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"disqusTitle": "The Gentle Cesarean: More Like A Birth Than An Operation",
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"content": "\u003cfigure id=\"attachment_24384\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Screen-Shot-2015-03-09-at-9.48.45-AM.png\">\u003cimg class=\"size-large wp-image-24384\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Screen-Shot-2015-03-09-at-9.48.45-AM-640x479.png\" alt=\"Kristen Caminiti cuddles her son Connor while doctors stitch her up following a C-section. (Courtesy: Kristen DeBoy Caminiti)\" width=\"640\" height=\"479\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kristen Caminiti cuddles her son Connor while doctors stitch her up following a C-section.\u003cbr>(Courtesy: Kristen DeBoy Caminiti)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jennifer Schmidt,\u003c/strong> \u003ca title=\"http://www.npr.org/blogs/health/2015/03/09/390977656/the-gentle-cesarean-more-like-a-birth-than-an-operation\" href=\"http://www.npr.org/blogs/health/2015/03/09/390977656/the-gentle-cesarean-more-like-a-birth-than-an-operation\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>There are many reasons women need cesareans. Sometimes the situation is truly life threatening. But often the problem is labor simply isn't progressing. That was the case for Valerie Echo Duckett, 35, who lives in Columbus, Ohio. After receiving an epidural for pain, Duckett's contractions stopped. By late evening she was told she'd need a C-section to deliver her son, Avery. Duckett says she has vague memories of being wheeled into the OR, strapped down and shaking from cold.\u003c/p>\n\u003cp>\"They were covering me up with warm blankets,\"she says. \"I kind of slept in and out of it.\" Her only memory of meeting her newborn son for the first time was from some pictures her husband took.\u003c/p>\n\u003cp>This is the experience many women have. The \u003ca href=\"http://www.nlm.nih.gov/medlineplus/cesareansection.html\">cesarean section\u003c/a> is the most common surgery in America – about 1 in 3 babies are delivered this way. But for many women, being told they need a C-section is unpleasant news. Duckett says she felt like she missed out on a pivotal moment in her pregnancy.\u003c!--more-->\u003c/p>\n\u003cp>\"It took me a long time even to be able to say that I gave birth to Avery,\" she says. \"I felt like I didn't earn the right to say I gave birth to him, like it was taken from me somehow, like I hadn't done what I was supposed to do.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Duckett's reaction to her C-section is unfortunately a common one, says Betsey Snow, head of Family and Child Services at Anne Arundel Medical Center, a community hospital in Annapolis, Md.\u003c/p>\n\u003cp>\"I hear a lot of moms say, 'I'm disappointed I had to have a C-section.' A lot of women felt like they failed because they couldn't do a vaginal delivery,\" says Snow.\u003c/p>\n\u003cp>Now some hospitals are offering small but significant changes to the procedure to make it seem more like a birth than major surgery.\u003c/p>\n\u003cp>In a typical C-section, a closed curtain shields the sterile operating field. Mothers don't see the procedure and their babies are immediately whisked away for pediatric care — a separation that can last for close to half an hour. \u003ca href=\"http://kcamfam.blogspot.com/2014/10/a-family-centered-miracle.html\" target=\"_blank\">Kristen Caminiti\u003c/a>\u003ca href=\"http://www.npr.org/blogs/health/2015/03/09/390977656/the-gentle-cesarean-more-like-a-birth-than-an-operation#_msocom_2\" name=\"_msoanchor_2\">\u003c/a>, of Crofton, Md., knows this routine well. Her first two sons were born by traditional cesarean. She was happy with their births because, she says, it was all she knew. Then, just a few weeks into her third pregnancy, Caminiti, who is 33, saw a post on Facebook about \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2613254/\" target=\"_blank\">family-centered cesarean\u003c/a> techniques catching on in England.\u003c/p>\n\u003cp>\"I clicked on the link and thought, 'I want that,' \" she says.\u003c/p>\n\u003cp>The techniques are relatively easy and the main goals simple: let moms see their babies being born if they want and put newborns immediately on the mother's chest for skin-to-skin contact. This helps stimulate bonding and breast feeding. Caminiti asked her obstetrician, Dr. Marcus Penn, if he'd allow her to have this kind of birth. He said yes.\u003c/p>\n\u003cp>When Caminiti told Penn what she wanted, his first thought was it wouldn't be that difficult to do. \"I didn't see anything that would be terribly out of the norm,\" he says. \"It would be different from the way we usually do it, but nothing terrible that anyone would say we shouldn't try that.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">\"It was the most amazing and grace-filled experience to finally have that moment of having my baby be placed on my chest.\" \u003c/aside>\n\u003cp>Family-centered cesareans are a relatively new idea in the U.S., and many doctors and hospitals have no experience with them. Penn and the staff at Anne Arundel Medical Center quickly realized the procedure would require some changes, including adding a nurse and bringing the neonatal team into the operating room.\u003c/p>\n\u003cp>And there were a bunch of little adjustments, such as moving the EKG monitors from their usual location on top of the mother's chest to her side. This allows the delivery team to place the newborn baby immediately on the mother's chest. In addition, Penn says, the mother's hands were not strapped down and the intravenous line was put in her non-dominant hand so she could hold the baby.\u003c/p>\n\u003cp>At the beginning of October, Caminiti underwent her C-section. She was alert, her head was up and the drape lowered so she could watch the delivery of her son, Connor. Caminiti's husband, Matt, recorded the event. After Connor was out, with umbilical cord still attached, he was placed right on Caminiti's chest.\u003c/p>\n\u003cp>\"It was the most amazing and grace-filled experience to finally have that moment of having my baby be placed on my chest,\" Caminiti says. \"He was screaming and then I remember that when I started to talk to him he stopped. It was awesome.\"\u003c/p>\n\u003cp>And the baby stayed with her for the rest of the procedure.\u003c/p>\n\u003cdiv id=\"res391244520\" class=\"bucketwrap internallink insettwocolumn inset2col \">\u003c/div>\n\u003cp>Changes like this can make a big difference, says Dr. William Camann, the director of obstetric anesthesiology at Brigham and Women's Hospital in Boston and one of the pioneers of the procedure in the U.S. At Brigham and Women's, their version of the family-centered cesarean is called the \u003ca href=\"http://www.brighamandwomens.org/about_bwh/publicaffairs/news/publications/DisplayBulletin.aspx?articleid=5992\" target=\"_blank\">gentle cesarean\u003c/a>. Moms who opt for it can view the birth through a clear plastic drape and immediate skin-to-skin contact follows.\u003c/p>\n\u003cp>Camann says the gentle C-section is not a replacement for a vaginal birth; it's just a way to improve the surgical experience. \"No one is trying to advocate for C-sections. We really don't want to increase the cesarean rate, we just want to make it better for those who have to have it,\" he says.\u003c/p>\n\u003cp>So why has the procedure been slow to catch on? Hospitals aren't charging more for it — so cost doesn't seem to be a major factor. What's lacking are clinical studies. Without hard scientific data on outcomes and other concerns like infection control, many hospitals may be wary of changing their routines. Betsey Snow of Anne Arundel Medical Center says the family-centered C-section represents a cultural shift and her hospital is helping break new ground by adopting it.\u003c/p>\n\u003cp>\"It is the first time we have really done anything innovative or creative with changing the C-section procedure in years,\" she says.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Kristen Caminiti says her hope is these innovations become routine. She says she'd like nothing more than to know that other women having C-sections are able to have the same amazing experience she had.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24384\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Screen-Shot-2015-03-09-at-9.48.45-AM.png\">\u003cimg class=\"size-large wp-image-24384\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Screen-Shot-2015-03-09-at-9.48.45-AM-640x479.png\" alt=\"Kristen Caminiti cuddles her son Connor while doctors stitch her up following a C-section. (Courtesy: Kristen DeBoy Caminiti)\" width=\"640\" height=\"479\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kristen Caminiti cuddles her son Connor while doctors stitch her up following a C-section.\u003cbr>(Courtesy: Kristen DeBoy Caminiti)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jennifer Schmidt,\u003c/strong> \u003ca title=\"http://www.npr.org/blogs/health/2015/03/09/390977656/the-gentle-cesarean-more-like-a-birth-than-an-operation\" href=\"http://www.npr.org/blogs/health/2015/03/09/390977656/the-gentle-cesarean-more-like-a-birth-than-an-operation\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>There are many reasons women need cesareans. Sometimes the situation is truly life threatening. But often the problem is labor simply isn't progressing. That was the case for Valerie Echo Duckett, 35, who lives in Columbus, Ohio. After receiving an epidural for pain, Duckett's contractions stopped. By late evening she was told she'd need a C-section to deliver her son, Avery. Duckett says she has vague memories of being wheeled into the OR, strapped down and shaking from cold.\u003c/p>\n\u003cp>\"They were covering me up with warm blankets,\"she says. \"I kind of slept in and out of it.\" Her only memory of meeting her newborn son for the first time was from some pictures her husband took.\u003c/p>\n\u003cp>This is the experience many women have. The \u003ca href=\"http://www.nlm.nih.gov/medlineplus/cesareansection.html\">cesarean section\u003c/a> is the most common surgery in America – about 1 in 3 babies are delivered this way. But for many women, being told they need a C-section is unpleasant news. Duckett says she felt like she missed out on a pivotal moment in her pregnancy.\u003c!--more-->\u003c/p>\n\u003cp>\"It took me a long time even to be able to say that I gave birth to Avery,\" she says. \"I felt like I didn't earn the right to say I gave birth to him, like it was taken from me somehow, like I hadn't done what I was supposed to do.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Duckett's reaction to her C-section is unfortunately a common one, says Betsey Snow, head of Family and Child Services at Anne Arundel Medical Center, a community hospital in Annapolis, Md.\u003c/p>\n\u003cp>\"I hear a lot of moms say, 'I'm disappointed I had to have a C-section.' A lot of women felt like they failed because they couldn't do a vaginal delivery,\" says Snow.\u003c/p>\n\u003cp>Now some hospitals are offering small but significant changes to the procedure to make it seem more like a birth than major surgery.\u003c/p>\n\u003cp>In a typical C-section, a closed curtain shields the sterile operating field. Mothers don't see the procedure and their babies are immediately whisked away for pediatric care — a separation that can last for close to half an hour. \u003ca href=\"http://kcamfam.blogspot.com/2014/10/a-family-centered-miracle.html\" target=\"_blank\">Kristen Caminiti\u003c/a>\u003ca href=\"http://www.npr.org/blogs/health/2015/03/09/390977656/the-gentle-cesarean-more-like-a-birth-than-an-operation#_msocom_2\" name=\"_msoanchor_2\">\u003c/a>, of Crofton, Md., knows this routine well. Her first two sons were born by traditional cesarean. She was happy with their births because, she says, it was all she knew. Then, just a few weeks into her third pregnancy, Caminiti, who is 33, saw a post on Facebook about \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2613254/\" target=\"_blank\">family-centered cesarean\u003c/a> techniques catching on in England.\u003c/p>\n\u003cp>\"I clicked on the link and thought, 'I want that,' \" she says.\u003c/p>\n\u003cp>The techniques are relatively easy and the main goals simple: let moms see their babies being born if they want and put newborns immediately on the mother's chest for skin-to-skin contact. This helps stimulate bonding and breast feeding. Caminiti asked her obstetrician, Dr. Marcus Penn, if he'd allow her to have this kind of birth. He said yes.\u003c/p>\n\u003cp>When Caminiti told Penn what she wanted, his first thought was it wouldn't be that difficult to do. \"I didn't see anything that would be terribly out of the norm,\" he says. \"It would be different from the way we usually do it, but nothing terrible that anyone would say we shouldn't try that.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">\"It was the most amazing and grace-filled experience to finally have that moment of having my baby be placed on my chest.\" \u003c/aside>\n\u003cp>Family-centered cesareans are a relatively new idea in the U.S., and many doctors and hospitals have no experience with them. Penn and the staff at Anne Arundel Medical Center quickly realized the procedure would require some changes, including adding a nurse and bringing the neonatal team into the operating room.\u003c/p>\n\u003cp>And there were a bunch of little adjustments, such as moving the EKG monitors from their usual location on top of the mother's chest to her side. This allows the delivery team to place the newborn baby immediately on the mother's chest. In addition, Penn says, the mother's hands were not strapped down and the intravenous line was put in her non-dominant hand so she could hold the baby.\u003c/p>\n\u003cp>At the beginning of October, Caminiti underwent her C-section. She was alert, her head was up and the drape lowered so she could watch the delivery of her son, Connor. Caminiti's husband, Matt, recorded the event. After Connor was out, with umbilical cord still attached, he was placed right on Caminiti's chest.\u003c/p>\n\u003cp>\"It was the most amazing and grace-filled experience to finally have that moment of having my baby be placed on my chest,\" Caminiti says. \"He was screaming and then I remember that when I started to talk to him he stopped. It was awesome.\"\u003c/p>\n\u003cp>And the baby stayed with her for the rest of the procedure.\u003c/p>\n\u003cdiv id=\"res391244520\" class=\"bucketwrap internallink insettwocolumn inset2col \">\u003c/div>\n\u003cp>Changes like this can make a big difference, says Dr. William Camann, the director of obstetric anesthesiology at Brigham and Women's Hospital in Boston and one of the pioneers of the procedure in the U.S. At Brigham and Women's, their version of the family-centered cesarean is called the \u003ca href=\"http://www.brighamandwomens.org/about_bwh/publicaffairs/news/publications/DisplayBulletin.aspx?articleid=5992\" target=\"_blank\">gentle cesarean\u003c/a>. Moms who opt for it can view the birth through a clear plastic drape and immediate skin-to-skin contact follows.\u003c/p>\n\u003cp>Camann says the gentle C-section is not a replacement for a vaginal birth; it's just a way to improve the surgical experience. \"No one is trying to advocate for C-sections. We really don't want to increase the cesarean rate, we just want to make it better for those who have to have it,\" he says.\u003c/p>\n\u003cp>So why has the procedure been slow to catch on? Hospitals aren't charging more for it — so cost doesn't seem to be a major factor. What's lacking are clinical studies. Without hard scientific data on outcomes and other concerns like infection control, many hospitals may be wary of changing their routines. Betsey Snow of Anne Arundel Medical Center says the family-centered C-section represents a cultural shift and her hospital is helping break new ground by adopting it.\u003c/p>\n\u003cp>\"It is the first time we have really done anything innovative or creative with changing the C-section procedure in years,\" she says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Kristen Caminiti says her hope is these innovations become routine. She says she'd like nothing more than to know that other women having C-sections are able to have the same amazing experience she had.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Don’t call Marty Turcios inspiring. Yes, he motivates and challenges his students, but not simply because he’s a golf coach with cerebral palsy.\u003c/p>\n\u003cp>Instead, his students say it’s his commitment to self-directed learning that is so empowering.\u003c/p>\n\u003cp>At the center of his coaching is this question: “When we teach, are we teaching people to think for themselves?”\u003c/p>\n\u003cp>https://vimeo.com/120747574\u003c/p>\n\u003cp>On Friday mornings, Turcios critiques the golf swings of able-bodied UC Berkeley students at the Tilden Park driving range. Some regulars have been coming for two years; others are holding a golf club for the first time.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For the uninitiated, it is surprising to see Turcios, with his spasmodic movements and halting gait, swing a golf club. But he says his disability is not his problem: “My problem is how people look at me with a disability.”\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Oppressive Misconceptions\u003c/strong>\u003c/p>\n\u003cp>In the 1960s, the disability rights movement grew out of the movement for civil rights. Activists criticized what they called the medical model of disability, which is the idea that people with, say, cerebral palsy are broken and must be rehabilitated by medical experts to rejoin society—in other words, to \"fix\" them.\u003c/p>\n\u003cp>The social model of disability, by contrast, says that people with disabilities are actually the experts on their conditions, and that they should be free to define their own normal. Society’s role is not to fix them, but to remove barriers to independent living by providing housing subsidies, assistive technology, choice of medical providers and other help.\u003c/p>\n\u003cfigure id=\"attachment_24142\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Marty_Toothbrush.png\">\u003cimg class=\"size-large wp-image-24142\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Marty_Toothbrush-640x360.png\" alt='With cerebral palsy, everyday tasks can be time-consuming, but Turcios says \"disability is not my problem...my problem is what people see.\" (Jeremy Raff/KQED)' width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Though everyday tasks can be time-consuming, Turcios says \"disability is not my problem … my problem is what people see.\" (Jeremy Raff/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp> \u003c/p>\n\u003cp>Another barrier is the baggage that comes along with having a disability. Ingrid Tischer of the Disability Rights Education & Defense Fund says misconceptions are a common burden. “Nobody wants to carry around being the personification of everyone’s worst nightmare,” she says.