Tag: healthcare

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A year ago today

Read the full Baby Talk series

(Content note: infertility, IVF, fatphobia)

A year ago today, my partner and I “properly” began the journey to become parents. We’d been on the path for a very long time: first trying, and trying, and trying, and failing, then trying to get help, and facing some pretty gross obstacles to that; and finally being in a position to overcome those (with money, which tells you how unnecessary those obstacles were in the first place) and then having incredible good luck and at long last, after wanting and hoping and waiting and longing, just over a month ago, she arrived. Our baby. The tiny helpless bean who has completely turned our lives upside down. (Sorry, spoiler alert: this one has a happy ending.)

Of course, I wrote it all down. Even the bits I don’t even want to look at, myself, because they’re too raw. But there are parts I do want to share, and thus my blog is getting resurrected because I’m too much of an old school millennial to do Substack even if they weren’t currently tanking as a platform after pandering to transphobes.

(Yes, even in the posts about how much I love my baby, there will always be politics. You know where you are, right?)

As for the timing: I couldn’t bring myself to post this stuff earlier, unlike my good mate Dave who had the incredible courage-slash-lack-of-filter to write about his and Kim’s journey as it was happening. On top of all the other layers of anxiety we were going through, it just felt like it would be unlucky; or at the very least, it might force us to reveal things we weren’t ready to, even if just by the lack of posting at a critical moment.

But she’s here now, and she’s as close to perfect as she needs to be, and even though I still have that fretful voice in the back of my mind telling me not to count my baby chicken even though she’s already hatched, I think it’s the right time to start pulling all these scattered drafts and notes together – not to mention an essential outlet for my brain as I’m at home on paid parental leave, desperately trying to work out what my life looks like now I’m a mother, and feel almost incapable of considering myself having any other role in the world.

So here’s (most of) what I wrote after that first “proper” consultation – the one where you go to Fertility Associates with a lot of money and say “help us make a baby”. With a few editorial comments from Stephanie-Of-The-Future.

The first consultation is like an infomercial which demands your most intimate details. But wait, if you throw in even MORE money we can take time-lapse photos of the embryo to make sure its legs are on properly. And there are lots of options for freezing the eggs we HARVEST OUT OF YOUR BODY after an unspecified course of drugs and scans that get right up ya.

And all of that costs more money on top of the money you’re already putting in. And will it increase your chances of success? Those chances which are already worse than a coin flip? I could see the value for people who know they have specific genetic conditions, who have already tried and failed a few times – but when it’s your first turn on the carousel it feels like cynical upselling, and in a way, it hurts that early relationship with your doctor, because they’re not just there for you, y’know?

J hates every bit of it and I can’t really blame him. He’s “the problem”. The reason we couldn’t just make a baby the fun way.

And this never stopped being incredibly difficult for both of us.

And the money. Everyone says oh there’ll never be a good time to spend all this money – whether you have to have All The Medical Assistance or even if it just pops out of its own accord, babies are expensive – but it’s so difficult to pull the trigger when maybe if we just wait until THIS contract renews or THIS job offer arrives or THIS chunk of the mortgage is paid off … and of course the Clock Is Ticking and that stupid dotted line on that stupid fucking Probability Of Success Based On Age of Woman graph keeps edging down and down and down.

I will always wish we’d been able to do this sooner. I will always wish that we were in a situation to do it again, to consider having a second baby. What I can tell myself – now, in 2021, with my actual baby coma’d out in the living room after a healthy feed – is that things happen for a reason and if things had happened differently maybe we wouldn’t be here at all.

I’m the problem too, of course. The Aging Woman who didn’t chop her leg off five years ago to qualify for public funding – because that would have been fine, you see. It’s not actually relevant how big my belly is, it makes no difference to the chances of success. BMI is literally just picking one variable – fatness – out of the hat in order to “ration” public healthcare. The best bit is it’s completely fucking racist but our society is so comfortable with openly hating fat people we can get away with pretending it’s not a hatred fundamentally rooted in racism, classism, and body-hating white supremacy.

I could have lost a limb in a terrible accident and the health system would say oh okay, you’re obviously Healthy Enough to have a baby on us.

I could have starved myself, vomited every meal, taken amphetamines, and it would have meant we could have a baby, sooner, and cheaper, and without anyone questioning how it happened – because losing weight when you’re fat is Always A Good Thing.

