scientist, so I don’t see how not liking Jane Eyre gives him the authority to make suppositions like that. And the whole debate ignores how kids and their teachers are socialized. But why am I so angry? I should not expect so much from the produce aisle.

Spotlight

March 10, 2006

There’s Got to Be a Morning After

Filed under: Bush Administration, Women's Issues, Family Issues, abortion, Feminism — maha @ 1:33 pm

More reproductive rights news to follow up “The Daughter Effect“:

Tony Pugh of Knight Ridder reports that Rep. Henry Waxman (da man!) discovered the Bush Administration is not being honest (ah-HEM!) about its morning-after-pill policies.

Internal documents made public Thursday have raised new questions about the federal government’s continued refusal to allow over-the-counter sales of the emergency contraceptive known as “Plan B.”

The documents, obtained by Rep. Henry Waxman, D-Calif., show that in February 2004, policymakers at the U.S. Food and Drug Administration found no problem in allowing the so-called morning-after pill to be sold without a prescription to women of all ages.

Yet 18 months later, former FDA Commissioner Lester Crawford cited concerns about selling the drug to younger teens as a major reason for blocking the move.

The move prompted outrage from women’s rights groups and Democratic lawmakers, who claimed that the agency was blocking the measure for political reasons despite scientific evidence that showed nonprescription sales of the pill were safe.
One FDA official opposed to the decision resigned.

Here’s the juicy part:

Barr Laboratories, the maker of Plan B, originally sought to sell the drug over-the-counter to women of all ages. Only after meeting resistance from FDA officials and conservative organizations did the company opt to require prescriptions for women ages 16 and under.

The FDA records indicate that the change was engineered by FDA senior officials who worked behind the scenes against the company while appearing to remain neutral.

After mid-level FDA officials made their recommendation to approve Plan B sales without prescriptions, their superiors told them that FDA Commissioner Mark McClellan and other senior managers at the agency “cannot support the non-prescription switch of Plan B,” according to the agency’s records.

By that time, the FDA already had begun urging Barr to seek over-the-counter sales for those 17 and older.

Barr eventually did so, but the request was tabled in August 2005 by Crawford, who claimed the move raised “difficult and novel policy and regulatory issues.” The FDA hasn’t yet decided the matter, and Plan B remains available by prescription only.

However, seven states allow Plan B to be sold over-the-counter. These are Washington, California, Alaska, Hawaii, New Mexico, Maine and New Hampshire.

What I want to know is. when is it going to be the morning after for the bozo Bush appointees in the FDA responsible for this nonsense?

Spotlight

November 12, 2005

Fathers’ Rights

Filed under: Family Issues — maha @ 11:08 am

I’m all for equal rights for fathers, but why don’t they have equal liability?

A 4-month-old girl died when her inebriated mother fell asleep on top of her while breast-feeding, prosecutors said. …

The 27-year-old — who was on probation for child neglect — had consumed six double-shot alcoholic beverages at a bowling alley, the complaint said. A toxicologist estimated her blood alcohol level ranged from .15 to .27 percent.

Her husband drove Hawkins and their 4-year-old daughter to the bowling alley and later brought them home, then went out drinking himself, according to the complaint. The baby was unresponsive when he returned an hour later, the complaint said.

Hawkins was on probation for neglect of the same child, and was prohibited from drinking alcohol and from having unsupervised contact with all four of her children at once, court documents show.

If there’s a negleced child, how come only the mother was on probation for neglect? And how come the father isn’t being charged with something regarding the child’s death?

Spotlight

October 15, 2005

Whackjobs Are Made, Not Born

Filed under: Women's Issues, Family Issues — maha @ 9:19 am

Truly, there is nothing new under the sun. This is especially true for child-rearing strategies. Each new generation of parents is bound to reject the old-fashioned techniques of their parents, thought to cause obsessive-compulsive and social anxiety and other disorders dramatized on the Family Channel, in favor of more enlightened practices that promise sparkling, minty-fresh, disorder-free children.

And inevitably, the new new thing is actually something the great-grandparents did to the grandparents, who rebelled against it.

Breast or bottle, solid food introduced early or late, the psychological impact of pacifiers–out of such things are many generational arguments born. But the Mother of All Controversies is–toilet training. Early or late?

Every twenty years or so, some genius promotes the idea that babies should be toilet trained at six months. Just imagine–no more diapers! Never mind that the critters can’t walk to the toilet at six months, or that a baby’s tiny bladder requires frequent emptying, and that babies can’t “hold it” even for the amount of time it takes you to grab them and run for the bathroom. Some pediatricians say that babies aren’t aware of their own urination until they are past the age of two.