\u003c/p>\n\u003cp>Turcios, for his part, says cerebral palsy is not as disabling as the stereotypes that come with it. “It’s a dismissive attitude—‘we’ll \u003cem>let\u003c/em> you do this, but it’s not real—you’re not doing it the way we would.' ” He says that if it weren't for him, disability and all, activities such as teaching golf in Concord to autistic teens and vets with PTSD wouldn't happen at all.\u003c/p>\n\u003cp>Turcios, who is 55 and lives in Martinez, provides instruction every Tuesday to Veterans Administration patients at a Concord driving range. “I really connect with them,” Turcios said, “because I probably suffered PTSD, too, only from the way I had to grow up.”\u003c/p>\n\u003cfigure id=\"attachment_24143\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Marty-Coaching.png\">\u003cimg class=\"wp-image-24143 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Marty-Coaching-640x360.png\" alt=\""Sometimes he helps you realize you're more capable than you think," said Katie Keliiaa, a UC Berkeley student. (Jeremy Raff/KQED)\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">'Sometimes he helps you realize you're more capable than you think,' said Katie Keliiaa, a UC Berkeley student. (Jeremy Raff/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>He feels like he’s had to defend his achievements, such as earning a master’s degree in therapeutic recreation at San Jose State and starting a nonprofit organization to support his coaching. “There are even members of my family who think [my work] is a joke or affirmative action,” he said. “It’s sad.\"\u003c/p>\n\u003cp>The late satirist and disability activist Stella Young discussed the negative effects of stereotypes, even if they're well-meaning. In a \u003ca href=\"http://www.ted.com/talks/stella_young_i_m_not_your_inspiration_thank_you_very_much/transcript?language=en#t-291496\" target=\"_blank\">TED talk titled \"I'm not your inspiration, thank you very much,\u003c/a>\" she said: “I've lost count of the number of times that I've been approached by strangers wanting to tell me that they think I'm brave or inspirational … just kind of congratulating me for managing to get up in the morning and remember my own name. It's objectifying ...” she said, calling the phenomenon \u003ca href=\"http://www.abc.net.au/rampup/articles/2012/07/02/3537035.htm\" target=\"_blank\">“inspiration porn.”\u003c/a>\u003c/p>\n\u003cp>The burden of these stereotypes contributed to Turcios’ alcoholism. He’s been sober for decades but says, “I could fall apart all over again in a heartbeat. That’s the reality of my life.”\u003c/p>\n\u003cp>Coaching gives him stability and a sense of meaning. “I love to watch people -- disabled and non-disabled -- be successful at something they thought they couldn’t do,” he said. “To watch people change their outlook.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And, he said, “in a lot of ways I’m helping myself more than anything else. I’m getting out of my head, and that’s why it works so well.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For the uninitiated, it is surprising to see Turcios, with his spasmodic movements and halting gait, swing a golf club. But he says his disability is not his problem: “My problem is how people look at me with a disability.”\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Oppressive Misconceptions\u003c/strong>\u003c/p>\n\u003cp>In the 1960s, the disability rights movement grew out of the movement for civil rights. Activists criticized what they called the medical model of disability, which is the idea that people with, say, cerebral palsy are broken and must be rehabilitated by medical experts to rejoin society—in other words, to \"fix\" them.\u003c/p>\n\u003cp>The social model of disability, by contrast, says that people with disabilities are actually the experts on their conditions, and that they should be free to define their own normal. Society’s role is not to fix them, but to remove barriers to independent living by providing housing subsidies, assistive technology, choice of medical providers and other help.\u003c/p>\n\u003cfigure id=\"attachment_24142\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Marty_Toothbrush.png\">\u003cimg class=\"size-large wp-image-24142\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Marty_Toothbrush-640x360.png\" alt='With cerebral palsy, everyday tasks can be time-consuming, but Turcios says \"disability is not my problem...my problem is what people see.\" (Jeremy Raff/KQED)' width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Though everyday tasks can be time-consuming, Turcios says \"disability is not my problem … my problem is what people see.\" (Jeremy Raff/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp> \u003c/p>\n\u003cp>Another barrier is the baggage that comes along with having a disability. Ingrid Tischer of the Disability Rights Education & Defense Fund says misconceptions are a common burden. “Nobody wants to carry around being the personification of everyone’s worst nightmare,” she says.\u003c/p>\n\u003cp>Turcios, for his part, says cerebral palsy is not as disabling as the stereotypes that come with it. “It’s a dismissive attitude—‘we’ll \u003cem>let\u003c/em> you do this, but it’s not real—you’re not doing it the way we would.' ” He says that if it weren't for him, disability and all, activities such as teaching golf in Concord to autistic teens and vets with PTSD wouldn't happen at all.\u003c/p>\n\u003cp>Turcios, who is 55 and lives in Martinez, provides instruction every Tuesday to Veterans Administration patients at a Concord driving range. “I really connect with them,” Turcios said, “because I probably suffered PTSD, too, only from the way I had to grow up.”\u003c/p>\n\u003cfigure id=\"attachment_24143\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Marty-Coaching.png\">\u003cimg class=\"wp-image-24143 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/Marty-Coaching-640x360.png\" alt=\""Sometimes he helps you realize you're more capable than you think," said Katie Keliiaa, a UC Berkeley student. (Jeremy Raff/KQED)\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">'Sometimes he helps you realize you're more capable than you think,' said Katie Keliiaa, a UC Berkeley student. (Jeremy Raff/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>He feels like he’s had to defend his achievements, such as earning a master’s degree in therapeutic recreation at San Jose State and starting a nonprofit organization to support his coaching. “There are even members of my family who think [my work] is a joke or affirmative action,” he said. “It’s sad.\"\u003c/p>\n\u003cp>The late satirist and disability activist Stella Young discussed the negative effects of stereotypes, even if they're well-meaning. In a \u003ca href=\"http://www.ted.com/talks/stella_young_i_m_not_your_inspiration_thank_you_very_much/transcript?language=en#t-291496\" target=\"_blank\">TED talk titled \"I'm not your inspiration, thank you very much,\u003c/a>\" she said: “I've lost count of the number of times that I've been approached by strangers wanting to tell me that they think I'm brave or inspirational … just kind of congratulating me for managing to get up in the morning and remember my own name. It's objectifying ...” she said, calling the phenomenon \u003ca href=\"http://www.abc.net.au/rampup/articles/2012/07/02/3537035.htm\" target=\"_blank\">“inspiration porn.”\u003c/a>\u003c/p>\n\u003cp>The burden of these stereotypes contributed to Turcios’ alcoholism. He’s been sober for decades but says, “I could fall apart all over again in a heartbeat. That’s the reality of my life.”\u003c/p>\n\u003cp>Coaching gives him stability and a sense of meaning. “I love to watch people -- disabled and non-disabled -- be successful at something they thought they couldn’t do,” he said. “To watch people change their outlook.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And, he said, “in a lot of ways I’m helping myself more than anything else. I’m getting out of my head, and that’s why it works so well.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_22472\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000016939839_Large-e1415663541743.jpg\">\u003cimg class=\"size-large wp-image-22472\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000016939839_Large-640x420.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"420\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/194211358\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>Going out to dinner is really stressful for Carolyn Desimone. She has a lot of friends who work in the tech sector, and they always want to go to trendy places.\u003c/p>\n\u003cp>“I went out for ramen with some startup kids and it was 30 bucks a person. It was stupid,” she says. “Everyone at the table is making twice as much as I do.”\u003c/p>\n\u003cp>And they’re willing to spend twice as much on food. It’s an economic dynamic she notices in the cost of therapy, too. Desimone pays $65 an hour at a community clinic to get help with her anxiety.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'Geek whisperers' needed now more than ever as the price of mental health services rises.\u003c/aside>\n\u003cp>“The pool of my friends, they’re all $100, $120 per appointment,” she says. “I’d never be able to do that. I couldn’t do that and pay my rent.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The influx of tech workers to the Bay Area has had a profound effect on the local economy: Affordable housing is nearly impossible to find. Dining out has become a competitive sport. And now, it seems the tech sector is applying upward pressure on the cost of some mental health services, too.\u003c/p>\n\u003cp>“One big variable is money,” says Michael Klein, a clinical psychologist in San Francisco. “The other is stress.”\u003c!--more-->\u003c/p>\n\u003cp>IPOs and venture capital rounds have armed tech workers with a lot of disposable income. With that money comes intense competition, long hours and the ever-looming threat of failure. That means there are more people willing to pay higher prices for someone to talk to.\u003c/p>\n\u003cp>“There are more and more people that have the affluence that they can afford therapy, and they have enough stress where therapy becomes more of a need,” Klein says.\u003c/p>\n\u003cp>Some large tech companies will even foot the bill. Managers see really talented engineers mess up projects because they don’t know how to work well with others.\u003c/p>\n\u003cp>“Their emotional maturity is on the lower side,” says Klein.\u003c/p>\n\u003cp>Klein is something of a geek whisperer. He’s been practicing in San Francisco for 20 years, and he often treats socially awkward tech workers.\u003c/p>\n\u003cp>When he asks new clients how they feel, they can’t answer the question.\u003c/p>\n\u003cp>“They don’t know what I’m talking about,” he says.\u003c/p>\n\u003cp>But after six months or a year of therapy, that changes.\u003c/p>\n\u003cp>“They blossom,” Klein says. “They can really track different emotions in themselves. And then they can start to notice them in their co-workers.”\u003c/p>\n\u003cp>\u003cstrong>Therapy Prices Rise\u003c/strong>\u003c/p>\n\u003cp>The increased demand for therapy from tech workers is compounded by another trend. About half the therapists in private practice in the state don't accept insurance, according to a recent survey by the California Association of Marriage and Family Therapists. That means their clients have to pay out-of-network fees, or completely out of pocket.\u003c/p>\n\u003cp>“Most people in the tech world can afford to do that,” Klein says.\u003c/p>\n\u003cp>Therapists can set prices accordingly -- leaving receptionists, waiters and teachers competing with wealthy tech workers for appointments. Established therapists in the Bay Area routinely charge $150 to $200 an hour.\u003c/p>\n\u003cp>“Many experienced therapists charge a lot and they’re out of reach to lower-middle-class or some middle-class people,” says Klein.\u003c/p>\n\u003cp>There are other options, he says. Less experienced therapists charge less, and there are several training institutes in San Francisco where people can see unlicensed therapists for as low as $30 a session.\u003c/p>\n\u003cp>Yet, even some of those clinics have had to raise their prices recently.\u003c/p>\n\u003cp>Take the Access Institute, where Carolyn Desimone goes for care. It is now facing its own set of financial pressures because of the tech boom -- evidenced by the new neighbors who have moved in since the clinic opened its doors 10 years ago in Hayes Valley.\u003c/p>\n\u003cp>A few blocks down the street in one direction is the Twitter office. In the other, near the corner of Hayes and Gough, there’s now an artisanal chocolate shop, an Oysteria and a Warby Parker glasses shop.\u003c/p>\n\u003cp>When the lease at Access Institute was up for renewal last year, the landlord wanted to increase the rent by almost 90 percent.\u003c/p>\n\u003cp>“We had been paying $5,900 a month,” said executive director Bart Magee, speaking over the construction noise outside his office. “It’s going to go to $11,000 a month.”\u003c/p>\n\u003cp>Magee managed to negotiate -- a bit. He still has to pay the full increase, but not for another five years. In the meantime, he got a 40 percent rent hike.\u003c/p>\n\u003cp>“That’s $50,000 a year that we could have provided more services; with that we’re not going to be able to,” he says, adding that the clinic has had to raise salaries as well, so the therapists who work there can afford the increases they’re facing in cost-of-living expenses.\u003c/p>\n\u003cp>Magee says the clinic had no choice but to raise its prices.\u003c/p>\n\u003cp>He’s also looking for new philanthropic donors, but he says the clinic needs a long-term plan for when the full rent increase takes effect or they won't be able to stay.\u003c/p>\n\u003cp>“There’s really no place to go,” he says. “Our commercial real estate has gotten to be one of the most expensive in the country.”\u003c/p>\n\u003cp>Carolyn Desimone says she doesn’t know what she’d do if Access Institute were ever forced to move or shut down.\u003c/p>\n\u003cp>“That would be really hard,” she says. “I’m worried that if I lost them, that the barrier to entry would seem too hard to find somebody else, and then I would get really bad again. I’m afraid I would be too overwhelmed by having to find somebody, that I would just not.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Curious about the boom/bust cycle that is reshaping the Bay Area? Check out our \u003ca href=\"http://kqed.org/boomtown\" target=\"_blank\">Boomtown series.\u003c/a>\u003c/em>\u003c/p>\n\n",
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"excerpt": "The tech boom is not just increasing the cost of housing and dining. Even mental health services have become pricy.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22472\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000016939839_Large-e1415663541743.jpg\">\u003cimg class=\"size-large wp-image-22472\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000016939839_Large-640x420.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"420\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/194211358&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/194211358'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Going out to dinner is really stressful for Carolyn Desimone. She has a lot of friends who work in the tech sector, and they always want to go to trendy places.\u003c/p>\n\u003cp>“I went out for ramen with some startup kids and it was 30 bucks a person. It was stupid,” she says. “Everyone at the table is making twice as much as I do.”\u003c/p>\n\u003cp>And they’re willing to spend twice as much on food. It’s an economic dynamic she notices in the cost of therapy, too. Desimone pays $65 an hour at a community clinic to get help with her anxiety.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'Geek whisperers' needed now more than ever as the price of mental health services rises.\u003c/aside>\n\u003cp>“The pool of my friends, they’re all $100, $120 per appointment,” she says. “I’d never be able to do that. I couldn’t do that and pay my rent.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The influx of tech workers to the Bay Area has had a profound effect on the local economy: Affordable housing is nearly impossible to find. Dining out has become a competitive sport. And now, it seems the tech sector is applying upward pressure on the cost of some mental health services, too.\u003c/p>\n\u003cp>“One big variable is money,” says Michael Klein, a clinical psychologist in San Francisco. “The other is stress.”\u003c!--more-->\u003c/p>\n\u003cp>IPOs and venture capital rounds have armed tech workers with a lot of disposable income. With that money comes intense competition, long hours and the ever-looming threat of failure. That means there are more people willing to pay higher prices for someone to talk to.\u003c/p>\n\u003cp>“There are more and more people that have the affluence that they can afford therapy, and they have enough stress where therapy becomes more of a need,” Klein says.\u003c/p>\n\u003cp>Some large tech companies will even foot the bill. Managers see really talented engineers mess up projects because they don’t know how to work well with others.\u003c/p>\n\u003cp>“Their emotional maturity is on the lower side,” says Klein.\u003c/p>\n\u003cp>Klein is something of a geek whisperer. He’s been practicing in San Francisco for 20 years, and he often treats socially awkward tech workers.\u003c/p>\n\u003cp>When he asks new clients how they feel, they can’t answer the question.\u003c/p>\n\u003cp>“They don’t know what I’m talking about,” he says.\u003c/p>\n\u003cp>But after six months or a year of therapy, that changes.\u003c/p>\n\u003cp>“They blossom,” Klein says. “They can really track different emotions in themselves. And then they can start to notice them in their co-workers.”\u003c/p>\n\u003cp>\u003cstrong>Therapy Prices Rise\u003c/strong>\u003c/p>\n\u003cp>The increased demand for therapy from tech workers is compounded by another trend. About half the therapists in private practice in the state don't accept insurance, according to a recent survey by the California Association of Marriage and Family Therapists. That means their clients have to pay out-of-network fees, or completely out of pocket.\u003c/p>\n\u003cp>“Most people in the tech world can afford to do that,” Klein says.\u003c/p>\n\u003cp>Therapists can set prices accordingly -- leaving receptionists, waiters and teachers competing with wealthy tech workers for appointments. Established therapists in the Bay Area routinely charge $150 to $200 an hour.\u003c/p>\n\u003cp>“Many experienced therapists charge a lot and they’re out of reach to lower-middle-class or some middle-class people,” says Klein.\u003c/p>\n\u003cp>There are other options, he says. Less experienced therapists charge less, and there are several training institutes in San Francisco where people can see unlicensed therapists for as low as $30 a session.\u003c/p>\n\u003cp>Yet, even some of those clinics have had to raise their prices recently.\u003c/p>\n\u003cp>Take the Access Institute, where Carolyn Desimone goes for care. It is now facing its own set of financial pressures because of the tech boom -- evidenced by the new neighbors who have moved in since the clinic opened its doors 10 years ago in Hayes Valley.\u003c/p>\n\u003cp>A few blocks down the street in one direction is the Twitter office. In the other, near the corner of Hayes and Gough, there’s now an artisanal chocolate shop, an Oysteria and a Warby Parker glasses shop.\u003c/p>\n\u003cp>When the lease at Access Institute was up for renewal last year, the landlord wanted to increase the rent by almost 90 percent.\u003c/p>\n\u003cp>“We had been paying $5,900 a month,” said executive director Bart Magee, speaking over the construction noise outside his office. “It’s going to go to $11,000 a month.”\u003c/p>\n\u003cp>Magee managed to negotiate -- a bit. He still has to pay the full increase, but not for another five years. In the meantime, he got a 40 percent rent hike.\u003c/p>\n\u003cp>“That’s $50,000 a year that we could have provided more services; with that we’re not going to be able to,” he says, adding that the clinic has had to raise salaries as well, so the therapists who work there can afford the increases they’re facing in cost-of-living expenses.\u003c/p>\n\u003cp>Magee says the clinic had no choice but to raise its prices.\u003c/p>\n\u003cp>He’s also looking for new philanthropic donors, but he says the clinic needs a long-term plan for when the full rent increase takes effect or they won't be able to stay.\u003c/p>\n\u003cp>“There’s really no place to go,” he says. “Our commercial real estate has gotten to be one of the most expensive in the country.”\u003c/p>\n\u003cp>Carolyn Desimone says she doesn’t know what she’d do if Access Institute were ever forced to move or shut down.\u003c/p>\n\u003cp>“That would be really hard,” she says. “I’m worried that if I lost them, that the barrier to entry would seem too hard to find somebody else, and then I would get really bad again. I’m afraid I would be too overwhelmed by having to find somebody, that I would just not.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Curious about the boom/bust cycle that is reshaping the Bay Area? Check out our \u003ca href=\"http://kqed.org/boomtown\" target=\"_blank\">Boomtown series.\u003c/a>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Silicon Valley is Thinner Than San Francisco-Oakland, Report Says",