Jarrod interrupted the doctor to say that I’m a pole dance teacher. I was annoyed. I don’t need to fucking prove my fitness to her. It wouldn’t matter if I’d just won a marathon. Fertility Associates are getting the money one way or the other.

So this is going to be a pretty major theme. Our health system, wonderful and public as it is (except for GP appointments and many prescriptions and don’t start me on access to contraception and abortion services even AFTER we supposedly decriminalized) uses the unscientific quackery that is BMI to ration access to fertility services, which is baseless, harmful and transparently racist. This was not our first visit to Fertility Associates, not even the fifth – this was just the first one where we were allowed to progress past the basic tests into actually doing something towards making a baby.

Because despite being the picture of health – perfect blood pressure, non-smoker, and, yes, being literally paid to perform and teach pole dancing and being able to bust out twelve burpees in a minute at one particularly energetic cardio class – my weight, alone, divorced of context or nuance was the reason we couldn’t get public assistance for our infertility. The only advice? Lose weight.

But how? It’s a post for another day, but let me simply assert a simple fact at this point: diets don’t work. Not predictably, not sustainably, not healthily. And not if you call them “lifestyle changes” or pretend that counting “points” isn’t the same as counting “calories”. And even if they did, I want to be really clear: no one at the District Health Board (adios) or the Ministry of Health was going to check how I lost the weight, if I did.

And that’s why I wrote that, a year ago: I could have lost a limb and as far as a health system, using BMI to ration services, is concerned, that would have been enough to get public funding for our IVF. The numbers have nothing to do with health or probability of success or anything except using our society’s hatred of fat people as an excuse to cut costs.

So.

That was a whole extra mindf*ck to take going into a process which already carried so much emotional and psychological baggage. With such low odds of success regardless of my dress size. And we knew so many people who had gone through it, and failed, and failed again and again, and seen the toll it took. So I just had to keep reminding myself, as we left the clinic that day filled with a mixture of hope and dread:

Three rounds. That’s the deal. Even though we probably can’t get the lootbox deal (pay for three rounds now, and get a refund if they all fail – or lose it all if you succeed first time). I can’t do this for the rest of my life. I don’t even want to be doing it now.

And that’s why I waited a year to write this. Because there’s been a lot of strife and plenty of tears but at the end of the road, we got her.

If you like this post, feel free to spot me a virtual coffee.

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Sunday reads

Alison Chandra: I shared my toddler’s hospital bill on Twitter. First came supporters — then death threats.

I told our story the same way I always do, softening the hard edges of Ethan’s struggle with photos of the tender-hearted little boy who’s fought so hard to make it this far. I wrote about his medical team, about the surgeries and procedures and medications that he will rely on for the rest of his life, and also I wrote about his love for sticks and fireflies and his mama. I begged the people in power to look him in his big brown eyes and tell him to his face that his life was too expensive to be worth saving.

And then I put down my phone and went to sleep, never expecting to find out that the whole world was listening. The days to come would introduce me to the darkness lurking in the savage corners of the internet, and to the promise it holds for families like mine who so desperately need to find community.

No Pride in Prisons: Torture in New Zealand Prisons: A Briefing

This booklet draws together the findings of reports made by the Office of the Ombudsman in its investigations of four New Zealand prisons. Using these reports, No Pride in Prisons researchers provide an account, in plain language, of the ongoing abuse and mistreatment of prisoners. Contextualising this information within historical trends, they also tell the stories of prisoners who have contacted No Pride in Prisons, reminding us how this treatment is a lived reality for far too many people. Together, these accounts demonstrate the disturbing but undeniable existence of widespread torture in New Zealand prisons.

 

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10 things you could do instead of a sugar tax

It’s sugar tax season again, when leftwing politicians hem and haw about increasing the costs of food they don’t like in order to coerce people to be healthier. Are you excited? I’m excited.

jafar-ecstatic

But I wonder if there’s maybe another way to do things. A way which isn’t punitive, judgemental, or unsubtly sending a message to fat people that their lives are worthless. Maybe it might look something like this.

10 things you could campaign on instead of a sugar tax

Raising wages. Guess what the major obstacle to eating a varied diet high in fruit, vegetables, and tasty protein is? Food costs money! People don’t have much money! Make sure they have more money! Rocket science.