So, exactly how does one “train” them?

The answer is, one can’t. It’s the parent–more specifically, the mother–who gets “trained” to anticipate when Little Petunia will need to be potted.

When I was enjoying the postpartum years, conventional wisdom said that early toilet training resulted in neurotic adults. This, and the fact that Procter & Gamble finally got the hang of making disposable diapers that didn’t leak, inspired us moms of the 1980s to keep the kids diapered until they were well into toddlerhood. (This in spite of the consternation of our mothers, who’d given birth to us during a McCarthy-era early-potty-training phase.)

But now those toddlers, grown up, are being sold on the glories of fast-track potty training. Last week Tina Kelley wrote in the New York Times (October 9),

… a growing number of parents are experimenting with infant potty training, seeing it as more sanitary, ecologically correct and likely to strengthen bonds between parent and child.

Translation: Mommy Madness writ large. Somebody (guess who) has to watch junior’s every hiccup for signals that he’s about to go, then grab him and dash for the pot. If, after a few weeks, one’s home smells like some of the gamier sections of the Times Square subway station, that’s just one more thing for Mom to feel guilty about. She may have a closer emotional bond with her baby, but whether that emotion is a positive one is another question.

I don’t have any proof, but I can’t help but suspect the same evil forces behind the “good mothers home school their children” movement are responsible for this “diaper free baby” nonsense. It’s a plot against women, I tell you. If they can’t keep us barefoot and pregnant, they’ll find some other way to keep us docile. Or, at least, preoccupied.

About 2,000 people across the country have joined Internet groups and e-mail lists to learn more about the techniques of encouraging a baby - a child too young to walk or talk - to go in a toilet, a sink or a pot. Through a nonprofit group, Diaper Free Baby (www.diaperfreebaby.org), 77 local groups have formed in 35 states to encourage the practice. One author’s how-to books on the subject have sold about 50,000 copies.

A sink? The kids piddle in the sink? That’s more sanitary?

Look, diapers aren’t so bad. In fact, the diaper thing was the one part of my parenting act I believe I got right. My kids never had diaper rash, because I changed and washed them frequently and treated every spot with copious amount of Desitin ointment, which my mother swore by. And for what it’s worth I didn’t use any kind of powder on them. My kids’ doctors often commented that my babies had the clearest butts they’d ever seen. Whatever else I did or didn’t do right–well, we all survived. But parenting is a hard enough job without making it more complicated.

And, please note that disposable diapers amount to less than one percent by weight or 1.5 percent by volume of the waste in landfills.

Tina Kelley continues,

Ingrid Bauer, author of “Diaper Free! The Gentle Wisdom of Natural Infant Hygiene” (Natural Wisdom Press, 2001), believes it is easiest to begin toilet training in the first six months. To start, parents are taught to hold the baby by the thighs in a seated position against their stomachs and to make an encouraging hiss or grunt. With practice, parents learn their child’s rhythms; some parents sleep next to their children and keep a potty at arm’s reach, or diaper their babies overnight.

One early-training advocate wrote to the New York Times that toilet training for both her daughter and granddaughter began at six months: “Voilà! Both were toilet-trained in a few short weeks.”

A few short weeks? Compare and contrast with the maha method–when my daughter was two and a half, I explained the potty thing to her. She said OK. By the next day she was good to go without diapers, at least during the daytime.

(I’d like to say the same method worked as well with my son. However, he’s a boy, and boys don’t take to civilization quite as easily as girls. He understood perfectly well what was expected; he just didn’t see the point to it. I don’t remember exactly when he finally conceded, but it was in time for Kindergarten.)

Kelley quotes a fast-potty-track mother:

“It’s just so simple,” said Lamelle Ryman, who recently attended a support meeting at an apartment on the Upper West Side. Ms. Ryman, the mother of 7-month-old Neshama, added, “I feel like it’s been such a gift in our relationship.”

Yeah, right. Ms. Ryman may eventually need another maha parenting technique, which I call “locking-the-critters-in-a-room-with-a-case-of-Twinkies- while-Mom-bounces-off-the-wall-for-an-hour-or-two.” It’s cheaper than a therapist.

Speaking of which–when today’s babies grow up, will Freud’s theories on the connection between toilet training and the anal-retentive personality come back into vogue? Stay tuned …

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