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"content": "\u003cfigure id=\"attachment_546\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/ScaleGeneric081211-e1425334365300.jpg\">\u003cimg class=\"size-large wp-image-546\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/ScaleGeneric081211-620x415.jpg\" alt=\"Woman's feet on scale.\" width=\"620\" height=\"415\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Justin Sullivan/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The South Bay and San Francisco compete on a multitude of fronts: Which will snag the hottest tech firms, which can retain or attract the most sports teams, which will win the prize for least affordable housing...\u003c/p>\n\u003cp>But no matter how many prestige points San Francisco racks up, the South Bay can claim bragging rights based on at least one important metric: weight.\u003c/p>\n\u003cp>\u003ca href=\"http://wallethub.com/edu/metro-areas-with-the-biggest-smallest-weight-problems/10532/\" target=\"_blank\">That's according to WalletHub,\u003c/a> a personal finance website that spends a lot of time compiling data on all sorts of things. (Last month they told us the Bay Area is one of the more diverse regions in the U.S.) From the site:\u003c/p>\n\u003cblockquote>\u003cp>In light of National Nutrition Month, WalletHub analyzed 100 of the most populated U.S. metro areas to identify those where weight-related problems call for heightened attention. We did so by examining 12 key metrics, among which are the percentage of adults and high school students who are obese and the percentage of people who are physically inactive.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>WalletHub ranked the San Jose-Sunnyvale-Santa Clara area as having the third-smallest problem with weight. That was best in the Bay Area and two slots higher than San Francisco-Oakland-Hayward, which came in at No. 5. (San Franciscans, feel free to blame Oakland and Hayward for weighing you down; Oaklanders and Haywardians, commence vice versa.)\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In terms of obesity itself, San Jose-Sunnyvale-Santa Clara is sixth best, San Francisco et al. is three slots behind at No. 9.\u003c/p>\n\u003cp>Here's the methodology the site used. The report drew on data from the Centers for Disease Control and Prevention, the U.S. Department of Agriculture Economic Research Service, the Child and Adolescent Health Measurement Initiative and WalletHub's own research, it said.\u003c/p>\n\u003cp>Of course, obesity's nothing to joke about -- it can lead to diabetes, heart disease, stroke and a host of other health problems. WalletHub asked medical and health academic experts to weigh in on the impact of the problem and how to combat it here.\u003c/p>\n\u003cp>And here's a clickable map where you can see which communities have the most and least problems with weight:\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ciframe src=\"//d2e70e9yced57e.cloudfront.net/wallethub/embed/10532/geochart-obesity4.html\" width=\"750\" height=\"477\" frameborder=\"0\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cdiv style=\"width: 750px;font-size: 12px;color: #888\">Source: \u003ca href=\"http://wallethub.com/edu/metro-areas-with-the-biggest-smallest-weight-problems/10532/\">WalletHub\u003c/a>\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_546\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/ScaleGeneric081211-e1425334365300.jpg\">\u003cimg class=\"size-large wp-image-546\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/ScaleGeneric081211-620x415.jpg\" alt=\"Woman's feet on scale.\" width=\"620\" height=\"415\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Justin Sullivan/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The South Bay and San Francisco compete on a multitude of fronts: Which will snag the hottest tech firms, which can retain or attract the most sports teams, which will win the prize for least affordable housing...\u003c/p>\n\u003cp>But no matter how many prestige points San Francisco racks up, the South Bay can claim bragging rights based on at least one important metric: weight.\u003c/p>\n\u003cp>\u003ca href=\"http://wallethub.com/edu/metro-areas-with-the-biggest-smallest-weight-problems/10532/\" target=\"_blank\">That's according to WalletHub,\u003c/a> a personal finance website that spends a lot of time compiling data on all sorts of things. (Last month they told us the Bay Area is one of the more diverse regions in the U.S.) From the site:\u003c/p>\n\u003cblockquote>\u003cp>In light of National Nutrition Month, WalletHub analyzed 100 of the most populated U.S. metro areas to identify those where weight-related problems call for heightened attention. We did so by examining 12 key metrics, among which are the percentage of adults and high school students who are obese and the percentage of people who are physically inactive.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>WalletHub ranked the San Jose-Sunnyvale-Santa Clara area as having the third-smallest problem with weight. That was best in the Bay Area and two slots higher than San Francisco-Oakland-Hayward, which came in at No. 5. (San Franciscans, feel free to blame Oakland and Hayward for weighing you down; Oaklanders and Haywardians, commence vice versa.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In terms of obesity itself, San Jose-Sunnyvale-Santa Clara is sixth best, San Francisco et al. is three slots behind at No. 9.\u003c/p>\n\u003cp>Here's the methodology the site used. The report drew on data from the Centers for Disease Control and Prevention, the U.S. Department of Agriculture Economic Research Service, the Child and Adolescent Health Measurement Initiative and WalletHub's own research, it said.\u003c/p>\n\u003cp>Of course, obesity's nothing to joke about -- it can lead to diabetes, heart disease, stroke and a host of other health problems. WalletHub asked medical and health academic experts to weigh in on the impact of the problem and how to combat it here.\u003c/p>\n\u003cp>And here's a clickable map where you can see which communities have the most and least problems with weight:\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ciframe src=\"//d2e70e9yced57e.cloudfront.net/wallethub/embed/10532/geochart-obesity4.html\" width=\"750\" height=\"477\" frameborder=\"0\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cdiv style=\"width: 750px;font-size: 12px;color: #888\">Source: \u003ca href=\"http://wallethub.com/edu/metro-areas-with-the-biggest-smallest-weight-problems/10532/\">WalletHub\u003c/a>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Is Your Dishwasher Increasing Your Child's Allergy Risk?",
"title": "Is Your Dishwasher Increasing Your Child's Allergy Risk?",
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"content": "\u003cfigure id=\"attachment_23978\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/iStock_000037223338_Medium-e1424720733978.jpg\">\u003cimg class=\"size-large wp-image-23978\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/iStock_000037223338_Medium-640x427.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Rob Stein,\u003c/strong> \u003ca title=\"http://www.npr.org/blogs/health/2015/02/23/387553285/kids-allergies-and-a-possible-downside-to-squeaky-clean-dishes\" href=\"http://www.npr.org/blogs/health/2015/02/23/387553285/kids-allergies-and-a-possible-downside-to-squeaky-clean-dishes\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Could using a dishwashing machine increase the chances your child will develop allergies? That's what some provocative new research suggests — but don't rip out your machine just yet.\u003c/p>\n\u003cp>The \u003ca href=\"http://pediatrics.aappublications.org/content/early/2015/02/17/peds.2014-2968.full.pdf+html\" target=\"_blank\">study\u003c/a> involved 1,029 Swedish children (ages 7 or 8) and found that those whose parents said they mostly wash the family's dishes by hand were significantly less likely to develop eczema, and somewhat less likely to develop allergic asthma and hay fever.\u003c/p>\n\u003cp>\"I think it is very interesting that with a very common lifestyle factor like dishwashing, we could see effects on allergy development,\" says \u003ca href=\"http://www.gu.se/english/about_the_university/staff/?languageId=100001&userId=xhesbi&userName=Bill+Hesselmar\" target=\"_blank\">Dr. Bill Hesselmar\u003c/a> of Sweden's University of Gothenburg, who led the study.\u003c!--more-->\u003c/p>\n\u003cp>The findings are the latest to support the \"hygiene hypothesis,\" a still-evolving proposition that's been gaining momentum in recent years. The hypothesis basically suggests that people in developed countries are growing up way too clean because of a variety of trends, including the use of hand sanitizers and detergents, and spending too little time around animals.\u003c/p>\n\u003cdiv id=\"res387854830\" class=\"bucketwrap internallink insettwocolumn inset2col \">\u003c/div>\n\u003cp>As a result, children don't tend to be exposed to as many bacteria and other microorganisms, and maybe that deprives their immune system of the chance to be trained to recognize microbial friend from foe.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That may make the immune system more likely to misfire and overreact in a way that leads to allergies, eczema and asthma, Hesselmar says.\u003c/p>\n\u003cp>He and his colleagues have been trying to figure out some of the simple day-to-day ways we might be too clean. A \u003ca href=\"http://www.npr.org/blogs/health/2013/05/06/180817114/parents-saliva-on-pacifiers-could-ward-off-babys-allergies\" target=\"_blank\">previous study\u003c/a> examined how parents cleaned off their children's pacifiers. In their latest research, the researchers took a look at how people wash their dishes.\u003c/p>\n\u003cp>\"The hypothesis was that these different dishwashing methods ... are not equally good in reducing bacteria from eating utensils and so on,\" Hesselmar says. \"So we thought that perhaps hand dishwashing was less effective, so that you are exposed to more bacteria\" in a way that's helpful.\u003c/p>\n\u003cp>In a study released Monday in the online version of the journal \u003cem>Pediatrics\u003c/em>, the researchers report what they found: In families who said they mostly wash dishes by hand, significantly fewer children had eczema, and somewhat fewer had either asthma or hay fever, compared to kids from families who let machines wash their dishes.\u003c/p>\n\u003cp>Other researchers say the new study may be onto something, though it's still too soon to tell.\u003c/p>\n\u003cdiv id=\"res387852160\" class=\"bucketwrap internallink insettwocolumn inset2col \">\u003c/div>\n\u003cp>\"I think it's very intriguing and lends one more 'X' on the column for the hygiene hypothesis,\" says \u003ca href=\"http://www.gundersenhealth.org/physicians/Todd-Mahr\" target=\"_blank\">Dr. Todd Mahr\u003c/a>\u003ca href=\"http://www.gundersenhealth.org/physicians/Todd-Mahr\">,\u003c/a> an allergist at the Gundersen Health System in La Crosse, Wis., and a member of the American Academy of Pediatrics.\u003c/p>\n\u003cp>Still, there are other possible explanations, Hesselmar and Mahr both caution. Though the researchers took economic status into account in the study, it could be that people who don't have dishwashers are alike in some other way that reduces their tendency to get allergies.\u003c/p>\n\u003cp>Interestingly, for example, certain other lifestyle characteristics — eating fermented foods regularly, and tending to buy some foods straight from the farm — seemed to strengthen the \"protective\" effect in families without dishwashers.\u003c/p>\n\u003cp>The doctors say they're not ready to recommend that parents stop using the machines.\u003c/p>\n\u003cp>\"If you're looking at, 'We have only a certain amount of money, and we're looking at buying a dishwasher or spending it on something else,' this might give you an argument to say: 'Well, maybe spend it on something else,' \" Mahr says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But, he adds, \"I'm not convinced it's going to make that big a difference.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23978\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/iStock_000037223338_Medium-e1424720733978.jpg\">\u003cimg class=\"size-large wp-image-23978\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/iStock_000037223338_Medium-640x427.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Rob Stein,\u003c/strong> \u003ca title=\"http://www.npr.org/blogs/health/2015/02/23/387553285/kids-allergies-and-a-possible-downside-to-squeaky-clean-dishes\" href=\"http://www.npr.org/blogs/health/2015/02/23/387553285/kids-allergies-and-a-possible-downside-to-squeaky-clean-dishes\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Could using a dishwashing machine increase the chances your child will develop allergies? That's what some provocative new research suggests — but don't rip out your machine just yet.\u003c/p>\n\u003cp>The \u003ca href=\"http://pediatrics.aappublications.org/content/early/2015/02/17/peds.2014-2968.full.pdf+html\" target=\"_blank\">study\u003c/a> involved 1,029 Swedish children (ages 7 or 8) and found that those whose parents said they mostly wash the family's dishes by hand were significantly less likely to develop eczema, and somewhat less likely to develop allergic asthma and hay fever.\u003c/p>\n\u003cp>\"I think it is very interesting that with a very common lifestyle factor like dishwashing, we could see effects on allergy development,\" says \u003ca href=\"http://www.gu.se/english/about_the_university/staff/?languageId=100001&userId=xhesbi&userName=Bill+Hesselmar\" target=\"_blank\">Dr. Bill Hesselmar\u003c/a> of Sweden's University of Gothenburg, who led the study.\u003c!--more-->\u003c/p>\n\u003cp>The findings are the latest to support the \"hygiene hypothesis,\" a still-evolving proposition that's been gaining momentum in recent years. The hypothesis basically suggests that people in developed countries are growing up way too clean because of a variety of trends, including the use of hand sanitizers and detergents, and spending too little time around animals.\u003c/p>\n\u003cdiv id=\"res387854830\" class=\"bucketwrap internallink insettwocolumn inset2col \">\u003c/div>\n\u003cp>As a result, children don't tend to be exposed to as many bacteria and other microorganisms, and maybe that deprives their immune system of the chance to be trained to recognize microbial friend from foe.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That may make the immune system more likely to misfire and overreact in a way that leads to allergies, eczema and asthma, Hesselmar says.\u003c/p>\n\u003cp>He and his colleagues have been trying to figure out some of the simple day-to-day ways we might be too clean. A \u003ca href=\"http://www.npr.org/blogs/health/2013/05/06/180817114/parents-saliva-on-pacifiers-could-ward-off-babys-allergies\" target=\"_blank\">previous study\u003c/a> examined how parents cleaned off their children's pacifiers. In their latest research, the researchers took a look at how people wash their dishes.\u003c/p>\n\u003cp>\"The hypothesis was that these different dishwashing methods ... are not equally good in reducing bacteria from eating utensils and so on,\" Hesselmar says. \"So we thought that perhaps hand dishwashing was less effective, so that you are exposed to more bacteria\" in a way that's helpful.\u003c/p>\n\u003cp>In a study released Monday in the online version of the journal \u003cem>Pediatrics\u003c/em>, the researchers report what they found: In families who said they mostly wash dishes by hand, significantly fewer children had eczema, and somewhat fewer had either asthma or hay fever, compared to kids from families who let machines wash their dishes.\u003c/p>\n\u003cp>Other researchers say the new study may be onto something, though it's still too soon to tell.\u003c/p>\n\u003cdiv id=\"res387852160\" class=\"bucketwrap internallink insettwocolumn inset2col \">\u003c/div>\n\u003cp>\"I think it's very intriguing and lends one more 'X' on the column for the hygiene hypothesis,\" says \u003ca href=\"http://www.gundersenhealth.org/physicians/Todd-Mahr\" target=\"_blank\">Dr. Todd Mahr\u003c/a>\u003ca href=\"http://www.gundersenhealth.org/physicians/Todd-Mahr\">,\u003c/a> an allergist at the Gundersen Health System in La Crosse, Wis., and a member of the American Academy of Pediatrics.\u003c/p>\n\u003cp>Still, there are other possible explanations, Hesselmar and Mahr both caution. Though the researchers took economic status into account in the study, it could be that people who don't have dishwashers are alike in some other way that reduces their tendency to get allergies.\u003c/p>\n\u003cp>Interestingly, for example, certain other lifestyle characteristics — eating fermented foods regularly, and tending to buy some foods straight from the farm — seemed to strengthen the \"protective\" effect in families without dishwashers.\u003c/p>\n\u003cp>The doctors say they're not ready to recommend that parents stop using the machines.\u003c/p>\n\u003cp>\"If you're looking at, 'We have only a certain amount of money, and we're looking at buying a dishwasher or spending it on something else,' this might give you an argument to say: 'Well, maybe spend it on something else,' \" Mahr says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But, he adds, \"I'm not convinced it's going to make that big a difference.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Licensed Midwife Opens Birth Center in Fresno",