Community gardens, school gardens, and fruit trees on berms. Just put the fresh food out there. Give kids and adults the tools and space to develop skills, provide for themselves, and develop a stronger relationship with where their food comes from.

Good school lunches. Give kids access to a wide range of fresh locally-made food and let them figure out what makes them feel good and full of energy. Bonus: local jobs and opportunities for young/unemployed people to learn skills and contribute to their communities.

Make school sports free. Like, really? I’m not even a parent and I’m hearing about schools charging up to hundreds of dollars, per kid, per team they’re on, per term.

Pools, playgrounds, skate parks, basketball courts. Outside of school, create safe local places for kids and adults to get out and be active.

Raising wages. You know what else makes people reach for convenient pre-packaged highly-processed “junk” foods? Working two or three jobs because they can’t afford to pay the rent, much less be at home every evening to cook a meal from scratch, or go out to the park to play frisbee.

Break up the supermarket duopoly. Two companies control most of our supermarkets, which pushes prices up. Encourage local farmers’ markets especially in urban centres, make it easier for small grocers to get started, crack down on price-fixing and supplier bullying.

Reverse the government’s $1.7 billion cuts to health and then some. Build a health system focused on prevention (of actual diseases, not existence-of-fat-people-itis)

Adopt a Health at Every Size approach. It may sound terrifying, but trufax – when you stop focusing entirely on people’s weight and promote actual physical and mental health, you get happier healthier people. End sizeist policies which exclude fat people from healthcare, and get medical staff looking beyond body size.

RAISING WAGES. Like, seriously. You know what causes a hell of a lot more damage to people’s health than having a fat ass? Stress. Not all the kale in the world is going to save your life if you’re barely sleeping from worry and overwork, never getting any natural light, or constantly fretting about unexpected costs or keeping up appearances despite being skint.

The ironic thing is, many of these policies are already in the political picture. But time and again we get distracted by the policy equivalent of the South Beach Diet- it’s quick! It’s easy! It might damage your health in the long term but you’ll do it anyway because there’s literally nothing worse than being fat!

Our distaste for the huge corporations who sell the packaged/processed/unrecognisable/cheap/nasty food we label as “junk” distracts us from the reality that they are only able to profit because far too many people do not have the luxury of picking and choosing a perfect organic macronutrient-balanced meal plan every week.

I get it. Those guys suck. But ultimately, a sugar tax does nothing but make the cheapest food available more expensive, in an environment where many people cannot make ends meet anyway. Those people won’t find magical quinoa salad under the mattress in the boot of their car if a bag of potato chips costs 50c more.

There are so many other things we can do – so many things that would improve people’s lives without marching into their homes and telling them what’s good for them. A more positive, supportive approach which says people have free will and good hearts, which trusts them to make the right choices for themselves and their whānau. Which is what we’re meant to be about, isn’t it?

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Midwives deserve equal pay

It’s another one of those less-easy-to-grasp pay equity cases: the College of Midwives has filed a discrimination suit on the basis that midwives aren’t paid as well as equivalently-skilled/trained/responsible workers in male-dominated industries.

The College of Midwives says the midwifery-led system in New Zealand has improved the outcomes for women and their babies to the extent that it is a world leader in maternity care and it has never been safer to be born.

Despite this however the LMC Midwife is paid the equivalent of someone considered unskilled, semi-skilled or junior staff. This is untenable and must be urgently addressed.

The thing is, unless you’ve had a baby yourself, you probably don’t know a huge amount about what they do or how they’re paid.

Thank god for living in the internet age: here’s a fantastic post on the subject from a Kiwi midwife:

Who do you compare the midwifery workforce to?  What group of  mainly men are specialized, medical care providers, with a responsibility for two lives, a 24/7 52 week a year responsibility for care provision, and the responsibility of two lives in every decision they make?  For that, I don’t have an answer.  But I am sure that as a group, we could come up with some ideas.  Leave a message in the comments if you have a job description that compares.  I am thinking maybe electricians?  Or something?

So.  i can’t resolve the “how do we decide who to compare to” question.  But I thought I would try and add a little light to the subject of “what do midwives actually get paid?”

Seriously read the whole thing before posting another snotty tweet about how ~unqualified~ midwives are.