"title": "Licensed Midwife Opens Birth Center in Fresno",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_23855\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/image-copy-e1423509749423.jpg\">\u003cimg class=\"size-large wp-image-23855\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/image-copy-640x473.jpg\" alt=\"Detrah Hele (left), a licensed midwife, opened The Birth Place in Fresno last fall. Alex DePastene (right) works with her. (Courtesy: Mike DePastene)\" width=\"640\" height=\"473\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Detrah Hele (left), a licensed midwife, opened The Birth Place in Fresno last fall. Alex DePastene (right) works with her. (Courtesy: Mike DePastene)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alice Daniel,\u003c/strong> \u003ca href=\"http://www.californiahealthline.org/insight/2015/birth-center-opens-in-san-joaquin-valley\" target=\"_blank\">CaliforniaHealthline\u003c/a>\u003c/p>\n\u003cp>Even as licensed midwife Detrah Hele explained why she recently opened a birth center in Fresno, she was in her car heading to a client's home in Visalia.\u003c/p>\n\u003cp>Her client was a labor and delivery nurse who had already had two home births and was about to have a third one under Hele's supervision. Hele has caught hundreds of babies since she got her license 10 years ago. She said it had been a dream of hers to establish a place where pregnant women could give birth outside a hospital setting.\u003c/p>\n\u003cp>After months of searching, she found the right property in downtown Fresno, a home on the historic register that was most recently the office of the Fresno Women's Medical Group. She dealt with all the necessary city codes and opened The Birth Place in October 2014. It is the only birth center in the San Joaquin Valley. Another licensed midwife, Alex DePastene, works with her.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>How Care Differs at Birth Centers, Hospitals\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Birth centers in the U.S. operate according to standards defined by the \u003ca href=\"http://www.birthcenters.org/\" target=\"_blank\">American Association of Birth Centers\u003c/a>. These include working only with low-risk pregnancies. Pain medications and epidurals aren't used, while pain management techniques such as walking or sitting in a tub of water are encouraged. To facilitate more comfortable labor, women at birth centers are not connected to electronic fetal monitors, which can prevent movement.\u003c/p>\n\u003cp>The model of care offered at a birth center is different from a labor and delivery unit in a hospital, said Kate Bauer, director of the American Association of Birth Centers. \"The philosophy is different,\" she said. At birth centers, \"pregnancy is not seen as an illness that needs to be cured. It's a wellness event for a woman and her family.\" Under birth centers' wellness model, interventions are used only when medically necessary.\u003c/p>\n\u003cp>Hospitals, said Bauer, are more intervention-oriented. That's useful when there are complications, but many healthy, low-risk pregnant women receive unnecessary interventions in hospitals, Bauer said. According to \u003ca href=\"http://www.childbirthconnection.org/pdfs/LTMII_report.pdf\" target=\"_blank\">a report in the \u003cem>Journal of Perinatal Education\u003c/em>\u003c/a>, 47 percent of women have their labor artificially accelerated with medications, and 43 percent of women giving birth for the first time have labor artificially induced.\u003c/p>\n\u003cp>\u003cstrong>Study Highlights Birth Center Benefits\u003c/strong>\u003c/p>\n\u003cp>Multiple studies show that birth centers offer quality and cost-effective care, Bauer said. The most recent report, \"\u003ca href=\"http://www.birthcenters.org/content/new-study-shows-midwife-led-birth-centers-improve-outcomes-and-lower-health-care-costs\" target=\"_blank\">The National Birth Center Study II\u003c/a>,\" published in the \u003cem>Journal of Midwifery and Women's Health\u003c/em>, found that birth centers not only provide safe outcomes for babies, but also have a much lower rate of cesarean sections. The C-section rate for low-risk women giving birth in birth centers was 6 percent, compared with a rate of 24 percent for low-risk women in hospitals.\u003c/p>\n\u003cp>[contextly_sidebar id=\"4fCvmsxGRJQQY1Xv31PYezfHdXCRYLn6\"]\u003c/p>\n\u003cp>There are 34 birth centers in California, many clustered around Southern California and the Bay Area. There are 295 nationwide, an increase of 20 percent since 2013, Bauer said. The country's first recognized birth center opened in New York City in 1975.\u003c/p>\n\u003cp>Birth centers \"have had to overcome some challenges in the reimbursement and liability insurance landscape,\" Bauer said. The recent increase in centers may be related, in part, to the Affordable Care Act. The ACA mandates Medicaid reimbursement for birth center facility services and providers. Prior to the law, reimbursements were open to interpretation and varied from state to state. However, the \u003ca href=\"http://www.birthcenters.org/content/medicaid-implementation-0\" target=\"_blank\">mandate\u003c/a> has been implemented correctly only in about half the states, Bauer said.\u003c/p>\n\u003cp>\u003cstrong>Few Women Opt for Birth Centers\u003c/strong>\u003c/p>\n\u003cp>Very few women use birth centers nationwide. According to the \u003ca href=\"http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf\" target=\"_blank\">most recent data\u003c/a> from CDC, only 1.4 percent of births took place out of a hospital in 2013. Of the more than 56,000 out-of-hospital births, about two-thirds took place at home and 30.2 percent in a freestanding birth center.\u003c/p>\n\u003cp>The Birth Place in Fresno can accommodate up to three laboring women at one time but Hele said most of her clients still opt for a home birth. Out of seven clients due in February, two of them want to give birth at the center. \"Home births and the birth center are essentially the same,\" she said. \"The only difference is, at the birth center, you're eventually going to have to go home. At your house, you stay in bed and we go home.\" She said that some clients are more comfortable at the birth center because it's directly across from a local hospital.\u003c/p>\n\u003cp>The American College of Obstetrics and Gynecology recommends hospitals and birthing centers as the safest place for labor and delivery. According to an ACOG spokesperson, the organization just released a new Obstetric Care Consensus recommending the creation of a new system of classification of care levels, including birthing centers.\u003c/p>\n\u003cp>Classifications are important because birthing centers offer different levels of capability, according to ACOG officials. Although obstetrical complications are rare, they can progress rapidly and can be life-threatening for the woman and infant, so it is important that birthing centers have the ability to provide care in an emergency, the spokesperson said.\u003c/p>\n\u003cp>\u003cstrong>Emergency Transfers to Hospitals Are Rare\u003c/strong>\u003c/p>\n\u003cp>According to the \"\u003ca title=\"http://www.birthcenters.org/content/new-study-shows-midwife-led-birth-centers-improve-outcomes-and-lower-health-care-costs\" href=\"http://www.birthcenters.org/content/new-study-shows-midwife-led-birth-centers-improve-outcomes-and-lower-health-care-costs\" target=\"_blank\">National Birth Center Study II,\u003c/a>\" most transfers to hospitals from birth centers were not emergencies -- the most common reason was prolonged labor. For emergency transfers during labor, the most common reason was concern about fetal heart rate patterns; fewer than 1 percent of the study's participants were transferred during labor for emergency reasons.\u003c/p>\n\u003cp>Hele said she always has two skilled attendants at a birth, also recommended by ACOG. \"We're always watching,\" Hele said. \"We know normal, so when something's not normal anymore, we're going to notice it.\"\u003c/p>\n\u003cp>California midwives are licensed and regulated by the Medical Board of California. Licensed midwives are different from Certified Nurse Midwives, who typically practice under doctors and deliver infants in hospitals. In January 2014, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/09/13/midwifery-physical-therapy-pharmacists-bills-move-to-governors-desk-scope-of-practice/\" href=\"http://ww2.kqed.org/stateofhealth/2013/09/13/midwifery-physical-therapy-pharmacists-bills-move-to-governors-desk-scope-of-practice/\" target=\"_blank\">a state law was passed\u003c/a> giving licensed midwives the right to practice without doctor supervision. Before that, licensed midwives were expected to work with doctors but found they had little support, according to Hele. \"For 20 years, midwives operated out of the letter of the law, and the state knew that,\" Hele said.\u003c/p>\n\u003cp>Hele said she typically charges $4,000 for a home birth and about $500 more at The Birth Place. She said insurance policies vary widely when it comes to births at home or in a center.\u003c/p>\n\u003cp>A \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/01/16/how-much-does-it-cost-to-have-a-baby-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/01/16/how-much-does-it-cost-to-have-a-baby-in-california/\" target=\"_blank\">study published last year\u003c/a> by UC-San Francisco found that costs for an uncomplicated vaginal delivery in California hospitals ranged from $3,296 to $37,227. Women who underwent C-sections were charged between $8,312 and $71,000.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"The birth center is not for everyone, but for many women it is a choice that can provide a really wonderful birth experience,\" said Bauer. \"It's the appropriate level of care at the appropriate time, and it starts with prenatal care.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23855\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/image-copy-e1423509749423.jpg\">\u003cimg class=\"size-large wp-image-23855\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/image-copy-640x473.jpg\" alt=\"Detrah Hele (left), a licensed midwife, opened The Birth Place in Fresno last fall. Alex DePastene (right) works with her. (Courtesy: Mike DePastene)\" width=\"640\" height=\"473\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Detrah Hele (left), a licensed midwife, opened The Birth Place in Fresno last fall. Alex DePastene (right) works with her. (Courtesy: Mike DePastene)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alice Daniel,\u003c/strong> \u003ca href=\"http://www.californiahealthline.org/insight/2015/birth-center-opens-in-san-joaquin-valley\" target=\"_blank\">CaliforniaHealthline\u003c/a>\u003c/p>\n\u003cp>Even as licensed midwife Detrah Hele explained why she recently opened a birth center in Fresno, she was in her car heading to a client's home in Visalia.\u003c/p>\n\u003cp>Her client was a labor and delivery nurse who had already had two home births and was about to have a third one under Hele's supervision. Hele has caught hundreds of babies since she got her license 10 years ago. She said it had been a dream of hers to establish a place where pregnant women could give birth outside a hospital setting.\u003c/p>\n\u003cp>After months of searching, she found the right property in downtown Fresno, a home on the historic register that was most recently the office of the Fresno Women's Medical Group. She dealt with all the necessary city codes and opened The Birth Place in October 2014. It is the only birth center in the San Joaquin Valley. Another licensed midwife, Alex DePastene, works with her.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>How Care Differs at Birth Centers, Hospitals\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Birth centers in the U.S. operate according to standards defined by the \u003ca href=\"http://www.birthcenters.org/\" target=\"_blank\">American Association of Birth Centers\u003c/a>. These include working only with low-risk pregnancies. Pain medications and epidurals aren't used, while pain management techniques such as walking or sitting in a tub of water are encouraged. To facilitate more comfortable labor, women at birth centers are not connected to electronic fetal monitors, which can prevent movement.\u003c/p>\n\u003cp>The model of care offered at a birth center is different from a labor and delivery unit in a hospital, said Kate Bauer, director of the American Association of Birth Centers. \"The philosophy is different,\" she said. At birth centers, \"pregnancy is not seen as an illness that needs to be cured. It's a wellness event for a woman and her family.\" Under birth centers' wellness model, interventions are used only when medically necessary.\u003c/p>\n\u003cp>Hospitals, said Bauer, are more intervention-oriented. That's useful when there are complications, but many healthy, low-risk pregnant women receive unnecessary interventions in hospitals, Bauer said. According to \u003ca href=\"http://www.childbirthconnection.org/pdfs/LTMII_report.pdf\" target=\"_blank\">a report in the \u003cem>Journal of Perinatal Education\u003c/em>\u003c/a>, 47 percent of women have their labor artificially accelerated with medications, and 43 percent of women giving birth for the first time have labor artificially induced.\u003c/p>\n\u003cp>\u003cstrong>Study Highlights Birth Center Benefits\u003c/strong>\u003c/p>\n\u003cp>Multiple studies show that birth centers offer quality and cost-effective care, Bauer said. The most recent report, \"\u003ca href=\"http://www.birthcenters.org/content/new-study-shows-midwife-led-birth-centers-improve-outcomes-and-lower-health-care-costs\" target=\"_blank\">The National Birth Center Study II\u003c/a>,\" published in the \u003cem>Journal of Midwifery and Women's Health\u003c/em>, found that birth centers not only provide safe outcomes for babies, but also have a much lower rate of cesarean sections. The C-section rate for low-risk women giving birth in birth centers was 6 percent, compared with a rate of 24 percent for low-risk women in hospitals.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>There are 34 birth centers in California, many clustered around Southern California and the Bay Area. There are 295 nationwide, an increase of 20 percent since 2013, Bauer said. The country's first recognized birth center opened in New York City in 1975.\u003c/p>\n\u003cp>Birth centers \"have had to overcome some challenges in the reimbursement and liability insurance landscape,\" Bauer said. The recent increase in centers may be related, in part, to the Affordable Care Act. The ACA mandates Medicaid reimbursement for birth center facility services and providers. Prior to the law, reimbursements were open to interpretation and varied from state to state. However, the \u003ca href=\"http://www.birthcenters.org/content/medicaid-implementation-0\" target=\"_blank\">mandate\u003c/a> has been implemented correctly only in about half the states, Bauer said.\u003c/p>\n\u003cp>\u003cstrong>Few Women Opt for Birth Centers\u003c/strong>\u003c/p>\n\u003cp>Very few women use birth centers nationwide. According to the \u003ca href=\"http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf\" target=\"_blank\">most recent data\u003c/a> from CDC, only 1.4 percent of births took place out of a hospital in 2013. Of the more than 56,000 out-of-hospital births, about two-thirds took place at home and 30.2 percent in a freestanding birth center.\u003c/p>\n\u003cp>The Birth Place in Fresno can accommodate up to three laboring women at one time but Hele said most of her clients still opt for a home birth. Out of seven clients due in February, two of them want to give birth at the center. \"Home births and the birth center are essentially the same,\" she said. \"The only difference is, at the birth center, you're eventually going to have to go home. At your house, you stay in bed and we go home.\" She said that some clients are more comfortable at the birth center because it's directly across from a local hospital.\u003c/p>\n\u003cp>The American College of Obstetrics and Gynecology recommends hospitals and birthing centers as the safest place for labor and delivery. According to an ACOG spokesperson, the organization just released a new Obstetric Care Consensus recommending the creation of a new system of classification of care levels, including birthing centers.\u003c/p>\n\u003cp>Classifications are important because birthing centers offer different levels of capability, according to ACOG officials. Although obstetrical complications are rare, they can progress rapidly and can be life-threatening for the woman and infant, so it is important that birthing centers have the ability to provide care in an emergency, the spokesperson said.\u003c/p>\n\u003cp>\u003cstrong>Emergency Transfers to Hospitals Are Rare\u003c/strong>\u003c/p>\n\u003cp>According to the \"\u003ca title=\"http://www.birthcenters.org/content/new-study-shows-midwife-led-birth-centers-improve-outcomes-and-lower-health-care-costs\" href=\"http://www.birthcenters.org/content/new-study-shows-midwife-led-birth-centers-improve-outcomes-and-lower-health-care-costs\" target=\"_blank\">National Birth Center Study II,\u003c/a>\" most transfers to hospitals from birth centers were not emergencies -- the most common reason was prolonged labor. For emergency transfers during labor, the most common reason was concern about fetal heart rate patterns; fewer than 1 percent of the study's participants were transferred during labor for emergency reasons.\u003c/p>\n\u003cp>Hele said she always has two skilled attendants at a birth, also recommended by ACOG. \"We're always watching,\" Hele said. \"We know normal, so when something's not normal anymore, we're going to notice it.\"\u003c/p>\n\u003cp>California midwives are licensed and regulated by the Medical Board of California. Licensed midwives are different from Certified Nurse Midwives, who typically practice under doctors and deliver infants in hospitals. In January 2014, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/09/13/midwifery-physical-therapy-pharmacists-bills-move-to-governors-desk-scope-of-practice/\" href=\"http://ww2.kqed.org/stateofhealth/2013/09/13/midwifery-physical-therapy-pharmacists-bills-move-to-governors-desk-scope-of-practice/\" target=\"_blank\">a state law was passed\u003c/a> giving licensed midwives the right to practice without doctor supervision. Before that, licensed midwives were expected to work with doctors but found they had little support, according to Hele. \"For 20 years, midwives operated out of the letter of the law, and the state knew that,\" Hele said.\u003c/p>\n\u003cp>Hele said she typically charges $4,000 for a home birth and about $500 more at The Birth Place. She said insurance policies vary widely when it comes to births at home or in a center.\u003c/p>\n\u003cp>A \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/01/16/how-much-does-it-cost-to-have-a-baby-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/01/16/how-much-does-it-cost-to-have-a-baby-in-california/\" target=\"_blank\">study published last year\u003c/a> by UC-San Francisco found that costs for an uncomplicated vaginal delivery in California hospitals ranged from $3,296 to $37,227. Women who underwent C-sections were charged between $8,312 and $71,000.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"The birth center is not for everyone, but for many women it is a choice that can provide a really wonderful birth experience,\" said Bauer. \"It's the appropriate level of care at the appropriate time, and it starts with prenatal care.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Health Officials Discourage 'Measles Parties'",
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"content": "\u003cfigure id=\"attachment_17842\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/167095303-e1393030020245.jpg\">\u003cimg class=\"size-medium wp-image-17842\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/167095303-300x287.jpg\" alt=\"Vial of Measles Mumps and Rubella (MMR) vaccine. (Geoff Caddick/AFP/Getty Images)\" width=\"300\" height=\"287\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Vial of Measles Mumps and Rubella (MMR) vaccine. (Geoff Caddick/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Julie Schiffman is a mother of two in Marin County. The choice to not vaccinate her kids, now 6 and 8, was a long and difficult one, she said. But deciding whether to intentionally expose them to measles was easy.\u003c/p>\n\u003cp>“I would never do that to my kid,” she said.\u003c/p>\n\u003cp>She was approached recently by a friend who knew her kids were unvaccinated. The friend offered to help set up a play date with another child who was sick.\u003c/p>\n\u003cp>“She said, ‘I know someone who has the measles, would you like to be connected with them?’” Schiffman said.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Measles parties and chicken pox parties are practices that developed in eras before vaccines for those diseases were available. Both viruses are known to cause greater, more dangerous complications in adults. So some parents would intentionally infect their kids when they were young to work through the illness in its milder form, then retain immunity.\u003c/p>\n\u003cp>“People did this with chicken pox all the time,” said \u003ca href=\"http://www.sph.berkeley.edu/arthur-reingold\">Art Reingold\u003c/a>, an epidemiology professor at UC Berkeley who worked at the Centers for Disease Control in the 1980s. “Parents would have kids lick a lollipop and give it to other kids, or mail it to other kids.”\u003c/p>\n\u003cp>The chicken pox vaccine was licensed for use in 1995; for measles in 1963. Today, some parents are still deliberately getting their kids sick because they don't believe in vaccines.\u003c/p>\n\u003cp>“The basic notion is ‘this is my opportunity for my kid to get immune the old fashioned way, the way God intended,’” Reingold said. “’The way nature intended.’”\u003c/p>\n\u003cp>Pockets of the\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/18/bay-area-communities-are-home-to-clusters-of-people-refusing-vaccines/\"> San Francisco Bay Area\u003c/a>, Los Angeles, and rural areas in the far north of the state have an unusually high number of parents who opt out of vaccinating their kids. Public health officials are worried about what might happen if parents take it upon themselves to infect their children with measles.\u003c/p>\n\u003cp>“It unnecessarily places the exposed children at potentially grave risk and could contribute to further spread of the outbreak,” the California Department of Public Health said in an email, adding that it \"strongly recommends against the intentional exposure of children to measles.\"\u003c/p>\n\u003cp>Thirty percent of people with measles in the current California outbreak have been hospitalized. While measles is most dangerous in children under 5 and adults over 20, there can be serious consequences for kids, including pneumonia or hearing loss. A small number die.\u003c/p>\n\u003cp>Reingold says hosting measles play dates or parties is ill-advised.\u003c/p>\n\u003cp>“To me, it's looney tunes,” he said. “We have a safe, effective vaccine, why would you do it?”\u003c/p>\n\u003cp>Julie Schiffman says she and her husband are willing to reconsider vaccinating their kids, but no evidence has surfaced to change their minds yet. She says she respects the choice of other parents who decide to expose their unvaccinated kids to measles. But she and her husband declined the opportunity.\u003c/p>\n\u003cp>“I would want that to be something they decide on their own, when they’re older and are more capable of assessing the risks and dangers,” she says.\u003c/p>\n\u003cp>“When they’re teenagers, I’d say, ‘okay, you have a choice, you can get vaccinated or you can get the measles, what would you rather?’” she said. “Then they have more say over what they do with their bodies. And I would respect their choice, whatever it was.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/189791419\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17842\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/167095303-e1393030020245.jpg\">\u003cimg class=\"size-medium wp-image-17842\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/167095303-300x287.jpg\" alt=\"Vial of Measles Mumps and Rubella (MMR) vaccine. (Geoff Caddick/AFP/Getty Images)\" width=\"300\" height=\"287\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Vial of Measles Mumps and Rubella (MMR) vaccine. (Geoff Caddick/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Julie Schiffman is a mother of two in Marin County. The choice to not vaccinate her kids, now 6 and 8, was a long and difficult one, she said. But deciding whether to intentionally expose them to measles was easy.\u003c/p>\n\u003cp>“I would never do that to my kid,” she said.\u003c/p>\n\u003cp>She was approached recently by a friend who knew her kids were unvaccinated. The friend offered to help set up a play date with another child who was sick.\u003c/p>\n\u003cp>“She said, ‘I know someone who has the measles, would you like to be connected with them?’” Schiffman said.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Measles parties and chicken pox parties are practices that developed in eras before vaccines for those diseases were available. Both viruses are known to cause greater, more dangerous complications in adults. So some parents would intentionally infect their kids when they were young to work through the illness in its milder form, then retain immunity.\u003c/p>\n\u003cp>“People did this with chicken pox all the time,” said \u003ca href=\"http://www.sph.berkeley.edu/arthur-reingold\">Art Reingold\u003c/a>, an epidemiology professor at UC Berkeley who worked at the Centers for Disease Control in the 1980s. “Parents would have kids lick a lollipop and give it to other kids, or mail it to other kids.”\u003c/p>\n\u003cp>The chicken pox vaccine was licensed for use in 1995; for measles in 1963. Today, some parents are still deliberately getting their kids sick because they don't believe in vaccines.\u003c/p>\n\u003cp>“The basic notion is ‘this is my opportunity for my kid to get immune the old fashioned way, the way God intended,’” Reingold said. “’The way nature intended.’”\u003c/p>\n\u003cp>Pockets of the\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/18/bay-area-communities-are-home-to-clusters-of-people-refusing-vaccines/\"> San Francisco Bay Area\u003c/a>, Los Angeles, and rural areas in the far north of the state have an unusually high number of parents who opt out of vaccinating their kids. Public health officials are worried about what might happen if parents take it upon themselves to infect their children with measles.\u003c/p>\n\u003cp>“It unnecessarily places the exposed children at potentially grave risk and could contribute to further spread of the outbreak,” the California Department of Public Health said in an email, adding that it \"strongly recommends against the intentional exposure of children to measles.\"\u003c/p>\n\u003cp>Thirty percent of people with measles in the current California outbreak have been hospitalized. While measles is most dangerous in children under 5 and adults over 20, there can be serious consequences for kids, including pneumonia or hearing loss. A small number die.\u003c/p>\n\u003cp>Reingold says hosting measles play dates or parties is ill-advised.\u003c/p>\n\u003cp>“To me, it's looney tunes,” he said. “We have a safe, effective vaccine, why would you do it?”\u003c/p>\n\u003cp>Julie Schiffman says she and her husband are willing to reconsider vaccinating their kids, but no evidence has surfaced to change their minds yet. She says she respects the choice of other parents who decide to expose their unvaccinated kids to measles. But she and her husband declined the opportunity.\u003c/p>\n\u003cp>“I would want that to be something they decide on their own, when they’re older and are more capable of assessing the risks and dangers,” she says.\u003c/p>\n\u003cp>“When they’re teenagers, I’d say, ‘okay, you have a choice, you can get vaccinated or you can get the measles, what would you rather?’” she said. “Then they have more say over what they do with their bodies. And I would respect their choice, whatever it was.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='undefined' height='undefined'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/189791419&visual=true&undefined'\n title='https://api.soundcloud.com/tracks/189791419'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Once A Vaccine Skeptic, This Mom Changed Her Mind",
"title": "Once A Vaccine Skeptic, This Mom Changed Her Mind",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_23813\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/Screen-Shot-2015-02-04-at-10.26.34-AM.png\">\u003cimg class=\"size-large wp-image-23813\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/Screen-Shot-2015-02-04-at-10.26.34-AM-640x420.png\" alt=\"Juniper Russo walks her dogs with her daughter Vivian (left). (Courtesy of Juniper Russo)\" width=\"640\" height=\"420\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Juniper Russo walks her dogs with her daughter Vivian (left).\u003cbr>(Courtesy of Juniper Russo)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jon Hamilton,\u003c/strong> \u003ca title=\"http://www.npr.org/blogs/health/2015/02/04/383567862/once-a-vaccine-skeptic-this-mom-changed-her-mind\" href=\"http://www.npr.org/blogs/health/2015/02/04/383567862/once-a-vaccine-skeptic-this-mom-changed-her-mind\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>The ongoing measles outbreak linked to Disneyland has led to some harsh comments about parents who don't vaccinate their kids. But Juniper Russo, a writer in Chattanooga, Tenn., says she understands those parents because she used to be one of them.\u003c/p>\n\u003cp>\"I know what it's like to be scared and just want to protect your children, and make the wrong decisions,\" Russo says.\u003c/p>\n\u003cp>When her daughter Vivian was born, \"I was really adamant that she not get vaccines,\" Russo says. \"I thought that she was going to be safe without them and they would unnecessarily introduce chemicals into her body that could hurt her.\"\u003c/p>\n\u003cp>That's a view shared by many parents who choose not to vaccinate. And in Russo's case, it was reinforced by parents she met online.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"I had a lot of online acquaintances who claimed that their kids had become autistic because of vaccines,\" Russo says. \"I got kind of swept up in that.\"\u003c/p>\n\u003cp>But fear of autism was only part of the reason Russo didn't want vaccines for her daughter. She says at that point in her life she identified strongly with what she calls \"crunchy moms\" who question mainstream medicine and things that aren't natural.\u003c/p>\n\u003cp>\"They're the ones who breast-feed and cloth-diaper and co-sleep and all that stuff,\" Russo says. \"And so much of who I was, was being a crunchy mom. At the time I thought that if I went along with what my pediatrician suggested ... I would be losing part of who I was.\"\u003c/p>\n\u003cp>Her daughter's pediatrician, though, kept talking to Russo about vaccines. And, over the next couple of years, she began to reconsider her position.\u003c/p>\n\u003cp>She also began to worry about Vivian. At 16 months old, her daughter still wasn't walking and her speech was odd.\u003c/p>\n\u003cp>Over the next year or so, Russo allowed the pediatrician to give her daughter a few shots — though not the vaccine against measles, mumps and rubella.\u003c/p>\n\u003cp>Then, when Vivian was nearly 3, Russo decided her daughter should get all her vaccines. By that time, Russo says, it was pretty clear that Vivian had autism, caused by something other than a vaccination.\u003c/p>\n\u003cp>Russo's story reveals a lot about why people fear vaccines, says David Ropeik, the author of How Risky Is It, Really? Why Our Fears Don't Always Match the Facts. For one thing, science often has little influence on what we are afraid of, Ropeik says.\u003c/p>\n\u003cp>\"Fear, or the perception of risk, is subjective,\" Ropeik says. \"It's a matter of how we feel about the facts we have, not just what the facts say.\u003c/p>\n\u003cp>\"Also, our perceptions are often shaped by the communities we choose to join,\" Ropeik says. In Russo's case, that community was self-described \"crunchy moms\" who distrust mainstream medicine. But there are plenty of other communities with subgroups that reject vaccination for other reasons, he says.\u003c/p>\n\u003cp>\"There's conservatism: I don't like government butting in. There's libertarianism: Leave me alone, I want to decide for myself. There's environmentalism, there's religion,\" Ropeik says.\u003c/p>\n\u003cp>And for a long time, Ropeik says, these subgroups didn't have to confront a downside to rejecting vaccines. \"There is the sense that the diseases are largely gone, so why take even a small risk for no benefit?\" he says.\u003c/p>\n\u003cp>Now that sort of thinking is getting \u003ca title=\"http://www.npr.org/blogs/13.7/2015/02/03/383501038/science-denialism-has-consequences\" href=\"http://www.npr.org/blogs/13.7/2015/02/03/383501038/science-denialism-has-consequences\" target=\"_blank\">harder to justify\u003c/a> because \"the diseases are back,\" Ropeik says. Equally important, the current measles outbreak involves Disneyland — \"an iconic, happy, associated-with-nothing-bad-happening kind of place,\" he says.\u003c/p>\n\u003cp>That's helped generate a huge amount of publicity for this outbreak, even though it's still much smaller than an outbreak centered in Ohio that occurred just last year. And it's got some former vaccine skeptics thinking that perhaps diseases do pose a greater risk than vaccines, Ropeik says.\u003c/p>\n\u003cp>Russo hopes the current outbreak gets a lot of people thinking about protecting children.\u003c/p>\n\u003cp>Her daughter is 6 now and has grown into a quirky kid who loves Pokemon, reading and writing and cats, Russo says. The concern now is for Russo's son, who is just 6 months old.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"He's too young to have the measles vaccine, and I know that there's a chance that he could end up catching measles before he's old enough to get the vaccine,\" she says.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23813\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/Screen-Shot-2015-02-04-at-10.26.34-AM.png\">\u003cimg class=\"size-large wp-image-23813\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/Screen-Shot-2015-02-04-at-10.26.34-AM-640x420.png\" alt=\"Juniper Russo walks her dogs with her daughter Vivian (left). (Courtesy of Juniper Russo)\" width=\"640\" height=\"420\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Juniper Russo walks her dogs with her daughter Vivian (left).\u003cbr>(Courtesy of Juniper Russo)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jon Hamilton,\u003c/strong> \u003ca title=\"http://www.npr.org/blogs/health/2015/02/04/383567862/once-a-vaccine-skeptic-this-mom-changed-her-mind\" href=\"http://www.npr.org/blogs/health/2015/02/04/383567862/once-a-vaccine-skeptic-this-mom-changed-her-mind\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>The ongoing measles outbreak linked to Disneyland has led to some harsh comments about parents who don't vaccinate their kids. But Juniper Russo, a writer in Chattanooga, Tenn., says she understands those parents because she used to be one of them.\u003c/p>\n\u003cp>\"I know what it's like to be scared and just want to protect your children, and make the wrong decisions,\" Russo says.\u003c/p>\n\u003cp>When her daughter Vivian was born, \"I was really adamant that she not get vaccines,\" Russo says. \"I thought that she was going to be safe without them and they would unnecessarily introduce chemicals into her body that could hurt her.\"\u003c/p>\n\u003cp>That's a view shared by many parents who choose not to vaccinate. And in Russo's case, it was reinforced by parents she met online.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"I had a lot of online acquaintances who claimed that their kids had become autistic because of vaccines,\" Russo says. \"I got kind of swept up in that.\"\u003c/p>\n\u003cp>But fear of autism was only part of the reason Russo didn't want vaccines for her daughter. She says at that point in her life she identified strongly with what she calls \"crunchy moms\" who question mainstream medicine and things that aren't natural.