I’m sad to see a bit of sneering and scoffing on this – from people on the left. I expect the “ew, be grateful for your scraps, peasants” attitude from the weirder parts of the right, but come on, people. We knew it was shady when Cameron Slater was trying to smear Ports of Auckland workers over their salaries. We know that capitalism seeks ways to devalue people’s labour in order to exploit them economically. We know that our healthcare system is stretched and our present government doesn’t value the long-term benefits of properly investing in skills and services.

This is part and parcel of the same project, to undermine women’s work, to paint midwifery as “just holding someone’s hand and telling her to breathe”, not “real qualified medicine”. This is one battle in the wider workers’ struggle. So get over the fact that 99% of the workers involved are women and back our midwives.

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Costly government

I wrote yesterday about our heartless, penny-pinching government, which emphasises Getting To Surplus at all costs even if that means kids dying in cold state houses.

This is the true irony of National governments. Their entire platform is one of “fiscal responsibility” and “good economic management” yet time and time again they spend money the way I did when I was a teenager: false economies and short-term wish fulfilment which meant at the end of the week I was calling home collect and begging for rides which cost our household a lot more than if I’d just made sure I had enough money for the bus.

Fifteen-year-old-me was pretty stellar at externalising the losses, but I don’t think anyone, especially my parents or me, would relish the idea of her running the country.

National are, on the surface, all about cracking down on unnecessary spending and bureaucratic bloat, delivering value for money, getting proper returns on investment.

And yet, they don’t save us money.

A 2013 report of the National Health Committee on respiratory diseases puts the cost of lower respiratory tract infections like pneumonia at:

The average length of stay was about 3.5 days and the average price per hospitalised individual was $4,700.

According to the coroner’s report, Emma-Lita Bourne was admitted to hospital on 6 August and died on 8 August. Three days; and probably higher than average costs given the complications she suffered.

Making sure her family could afford to heat their home and throw some carpet on the floor wouldn’t have cost $5,000 – and could not only have saved her life in 2014 but prevented any number of future illnesses for her and her siblings.

A 2014 report from UNICEF states:

Every year, taxpayers face a bill of $6-8 billion for additional health needs, remedial education and reduced productivity that result from 260,000 children living in poverty.  This cost is largely due to the fact that children most likely to be in poverty are very young, when the most important physical, mental and social development is occurring.  Furthermore, a large group of children live in poverty for a long time – 7 years – and about ten per cent of Kiwi Kids live in severe poverty.

Six to eight billion. What was the estimated cost of Hone Harawira’s Feed the Kids bill again? $100 million. Estimated cost of Sue Moroney’s extension to paid parental leave? $276 million over three years. Drops in a bucket.

The Greens-initiated housing insulation policy had, as of May 2012, cost $347 million and returned estimated benefits – in reduced healthcare costs – of $1.68 billion. That’s some good fiscal management right there.

And as the fabulous Dr Liz Craig put it a couple of years ago:

… a housing warrant of fitness could improve the condition of rental properties, and although it could increase rents, at the moment all taxpayers are covering the costs of substandard housing through the health system and it’s a conversation the country needs to have.

Emphasis mine.

It’s almost like the radical notion that prevention is better than cure stacks up – ethically and financially. Maybe not on a single year’s balance sheet; but when we’re talking about caring for people from cradle to grave, a single year’s balance sheet is irrelevant.

So if National were truly interested in efficiencies and return on investment – instead of just using those buzzwords to sell their latest erosion of the public service – every state house would be warm and dry. Every kid would get breakfast and lunch. Every parent could give their kids the best start in life with mum or dad at home for those crucial early months.

Sometimes people on the left object to putting things in monetary terms – when the Public Service Association put the cost of domestic violence to business in numbers ($368 million a year) there was criticism: surely we’re motivated to stop domestic violence because it’s a bad thing which should never happen to anyone!

They’re right. They’re also wrong. This is a heartless government. They don’t do things “just because” it’s the right thing to do. Their focus is always on the money: they balance the books, they do the practical stuff, not the wasteful airy-fairy lefty stuff.

So we must, and can, argue this on both fronts. Of course every Kiwi kid should get breakfast and lunch because food is a fundamental part of being healthy and happy. But it’s also not just feelgood. It saves a huge amount of money in the long run, in education, in healthcare, in law enforcement.

It doesn’t mean we accept the frame that everything is about money. We just show very clearly how doing the right thing morally also means doing the right thing financially. The National Party isn’t selling our soul to save dollars; it’s selling our soul and costing us money at the same time.

That can’t be anyone’s definition of “good government.”