\u003c/p>\n\u003cp>\"They're the ones who breast-feed and cloth-diaper and co-sleep and all that stuff,\" Russo says. \"And so much of who I was, was being a crunchy mom. At the time I thought that if I went along with what my pediatrician suggested ... I would be losing part of who I was.\"\u003c/p>\n\u003cp>Her daughter's pediatrician, though, kept talking to Russo about vaccines. And, over the next couple of years, she began to reconsider her position.\u003c/p>\n\u003cp>She also began to worry about Vivian. At 16 months old, her daughter still wasn't walking and her speech was odd.\u003c/p>\n\u003cp>Over the next year or so, Russo allowed the pediatrician to give her daughter a few shots — though not the vaccine against measles, mumps and rubella.\u003c/p>\n\u003cp>Then, when Vivian was nearly 3, Russo decided her daughter should get all her vaccines. By that time, Russo says, it was pretty clear that Vivian had autism, caused by something other than a vaccination.\u003c/p>\n\u003cp>Russo's story reveals a lot about why people fear vaccines, says David Ropeik, the author of How Risky Is It, Really? Why Our Fears Don't Always Match the Facts. For one thing, science often has little influence on what we are afraid of, Ropeik says.\u003c/p>\n\u003cp>\"Fear, or the perception of risk, is subjective,\" Ropeik says. \"It's a matter of how we feel about the facts we have, not just what the facts say.\u003c/p>\n\u003cp>\"Also, our perceptions are often shaped by the communities we choose to join,\" Ropeik says. In Russo's case, that community was self-described \"crunchy moms\" who distrust mainstream medicine. But there are plenty of other communities with subgroups that reject vaccination for other reasons, he says.\u003c/p>\n\u003cp>\"There's conservatism: I don't like government butting in. There's libertarianism: Leave me alone, I want to decide for myself. There's environmentalism, there's religion,\" Ropeik says.\u003c/p>\n\u003cp>And for a long time, Ropeik says, these subgroups didn't have to confront a downside to rejecting vaccines. \"There is the sense that the diseases are largely gone, so why take even a small risk for no benefit?\" he says.\u003c/p>\n\u003cp>Now that sort of thinking is getting \u003ca title=\"http://www.npr.org/blogs/13.7/2015/02/03/383501038/science-denialism-has-consequences\" href=\"http://www.npr.org/blogs/13.7/2015/02/03/383501038/science-denialism-has-consequences\" target=\"_blank\">harder to justify\u003c/a> because \"the diseases are back,\" Ropeik says. Equally important, the current measles outbreak involves Disneyland — \"an iconic, happy, associated-with-nothing-bad-happening kind of place,\" he says.\u003c/p>\n\u003cp>That's helped generate a huge amount of publicity for this outbreak, even though it's still much smaller than an outbreak centered in Ohio that occurred just last year. And it's got some former vaccine skeptics thinking that perhaps diseases do pose a greater risk than vaccines, Ropeik says.\u003c/p>\n\u003cp>Russo hopes the current outbreak gets a lot of people thinking about protecting children.\u003c/p>\n\u003cp>Her daughter is 6 now and has grown into a quirky kid who loves Pokemon, reading and writing and cats, Russo says. The concern now is for Russo's son, who is just 6 months old.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"He's too young to have the measles vaccine, and I know that there's a chance that he could end up catching measles before he's old enough to get the vaccine,\" she says.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Got P.E.? Settlement Says Schools Must Prove They Provide It",
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"content": "\u003cfigure id=\"attachment_23798\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/Kids-running-Santa-Rosa-elementary-e1422991871174.jpg\">\u003cimg class=\"wp-image-23798 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/Kids-running-Santa-Rosa-elementary-640x427.jpg\" alt=\"Recess at Cox Academy in Oakland. (Jane Meredith Adams/EdSource)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Recess at Cox Academy in Oakland. (Jane Meredith Adams/EdSource)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jane Meredith Adams, \u003ca title=\"http://edsource.org/2015/lawsuit-agreement-to-force-schools-to-provide-physical-education/73544#.VNEhmEvJ4Tt\" href=\"http://edsource.org/2015/lawsuit-agreement-to-force-schools-to-provide-physical-education/73544#.VNEhmEvJ4Tt\" target=\"_blank\">EdSource\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>As schools tout the importance of exercise in an era of childhood obesity, a California parent and his lawyer have agreed to a settlement with \u003ca title=\"http://edsource.org/wp-content/uploads/2015/01/pe-lawsuit.png\" href=\"http://edsource.org/wp-content/uploads/2015/01/pe-lawsuit.png\" target=\"_blank\">dozens of districts across California \u003c/a>that will force elementary schools to prove they are providing at least the minimum amount of physical education required by state law.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Now there's another lawsuit against Oakland Unified and other districts. \u003c/aside>\n\u003cp>“We think it’s a huge accomplishment and it’s going to benefit public health in California,” said attorney Donald Driscoll, who represents Alameda parent Marc Babin and the advocacy group Cal200 in a\u003ca title=\"https://www.documentcloud.org/documents/1513042-1stamendedcomplaintcal200babin.html\" href=\"https://www.documentcloud.org/documents/1513042-1stamendedcomplaintcal200babin.html\" target=\"_blank\"> 2013 lawsuit\u003c/a> that alleges 37 school districts, including Los Angeles Unified, the largest district in the state, are out of compliance with state physical education law.\u003c/p>\n\u003cp>The districts, which educate more than 20 percent of elementary students grades 1 through 6 statewide, have agreed to a settlement that requires elementary school teachers to publicly document how many minutes of physical education students receive, according to lawyers involved in the case.\u003c!--more-->\u003c/p>\n\u003cp>Under \u003ca title=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=51001-52000&file=51210-51212\" href=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=51001-52000&file=51210-51212\" target=\"_blank\">the state education code\u003c/a>, schools are required to provide 200 minutes of physical education every 10 school days for elementary students, but physical education classes have sunk to the bottom of the priority list in many schools that focus on preparing students for standardized tests.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>All parties in the lawsuit have asked San Francisco Superior Court Judge Mary Wiss to grant final approval to the settlement, which is expected by late March. Babin is president of Cal200, which advocates for physical education; it takes its name from the 200-minute physical education requirement.\u003c/p>\n\u003cp>What began as a quest in 2009 by Driscoll to ensure that his 3rd-grade son was receiving state-mandated physical education time at Albany’s Cornell Elementary School has developed into a series of lawsuits filed by Driscoll, Babin and \u003ca title=\"http://cal200.org/\" href=\"http://cal200.org/\" target=\"_blank\">Cal200\u003c/a> to ensure that all elementary school students in the state are receiving the physical education instruction they are entitled to by law.\u003c/p>\n\u003cp>Public health \u003ca title=\"http://cwh.berkeley.edu/sites/default/files/primary_pdfs/PE_Toolkit_Presentation_9.13.pdf\" href=\"http://cwh.berkeley.edu/sites/default/files/primary_pdfs/PE_Toolkit_Presentation_9.13.pdf\" target=\"_blank\">advocates\u003c/a>, physical education teachers and the California Legislature have long urged districts to comply with physical education requirements, but those requirements are “rarely enforced,” according to a \u003ca title=\"http://tcenews.calendow.org/archives/california-physical-education\" href=\"http://tcenews.calendow.org/archives/california-physical-education\" target=\"_blank\">2008 report, “Physical Education Matters,”\u003c/a> by researchers at San Diego State University. The California Department of Education includes an evaluation of physical education in its cycle of compliance monitoring of districts, but according to the researchers at San Diego State, “There are no real consequences for failure to comply.”\u003c/p>\n\u003cp>A key legal turning point occurred during a 2009 lawsuit Driscoll filed against Albany Unified. When the district argued that the Education Code requirement of 200 minutes of physical education every 10 days was a goal and a guideline, not a mandate, a Sacramento Superior Court judge agreed and dismissed the case. But the California Third District Court of Appeals overturned that judgment and\u003ca title=\"http://www.leagle.com/decision/In%20CACO%2020101130059\" href=\"http://www.leagle.com/decision/In%20CACO%2020101130059\" target=\"_blank\"> ruled that physical education requirements were a mandate\u003c/a>, not a suggestion.\u003c/p>\n\u003cp>\u003cstrong>New Suit Filed Against Oakland Unified and Other Districts\u003c/strong>\u003c/p>\n\u003cp>Driscoll then teamed up with Babin, a retired investigator with the California Department of Insurance. Babin declined through Driscoll to be interviewed. But Driscoll said Babin likes the investigative challenge of the cases. “In a sense it’s an extension of the sorts of things he did as an investigator for the state,” he said.\u003c/p>\n\u003cp>They began to look into physical education instruction compliance in elementary schools across the state.\u003c/p>\n\u003cp>“I thought it was important to speak up not just for my son’s school but for the schools of other people’s kids,” Driscoll said.\u003c/p>\n\u003cp>They have no plans to stop.\u003c/p>\n\u003cp>“He’s just going to keep going after folks,” said Michael Fine, deputy superintendent for the Riverside Unified School District, one of the districts named in the lawsuit, Cal200 and Marc Babin v. San Francisco Unified School District et al. Asked if he was referring to Driscoll or Babin, Fine said, “Both. I think they’re going to pick off groups of districts.”\u003c/p>\n\u003cp>That appears to be happening already. In November, Babin and Cal200, represented by Driscoll, \u003ca title=\"https://www.documentcloud.org/documents/1513063-cal200babin-oaklandunifed-relatedcase.html\" href=\"https://www.documentcloud.org/documents/1513063-cal200babin-oaklandunifed-relatedcase.html\" target=\"_blank\">filed suit\u003c/a> against Oakland Unified School District et al., alleging that Oakland and other districts, which are to be named at a later date, are not compliant with elementary school physical education requirements.\u003c/p>\n\u003cp>Insurers have put school districts on notice. In 2013, the Alliance of Schools for Cooperative Insurance Programs, a public agency that provides insurance to about 100 California school districts, sent out a “risk alert” that Cal200 and Babin “are seeking additional districts” to sue. Districts should be prepared to prove they are providing the required minutes of physical education or that they have an action plan to do so, the alert stated.\u003c/p>\n\u003cp>Under the settlement agreement, elementary school teachers in the districts must report the minutes they spend teaching physical education, publish the schedule to parents and be subject to spot checks from principals. If teachers skip scheduled physical education instruction, they will note the reason why and report when those minutes were made up. The schedules will be submitted to local school boards for review.\u003c/p>\n\u003cp>While no one disputes the value of exercise in children’s development, budget cuts have reduced or eliminated credentialed physical education teaching positions in many elementary schools. As a result, classroom teachers are asked to squeeze in physical education while simultaneously improving academic test scores.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Jane Meredith Adams covers student health and well-being for \u003ca title=\"http://edsource.org\" href=\"http://edsource.org\" target=\"_blank\">EdSource.\u003c/a>\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23798\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/Kids-running-Santa-Rosa-elementary-e1422991871174.jpg\">\u003cimg class=\"wp-image-23798 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/Kids-running-Santa-Rosa-elementary-640x427.jpg\" alt=\"Recess at Cox Academy in Oakland. (Jane Meredith Adams/EdSource)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Recess at Cox Academy in Oakland. (Jane Meredith Adams/EdSource)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jane Meredith Adams, \u003ca title=\"http://edsource.org/2015/lawsuit-agreement-to-force-schools-to-provide-physical-education/73544#.VNEhmEvJ4Tt\" href=\"http://edsource.org/2015/lawsuit-agreement-to-force-schools-to-provide-physical-education/73544#.VNEhmEvJ4Tt\" target=\"_blank\">EdSource\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>As schools tout the importance of exercise in an era of childhood obesity, a California parent and his lawyer have agreed to a settlement with \u003ca title=\"http://edsource.org/wp-content/uploads/2015/01/pe-lawsuit.png\" href=\"http://edsource.org/wp-content/uploads/2015/01/pe-lawsuit.png\" target=\"_blank\">dozens of districts across California \u003c/a>that will force elementary schools to prove they are providing at least the minimum amount of physical education required by state law.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Now there's another lawsuit against Oakland Unified and other districts. \u003c/aside>\n\u003cp>“We think it’s a huge accomplishment and it’s going to benefit public health in California,” said attorney Donald Driscoll, who represents Alameda parent Marc Babin and the advocacy group Cal200 in a\u003ca title=\"https://www.documentcloud.org/documents/1513042-1stamendedcomplaintcal200babin.html\" href=\"https://www.documentcloud.org/documents/1513042-1stamendedcomplaintcal200babin.html\" target=\"_blank\"> 2013 lawsuit\u003c/a> that alleges 37 school districts, including Los Angeles Unified, the largest district in the state, are out of compliance with state physical education law.\u003c/p>\n\u003cp>The districts, which educate more than 20 percent of elementary students grades 1 through 6 statewide, have agreed to a settlement that requires elementary school teachers to publicly document how many minutes of physical education students receive, according to lawyers involved in the case.\u003c!--more-->\u003c/p>\n\u003cp>Under \u003ca title=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=51001-52000&file=51210-51212\" href=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=51001-52000&file=51210-51212\" target=\"_blank\">the state education code\u003c/a>, schools are required to provide 200 minutes of physical education every 10 school days for elementary students, but physical education classes have sunk to the bottom of the priority list in many schools that focus on preparing students for standardized tests.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>All parties in the lawsuit have asked San Francisco Superior Court Judge Mary Wiss to grant final approval to the settlement, which is expected by late March. Babin is president of Cal200, which advocates for physical education; it takes its name from the 200-minute physical education requirement.\u003c/p>\n\u003cp>What began as a quest in 2009 by Driscoll to ensure that his 3rd-grade son was receiving state-mandated physical education time at Albany’s Cornell Elementary School has developed into a series of lawsuits filed by Driscoll, Babin and \u003ca title=\"http://cal200.org/\" href=\"http://cal200.org/\" target=\"_blank\">Cal200\u003c/a> to ensure that all elementary school students in the state are receiving the physical education instruction they are entitled to by law.\u003c/p>\n\u003cp>Public health \u003ca title=\"http://cwh.berkeley.edu/sites/default/files/primary_pdfs/PE_Toolkit_Presentation_9.13.pdf\" href=\"http://cwh.berkeley.edu/sites/default/files/primary_pdfs/PE_Toolkit_Presentation_9.13.pdf\" target=\"_blank\">advocates\u003c/a>, physical education teachers and the California Legislature have long urged districts to comply with physical education requirements, but those requirements are “rarely enforced,” according to a \u003ca title=\"http://tcenews.calendow.org/archives/california-physical-education\" href=\"http://tcenews.calendow.org/archives/california-physical-education\" target=\"_blank\">2008 report, “Physical Education Matters,”\u003c/a> by researchers at San Diego State University. The California Department of Education includes an evaluation of physical education in its cycle of compliance monitoring of districts, but according to the researchers at San Diego State, “There are no real consequences for failure to comply.”\u003c/p>\n\u003cp>A key legal turning point occurred during a 2009 lawsuit Driscoll filed against Albany Unified. When the district argued that the Education Code requirement of 200 minutes of physical education every 10 days was a goal and a guideline, not a mandate, a Sacramento Superior Court judge agreed and dismissed the case. But the California Third District Court of Appeals overturned that judgment and\u003ca title=\"http://www.leagle.com/decision/In%20CACO%2020101130059\" href=\"http://www.leagle.com/decision/In%20CACO%2020101130059\" target=\"_blank\"> ruled that physical education requirements were a mandate\u003c/a>, not a suggestion.\u003c/p>\n\u003cp>\u003cstrong>New Suit Filed Against Oakland Unified and Other Districts\u003c/strong>\u003c/p>\n\u003cp>Driscoll then teamed up with Babin, a retired investigator with the California Department of Insurance. Babin declined through Driscoll to be interviewed. But Driscoll said Babin likes the investigative challenge of the cases. “In a sense it’s an extension of the sorts of things he did as an investigator for the state,” he said.\u003c/p>\n\u003cp>They began to look into physical education instruction compliance in elementary schools across the state.\u003c/p>\n\u003cp>“I thought it was important to speak up not just for my son’s school but for the schools of other people’s kids,” Driscoll said.\u003c/p>\n\u003cp>They have no plans to stop.\u003c/p>\n\u003cp>“He’s just going to keep going after folks,” said Michael Fine, deputy superintendent for the Riverside Unified School District, one of the districts named in the lawsuit, Cal200 and Marc Babin v. San Francisco Unified School District et al. Asked if he was referring to Driscoll or Babin, Fine said, “Both. I think they’re going to pick off groups of districts.”\u003c/p>\n\u003cp>That appears to be happening already. In November, Babin and Cal200, represented by Driscoll, \u003ca title=\"https://www.documentcloud.org/documents/1513063-cal200babin-oaklandunifed-relatedcase.html\" href=\"https://www.documentcloud.org/documents/1513063-cal200babin-oaklandunifed-relatedcase.html\" target=\"_blank\">filed suit\u003c/a> against Oakland Unified School District et al., alleging that Oakland and other districts, which are to be named at a later date, are not compliant with elementary school physical education requirements.\u003c/p>\n\u003cp>Insurers have put school districts on notice. In 2013, the Alliance of Schools for Cooperative Insurance Programs, a public agency that provides insurance to about 100 California school districts, sent out a “risk alert” that Cal200 and Babin “are seeking additional districts” to sue. Districts should be prepared to prove they are providing the required minutes of physical education or that they have an action plan to do so, the alert stated.\u003c/p>\n\u003cp>Under the settlement agreement, elementary school teachers in the districts must report the minutes they spend teaching physical education, publish the schedule to parents and be subject to spot checks from principals. If teachers skip scheduled physical education instruction, they will note the reason why and report when those minutes were made up. The schedules will be submitted to local school boards for review.\u003c/p>\n\u003cp>While no one disputes the value of exercise in children’s development, budget cuts have reduced or eliminated credentialed physical education teaching positions in many elementary schools. As a result, classroom teachers are asked to squeeze in physical education while simultaneously improving academic test scores.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Jane Meredith Adams covers student health and well-being for \u003ca title=\"http://edsource.org\" href=\"http://edsource.org\" target=\"_blank\">EdSource.\u003c/a>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Vaccine Opt-Out Rate Drops -- First Time Since 1998; Look Up Your Calif. School",
"title": "Vaccine Opt-Out Rate Drops -- First Time Since 1998; Look Up Your Calif. School",
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"content": "\u003cp>\u003cstrong>By Olivia Allen-Price and Lisa Aliferis\u003c/strong>\u003c/p>\n\u003cp>Under California law, all kindergarteners must be vaccinated against a range of communicable diseases before they can start school. But California also permits parents to opt-out of vaccines on behalf of their children. The opt-out rate \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine-opt-out-rate-doubled-in-7-years-look-up-your-school-online/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine-opt-out-rate-doubled-in-7-years-look-up-your-school-online/\" target=\"_blank\">doubled over a seven year\u003c/a> period ending last school year. But now, for the first time since 1998, the opt-out rate has declined, from 3.15 percent statewide to 2.5 percent.\u003c/p>\n\u003cp>A\u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/08/23/new-requirement-for-vaccine-exemption-passed-by-senate/\" href=\"http://ww2.kqed.org/stateofhealth/2012/08/23/new-requirement-for-vaccine-exemption-passed-by-senate/\" target=\"_blank\"> new state law\u003c/a> appears to be the driver. Under \u003ca title=\"http://www.aroundthecapitol.com/billtrack/text.html?bvid=20110AB210996AMD\" href=\"http://www.aroundthecapitol.com/billtrack/text.html?bvid=20110AB210996AMD\" target=\"_blank\">AB 2109\u003c/a>, parents who wish to opt out of vaccines must file a personal belief exemption or PBE, a signed statement that vaccines are against their personal belief.\u003c/p>\n\u003cp>\u003ca href=\"#lookup\">\u003cimg class=\"alignright size-full wp-image-23583\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/lookup.jpg\" alt=\"lookup\" width=\"300\" height=\"151\">\u003c/a>This school year, for the first time, parents must first meet with a health provider who explains the risks and benefits of both vaccines and vaccine-preventable diseases. Until the current school year, parents simply had to sign the statement without any consultation.\u003c/p>\n\u003cp>State senator Richard Pan (D-Sacramento) sponsored the bill and is pretty happy about the decline. He believes that requiring the meeting with a health care provider clears up confusion some parents have about vaccines.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"By requiring them to talk to a physician or other health provider,\" Pan said, \"they can get more information and when they get that information, they feel more comfortable about getting their children vaccinated.\"\u003c/p>\n\u003cp>\"In addition, the law likely catches people who might have been too busy to get to the doctor. \"In the past you could just sign before you could go to school,\" said Dr. Dean Blumberg of the UC Davis medical center who is involved in vaccine research. \"Now since you have to talk to your health provider to sign the form, you may as well -- since you're talking to the doctor -- get them vaccinated.\"\u003c/p>\n\u003cp>\u003cstrong>PBE Rates Changed Over Time\u003c/strong>\u003c/p>\n\u003cp>Blumberg provided State of Health with data from a \u003ca title=\"https://cdc.confex.com/cdc/nic2010/webprogram/Paper22752.html\" href=\"https://cdc.confex.com/cdc/nic2010/webprogram/Paper22752.html\" target=\"_blank\">Centers for Disease Control vaccine conference\u003c/a> showing historical rates of personal belief exemptions in California. Rates had been comparatively low, especially after the 1989-1991 measles epidemic when there were 17,000 cases of measles and 70 people died in California.\u003c/p>\n\u003cp>Vaccine rates need to be 90 percent -- or higher -- depending on the disease to create what's known as \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\">herd immunity\u003c/a>. That means that enough people are vaccinated to protect those who cannot be vaccinated for medical reasons or whose immune system is compromised. This includes \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" target=\"_blank\">people being treated for cancer\u003c/a> or HIV patients and more. When vaccine rates are high, a disease introduced into a community cannot take hold.\u003c/p>\n\u003cp>Health officials would not be as concerned about the average PBE rate statewide -- but the rate \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/18/bay-area-communities-are-home-to-clusters-of-people-refusing-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/18/bay-area-communities-are-home-to-clusters-of-people-refusing-vaccines/\" target=\"_blank\">hides clusters where PBE rates are significantly higher\u003c/a>. In the Bay Area there are geographic clusters of vaccine refusals above 10 percent.\u003c/p>\n\u003cp>Right now, California health officials are working to contain a measles outbreak that has reached 91 cases this month.\u003c/p>\n\u003cp>After nearly a decade of low PBE rates in the 1990s, they started to increase in 1998. That was the same year a study was published that claimed a link between the measles, mumps, rubella vaccine and autism. The study was \u003ca title=\"http://www2.aap.org/immunization/families/mmr.html\" href=\"http://www2.aap.org/immunization/families/mmr.html\" target=\"_blank\">later debunked and retracted\u003c/a>.\u003c/p>\n\u003cp>But the damage was done. PBE rates have climbed steadily ever since, until now.\u003c/p>\n\u003cp>The California Department of Public Health \u003ca title=\"California Department of Public Health Immunization page\" href=\"http://www.cdph.ca.gov/programs/immunize/pages/immunizationlevels.aspx\" target=\"_blank\">collects vaccination rates\u003c/a> and PBE rates at every kindergarten in the state with more than 10 students — both public and private schools. Further below, we’ve made it easy for you to look up your own school.\u003c/p>\n\u003cp>Entering kindergarten children are required to be vaccinated against:\u003c/p>\n\u003cul>\n\u003cli>Polio\u003c/li>\n\u003cli>Diphtheria, Tetanus, and Pertussis (DTaP)\u003c/li>\n\u003cli>Measles, Mumps, and Rubella (MMR)\u003c/li>\n\u003cli>Hepatitis B\u003c/li>\n\u003cli>Varicella (Chickenpox)\u003c/li>\n\u003c/ul>\n\u003cp>For years, Marin County has had the highest PBE rate in the Bay Area. In the 2013-2014 school year, the county's PBE rate was 7.57 percent. This school year, it declined to 6.45 percent.\u003c/p>\n\u003cp>Four other Bay Area counties have lower PBE rates than Marin -- and their opt-out rates also declined from last year, as follows:\u003c/p>\n\u003cul>\n\u003cli>Santa Clara: 1.72 percent in 2013-2014 to 1.57 percent this year\u003c/li>\n\u003cli>Alameda: 1.78 percent to 1.54 percent\u003c/li>\n\u003cli>San Mateo: 2.26 percent to 1.85 percent\u003c/li>\n\u003cli>Contra Costa: 2.32 percent to 1.90 percent\u003c/li>\n\u003c/ul>\n\u003cp>But San Francisco County saw a slight increase in its PBE rate from 1.64 percent last year to 1.80 percent this year.\u003c/p>\n\u003cp>\u003cstrong>Find Any School in California\u003c/strong>\u003c/p>\n\u003cp>You can look up the personal belief exemption rate at your own school below. So you can see the trend, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/11/our-vaccine-database-methodology/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/our-vaccine-database-methodology/\" target=\"_blank\">we include data\u003c/a> from the 2007-2008 school year through the 2014-2015 school year, the most recent year for which data are available. This tool includes data from every kindergarten in the state, public or private, with 10 or more students.\u003c/p>\n\u003cp>The column to the far right — “PBE” — shows the percentage of children at a kindergarten with a personal belief exemption on file. The higher the number, the more children are not receiving vaccines.\u003c/p>\n\u003cp>\u003cstrong>Enter your child’s school in the search box at right:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ciframe src=\"http://projects1.kqed.org/vaccines/pbe2014-6.html\" width=\"100%\" height=\"1300px\" id=\"lookup\">\u003c/iframe>\u003c/p>\n\u003cstyle>\t \t \n.single-post #content {width: 100%; }\t \t \n.single-post #sidebar {display: none;}\t \t \n\u003c/style>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Olivia Allen-Price and Lisa Aliferis\u003c/strong>\u003c/p>\n\u003cp>Under California law, all kindergarteners must be vaccinated against a range of communicable diseases before they can start school. But California also permits parents to opt-out of vaccines on behalf of their children. The opt-out rate \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine-opt-out-rate-doubled-in-7-years-look-up-your-school-online/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine-opt-out-rate-doubled-in-7-years-look-up-your-school-online/\" target=\"_blank\">doubled over a seven year\u003c/a> period ending last school year. But now, for the first time since 1998, the opt-out rate has declined, from 3.15 percent statewide to 2.5 percent.\u003c/p>\n\u003cp>A\u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/08/23/new-requirement-for-vaccine-exemption-passed-by-senate/\" href=\"http://ww2.kqed.org/stateofhealth/2012/08/23/new-requirement-for-vaccine-exemption-passed-by-senate/\" target=\"_blank\"> new state law\u003c/a> appears to be the driver. Under \u003ca title=\"http://www.aroundthecapitol.com/billtrack/text.html?bvid=20110AB210996AMD\" href=\"http://www.aroundthecapitol.com/billtrack/text.html?bvid=20110AB210996AMD\" target=\"_blank\">AB 2109\u003c/a>, parents who wish to opt out of vaccines must file a personal belief exemption or PBE, a signed statement that vaccines are against their personal belief.\u003c/p>\n\u003cp>\u003ca href=\"#lookup\">\u003cimg class=\"alignright size-full wp-image-23583\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/lookup.jpg\" alt=\"lookup\" width=\"300\" height=\"151\">\u003c/a>This school year, for the first time, parents must first meet with a health provider who explains the risks and benefits of both vaccines and vaccine-preventable diseases. Until the current school year, parents simply had to sign the statement without any consultation.\u003c/p>\n\u003cp>State senator Richard Pan (D-Sacramento) sponsored the bill and is pretty happy about the decline. He believes that requiring the meeting with a health care provider clears up confusion some parents have about vaccines.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"By requiring them to talk to a physician or other health provider,\" Pan said, \"they can get more information and when they get that information, they feel more comfortable about getting their children vaccinated.\"\u003c/p>\n\u003cp>\"In addition, the law likely catches people who might have been too busy to get to the doctor. \"In the past you could just sign before you could go to school,\" said Dr. Dean Blumberg of the UC Davis medical center who is involved in vaccine research. \"Now since you have to talk to your health provider to sign the form, you may as well -- since you're talking to the doctor -- get them vaccinated.\"\u003c/p>\n\u003cp>\u003cstrong>PBE Rates Changed Over Time\u003c/strong>\u003c/p>\n\u003cp>Blumberg provided State of Health with data from a \u003ca title=\"https://cdc.confex.com/cdc/nic2010/webprogram/Paper22752.html\" href=\"https://cdc.confex.com/cdc/nic2010/webprogram/Paper22752.html\" target=\"_blank\">Centers for Disease Control vaccine conference\u003c/a> showing historical rates of personal belief exemptions in California. Rates had been comparatively low, especially after the 1989-1991 measles epidemic when there were 17,000 cases of measles and 70 people died in California.\u003c/p>\n\u003cp>Vaccine rates need to be 90 percent -- or higher -- depending on the disease to create what's known as \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\">herd immunity\u003c/a>. That means that enough people are vaccinated to protect those who cannot be vaccinated for medical reasons or whose immune system is compromised. This includes \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" target=\"_blank\">people being treated for cancer\u003c/a> or HIV patients and more. When vaccine rates are high, a disease introduced into a community cannot take hold.\u003c/p>\n\u003cp>Health officials would not be as concerned about the average PBE rate statewide -- but the rate \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/18/bay-area-communities-are-home-to-clusters-of-people-refusing-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/18/bay-area-communities-are-home-to-clusters-of-people-refusing-vaccines/\" target=\"_blank\">hides clusters where PBE rates are significantly higher\u003c/a>. In the Bay Area there are geographic clusters of vaccine refusals above 10 percent.\u003c/p>\n\u003cp>Right now, California health officials are working to contain a measles outbreak that has reached 91 cases this month.\u003c/p>\n\u003cp>After nearly a decade of low PBE rates in the 1990s, they started to increase in 1998. That was the same year a study was published that claimed a link between the measles, mumps, rubella vaccine and autism. The study was \u003ca title=\"http://www2.aap.org/immunization/families/mmr.html\" href=\"http://www2.aap.org/immunization/families/mmr.html\" target=\"_blank\">later debunked and retracted\u003c/a>.\u003c/p>\n\u003cp>But the damage was done. PBE rates have climbed steadily ever since, until now.\u003c/p>\n\u003cp>The California Department of Public Health \u003ca title=\"California Department of Public Health Immunization page\" href=\"http://www.cdph.ca.gov/programs/immunize/pages/immunizationlevels.aspx\" target=\"_blank\">collects vaccination rates\u003c/a> and PBE rates at every kindergarten in the state with more than 10 students — both public and private schools. Further below, we’ve made it easy for you to look up your own school.\u003c/p>\n\u003cp>Entering kindergarten children are required to be vaccinated against:\u003c/p>\n\u003cul>\n\u003cli>Polio\u003c/li>\n\u003cli>Diphtheria, Tetanus, and Pertussis (DTaP)\u003c/li>\n\u003cli>Measles, Mumps, and Rubella (MMR)\u003c/li>\n\u003cli>Hepatitis B\u003c/li>\n\u003cli>Varicella (Chickenpox)\u003c/li>\n\u003c/ul>\n\u003cp>For years, Marin County has had the highest PBE rate in the Bay Area. In the 2013-2014 school year, the county's PBE rate was 7.57 percent. This school year, it declined to 6.45 percent.\u003c/p>\n\u003cp>Four other Bay Area counties have lower PBE rates than Marin -- and their opt-out rates also declined from last year, as follows:\u003c/p>\n\u003cul>\n\u003cli>Santa Clara: 1.72 percent in 2013-2014 to 1.57 percent this year\u003c/li>\n\u003cli>Alameda: 1.78 percent to 1.54 percent\u003c/li>\n\u003cli>San Mateo: 2.26 percent to 1.85 percent\u003c/li>\n\u003cli>Contra Costa: 2.32 percent to 1.90 percent\u003c/li>\n\u003c/ul>\n\u003cp>But San Francisco County saw a slight increase in its PBE rate from 1.64 percent last year to 1.80 percent this year.\u003c/p>\n\u003cp>\u003cstrong>Find Any School in California\u003c/strong>\u003c/p>\n\u003cp>You can look up the personal belief exemption rate at your own school below. So you can see the trend, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/11/our-vaccine-database-methodology/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/our-vaccine-database-methodology/\" target=\"_blank\">we include data\u003c/a> from the 2007-2008 school year through the 2014-2015 school year, the most recent year for which data are available. This tool includes data from every kindergarten in the state, public or private, with 10 or more students.\u003c/p>\n\u003cp>The column to the far right — “PBE” — shows the percentage of children at a kindergarten with a personal belief exemption on file. 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"content": "\u003cp>\u003cstrong>By Olivia Allen-Price and Lisa Aliferis\u003c/strong>\u003c/p>\n\u003cp>When parents sign a personal belief exemption (PBE) in California, it allows them to legally send their child to school without being vaccinated.\u003c/p>\n\u003cp>Find the percentage of kindergarteners who are unvaccinated at your child's school below. We've included data from the last eight school years. This tool includes reports from every kindergarten in the state, public or private, with 10 or more students. \u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Enter your child’s school in the search box at the far right:\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ciframe src=\"http://projects1.kqed.org/vaccines/pbe2014-6.html\" width=\"100%\" height=\"1300px\">\u003c/iframe>\u003c/p>\n\u003cstyle>\t \t \n.single-post #content {width: 100%; }\t \t \n.single-post #sidebar {display: none;}\t \t \n\u003c/style>\n\u003cp>Learn more about \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/our-vaccine-database-methodology/\" target=\"_blank\">our methodology.\u003c/a> \u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"7p8mtINjF09t60dXF6vueZsxohXkoyws\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Olivia Allen-Price and Lisa Aliferis\u003c/strong>\u003c/p>\n\u003cp>When parents sign a personal belief exemption (PBE) in California, it allows them to legally send their child to school without being vaccinated.\u003c/p>\n\u003cp>Find the percentage of kindergarteners who are unvaccinated at your child's school below. We've included data from the last eight school years. This tool includes reports from every kindergarten in the state, public or private, with 10 or more students. \u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Enter your child’s school in the search box at the far right:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Call the Midwife: A Home Birth Story",
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"content": "\u003cfigure id=\"attachment_23671\" class=\"wp-caption aligncenter\" style=\"max-width: 632px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM.png\">\u003cimg class=\"size-full wp-image-23671\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM.png\" alt=\"The author's wife, Pippa, and their daughter, Caitlin, who was born at home, in 1982. (Courtesy: Nick Allen)\" width=\"632\" height=\"568\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM.png 632w, https://ww2.kqed.org/app/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM-400x359.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM-320x288.png 320w\" sizes=\"(max-width: 632px) 100vw, 632px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The author's wife, Pippa, and their daughter, Caitlin, who was born at home, in 1982. (Courtesy: Nick Allen)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Stephen Talbot\u003c/strong>\u003c/p>\n\u003cp>My wife, Pippa, gave birth like a giraffe, standing up.\u003c/p>\n\u003cp>I was astonished. This wasn’t quite the nativity scene I’d imagined. Then again, I should not have been too shocked. Pippa grew up in South Africa, she’s very keen on giraffes, and she likes doing things unconventionally.\u003c/p>\n\u003cp>I should also mention that this was happening at home, in our bedroom, in the middle of the night, and that no one else was around. Except for our two-year-old son asleep in another room.\u003c/p>\n\u003cp>Not to worry. Women have been giving birth in their homes, in their own fashion, for centuries, right? Well, actually, not so much these days, at least not in this country. A mere \u003ca title=\"http://www.cdc.gov/nchs/data/databriefs/db144.htm\" href=\"http://www.cdc.gov/nchs/data/databriefs/db144.htm\" target=\"_blank\">1.36 percent of births in the United States\u003c/a> in 2012 took place outside a hospital.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But this was 1982; we lived in a more freewheeling San Francisco, and home births with midwives were not so rare. In fact, our son Dashiell had been born in the very same bedroom, in then funky Bernal Heights, ushered into the world by his mother and a full cast of attendants. Led by a very experienced (if unlicensed) midwife, the birth team included her assistant, her back-up doctor complete with a traveling medical kit and oxygen tank, and three other doctors, all women, who happened to be relatives or close friends. I even had a bit role as a labor coach. There was little need for this full entourage, but it was reassuring.\u003c/p>\n\u003cp>Dash was three weeks past his due date — these days two weeks is the usual maximum before labor is induced. But Pippa had been intent on a home delivery and at the last possible moment, after a spicy dinner and some strong tea, she went into labor. With the midwife’s expert help, all went well. In just under three hours, from start to finish, our son slid into the world in that small room full of people.\u003c/p>\n\u003cp>This time, however, the room was empty, except for Pippa, me and our rapidly approaching second child. My only reassuring thought was that I’d been through this before, and I hadn’t passed out.\u003c/p>\n\u003cp>Frankly, I would have opted for a hospital delivery, but I wasn’t the one having the baby.\u003c/p>\n\u003cp>Pippa had been born at home in Johannesburg, and in those days, especially for a privileged family, the doctor came to you. Even though Pippa was a social worker in a San Francisco medical clinic, she still preferred to avoid hospitals unless absolutely necessary. For a pregnant American, this attitude was considered rebellious, even ill-advised. And the U.S. medical establishment still discourages home birth.\u003c/p>\n\u003cp>But the British national health service \u003ca title=\"http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html\" href=\"http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html\" target=\"_blank\">now agrees\u003c/a> with Pippa, declaring late last year that it’s safer in the UK for healthy women with uncomplicated pregnancies to give birth at home or in a birthing clinic than in a hospital. Naturally, “\u003ca title=\"http://www.kqed.org/tv/programs/archive/index.jsp?pgmid=20957\" href=\"http://www.kqed.org/tv/programs/archive/index.jsp?pgmid=20957\" target=\"_blank\">Call the Midwife\u003c/a>” on KQED is one of Pippa’s favorite British import shows.\u003c/p>\n\u003cp>For this second pregnancy, Pippa had chosen a team of licensed midwives affiliated with a local San Francisco hospital.\u003c/p>\n\u003cp>When her first labor cramps woke her around midnight, she promptly called the midwife on duty. They timed the contractions over the phone. The midwife advised her to take a warm bath to slow down the labor and give her a call later.\u003c/p>\n\u003cp>Pippa drew the bath and I started vacuuming. It’s a habit I picked up from my mother. She vacuumed with great vigor before any major event at home. It’s the one household chore I’ve never minded. It's something about operating machinery and making myself useful. Very appealing.\u003c/p>\n\u003cp>But before I could finish the carpeting in our living room, Pippa emerged — starkers — from the bath, saying, “Bloody hell, this baby won’t wait.” Wrapping herself in a robe, grabbing the phone, she notified the midwife, “This is it, ready or not.”\u003c/p>\n\u003cp>I was not feeling quite so ready myself. The midwife was now on her way, but she lived in Marin County, north of the Golden Gate Bridge. She wouldn't be here anytime soon. I encouraged Pippa to relax. But as the contractions came stronger and faster, relaxation was not much of an option. With mounting anxiety, I called the nearest doctor I could think of, our friend Kathy, who lived in our neighborhood. She’s a gerontologist, but at that moment I was not particularly picky.\u003c/p>\n\u003cp>Pippa began pacing, insisting that our child’s arrival was imminent. I implored her to hold back. She informed me this was no longer possible. A brief “I Love Lucy” scene ensued in which I kept yelling, “Not yet!” and Pippa kept moaning, “Yes, now.” Then she pressed her hands against the wall and pushed and I saw the undeniable validity of her argument. Our child’s head was emerging.\u003c/p>\n\u003cp>In a flash, she was born. I had just enough sense to reach over and let her slide out into my hands. It was a basket catch, Willie Mays-style. She was slippery, and she was blue. Wrong color, I thought. I stuck my finger in her little mouth, she gagged, coughed, and instantly turned a proper pink. I was euphoric with relief.\u003c/p>\n\u003cp>The doorbell rang. I handed our gurgling baby to her joyous, exhausted mother, and raced downstairs to admit a breathless Kathy. Upstairs, she quickly ascertained that everyone was alive and breathing and apparently healthy. She started to ask how this happened, but I interrupted to ask, “Aren’t we supposed to cut the umbilical cord?”\u003c/p>\n\u003cp>Scissors were promptly sterilized in boiling water; the deed was done.\u003c/p>\n\u003cp>The next hour or so passed in a daze, but we were all smiling now, temporarily delirious, as this newborn child, Caitlin, began to nurse. By dawn the house was full of relatives and friends, including the midwife who, apologizing for her late arrival, made certain all was well. It had been chaotic, but successful. A delivery in less than an hour. Mother and daughter doing fine.\u003c/p>\n\u003cp>When he awoke, our son Dash walked out of his room, saw all the people, yawned, and wondered aloud, “What’s happening?”\u003c/p>\n\u003cp>“You have a baby sister,” I said, “born right here at home.” And he wandered into our bedroom to see for himself.\u003c/p>\n\u003cp>Caitlin was not the only baby born at home in San Francisco that year. But over time, Pippa and I noticed that home births were going out of fashion. Our own son and his wife chose to have their first baby last year in a hospital in Santa Monica, where they were very happy with the way things went. Deliveries at home or in birthing clinics aren’t for everyone.\u003c/p>\n\u003cp>But now, 30 years after the home birth of my daughter, and after much debate over the soaring frequency of hospital C-sections, I wonder if this \u003ca title=\"http://www.nice.org.uk/guidance/CG190\" href=\"http://www.nice.org.uk/guidance/CG190\" target=\"_blank\">new endorsement by British medical authorities\u003c/a> of non-hospital births will lead to a resurgence in midwifery, even in the U.S.\u003c/p>\n\u003cp>My advice to prospective parents? Hospital or not, just in case, be prepared to handle that delivery yourselves.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Stephen Talbot was a staff reporter and producer at KQED from 1980-89. He has written and produced over 40 documentaries for public television, including the PBS series FRONTLINE and his music show, SOUND TRACKS. He’s a proud new grandfather.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23671\" class=\"wp-caption aligncenter\" style=\"max-width: 632px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM.png\">\u003cimg class=\"size-full wp-image-23671\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM.png\" alt=\"The author's wife, Pippa, and their daughter, Caitlin, who was born at home, in 1982. (Courtesy: Nick Allen)\" width=\"632\" height=\"568\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM.png 632w, https://ww2.kqed.org/app/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM-400x359.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM-320x288.png 320w\" sizes=\"(max-width: 632px) 100vw, 632px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The author's wife, Pippa, and their daughter, Caitlin, who was born at home, in 1982. (Courtesy: Nick Allen)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Stephen Talbot\u003c/strong>\u003c/p>\n\u003cp>My wife, Pippa, gave birth like a giraffe, standing up.\u003c/p>\n\u003cp>I was astonished. This wasn’t quite the nativity scene I’d imagined. Then again, I should not have been too shocked. Pippa grew up in South Africa, she’s very keen on giraffes, and she likes doing things unconventionally.\u003c/p>\n\u003cp>I should also mention that this was happening at home, in our bedroom, in the middle of the night, and that no one else was around. Except for our two-year-old son asleep in another room.\u003c/p>\n\u003cp>Not to worry. Women have been giving birth in their homes, in their own fashion, for centuries, right? Well, actually, not so much these days, at least not in this country. A mere \u003ca title=\"http://www.cdc.gov/nchs/data/databriefs/db144.htm\" href=\"http://www.cdc.gov/nchs/data/databriefs/db144.htm\" target=\"_blank\">1.36 percent of births in the United States\u003c/a> in 2012 took place outside a hospital.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But this was 1982; we lived in a more freewheeling San Francisco, and home births with midwives were not so rare. In fact, our son Dashiell had been born in the very same bedroom, in then funky Bernal Heights, ushered into the world by his mother and a full cast of attendants. Led by a very experienced (if unlicensed) midwife, the birth team included her assistant, her back-up doctor complete with a traveling medical kit and oxygen tank, and three other doctors, all women, who happened to be relatives or close friends. I even had a bit role as a labor coach. There was little need for this full entourage, but it was reassuring.\u003c/p>\n\u003cp>Dash was three weeks past his due date — these days two weeks is the usual maximum before labor is induced. But Pippa had been intent on a home delivery and at the last possible moment, after a spicy dinner and some strong tea, she went into labor. With the midwife’s expert help, all went well. In just under three hours, from start to finish, our son slid into the world in that small room full of people.\u003c/p>\n\u003cp>This time, however, the room was empty, except for Pippa, me and our rapidly approaching second child. My only reassuring thought was that I’d been through this before, and I hadn’t passed out.\u003c/p>\n\u003cp>Frankly, I would have opted for a hospital delivery, but I wasn’t the one having the baby.\u003c/p>\n\u003cp>Pippa had been born at home in Johannesburg, and in those days, especially for a privileged family, the doctor came to you. Even though Pippa was a social worker in a San Francisco medical clinic, she still preferred to avoid hospitals unless absolutely necessary. For a pregnant American, this attitude was considered rebellious, even ill-advised. And the U.S. medical establishment still discourages home birth.\u003c/p>\n\u003cp>But the British national health service \u003ca title=\"http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html\" href=\"http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html\" target=\"_blank\">now agrees\u003c/a> with Pippa, declaring late last year that it’s safer in the UK for healthy women with uncomplicated pregnancies to give birth at home or in a birthing clinic than in a hospital. Naturally, “\u003ca title=\"http://www.kqed.org/tv/programs/archive/index.jsp?pgmid=20957\" href=\"http://www.kqed.org/tv/programs/archive/index.jsp?pgmid=20957\" target=\"_blank\">Call the Midwife\u003c/a>” on KQED is one of Pippa’s favorite British import shows.\u003c/p>\n\u003cp>For this second pregnancy, Pippa had chosen a team of licensed midwives affiliated with a local San Francisco hospital.\u003c/p>\n\u003cp>When her first labor cramps woke her around midnight, she promptly called the midwife on duty. They timed the contractions over the phone. The midwife advised her to take a warm bath to slow down the labor and give her a call later.\u003c/p>\n\u003cp>Pippa drew the bath and I started vacuuming. It’s a habit I picked up from my mother. She vacuumed with great vigor before any major event at home. It’s the one household chore I’ve never minded. It's something about operating machinery and making myself useful. Very appealing.\u003c/p>\n\u003cp>But before I could finish the carpeting in our living room, Pippa emerged — starkers — from the bath, saying, “Bloody hell, this baby won’t wait.” Wrapping herself in a robe, grabbing the phone, she notified the midwife, “This is it, ready or not.”\u003c/p>\n\u003cp>I was not feeling quite so ready myself. The midwife was now on her way, but she lived in Marin County, north of the Golden Gate Bridge. She wouldn't be here anytime soon. I encouraged Pippa to relax. But as the contractions came stronger and faster, relaxation was not much of an option. With mounting anxiety, I called the nearest doctor I could think of, our friend Kathy, who lived in our neighborhood. She’s a gerontologist, but at that moment I was not particularly picky.\u003c/p>\n\u003cp>Pippa began pacing, insisting that our child’s arrival was imminent. I implored her to hold back. She informed me this was no longer possible. A brief “I Love Lucy” scene ensued in which I kept yelling, “Not yet!” and Pippa kept moaning, “Yes, now.” Then she pressed her hands against the wall and pushed and I saw the undeniable validity of her argument. Our child’s head was emerging.\u003c/p>\n\u003cp>In a flash, she was born. I had just enough sense to reach over and let her slide out into my hands. It was a basket catch, Willie Mays-style. She was slippery, and she was blue. Wrong color, I thought. I stuck my finger in her little mouth, she gagged, coughed, and instantly turned a proper pink. I was euphoric with relief.\u003c/p>\n\u003cp>The doorbell rang. I handed our gurgling baby to her joyous, exhausted mother, and raced downstairs to admit a breathless Kathy. Upstairs, she quickly ascertained that everyone was alive and breathing and apparently healthy. She started to ask how this happened, but I interrupted to ask, “Aren’t we supposed to cut the umbilical cord?”\u003c/p>\n\u003cp>Scissors were promptly sterilized in boiling water; the deed was done.\u003c/p>\n\u003cp>The next hour or so passed in a daze, but we were all smiling now, temporarily delirious, as this newborn child, Caitlin, began to nurse. By dawn the house was full of relatives and friends, including the midwife who, apologizing for her late arrival, made certain all was well. It had been chaotic, but successful. A delivery in less than an hour. Mother and daughter doing fine.\u003c/p>\n\u003cp>When he awoke, our son Dash walked out of his room, saw all the people, yawned, and wondered aloud, “What’s happening?”\u003c/p>\n\u003cp>“You have a baby sister,” I said, “born right here at home.” And he wandered into our bedroom to see for himself.\u003c/p>\n\u003cp>Caitlin was not the only baby born at home in San Francisco that year. But over time, Pippa and I noticed that home births were going out of fashion. Our own son and his wife chose to have their first baby last year in a hospital in Santa Monica, where they were very happy with the way things went. Deliveries at home or in birthing clinics aren’t for everyone.\u003c/p>\n\u003cp>But now, 30 years after the home birth of my daughter, and after much debate over the soaring frequency of hospital C-sections, I wonder if this \u003ca title=\"http://www.nice.org.uk/guidance/CG190\" href=\"http://www.nice.org.uk/guidance/CG190\" target=\"_blank\">new endorsement by British medical authorities\u003c/a> of non-hospital births will lead to a resurgence in midwifery, even in the U.S.\u003c/p>\n\u003cp>My advice to prospective parents? Hospital or not, just in case, be prepared to handle that delivery yourselves.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Stephen Talbot was a staff reporter and producer at KQED from 1980-89. He has written and produced over 40 documentaries for public television, including the PBS series FRONTLINE and his music show, SOUND TRACKS. He’s a proud new grandfather.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"radiolab": {
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"reveal": {
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},
"rightnowish": {
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"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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"snap-judgment": {
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"title": "Snap Judgment",
"tagline": "Real stories with killer beats",
"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
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