Sobering Statistics on Chronic Depression

About one of every nine Americans age 12 and older takes antidepressants. That makes them the third most commonly used prescription drug and the most used by people 18 to 44, according to a study by the National Health and Nutrition Examination Surveys of the Centers for Disease Control and Prevention. The study involved almost 13,000 people between 2005 and 2008. A 2010 update indicates similar results.

What is particularly shocking about the results is that about four times as many people are on antidepressants as there were in 1988. While it is true that the statistic does not mean that four times as many people were depressed, it does indicate that four times as many people were taking antidepressants.

In the first chapter of our book Enough of us: Why We Should Think Twice Before Making Children, we consider the possibility that the children we hope to create as individuals are not always the happy people we dream of raising.

The results of the study are sobering reminders of just one aspect of the perils facing anyone brought into the world.

A deeper analysis brings even worse news. According to the study, only “about one-third of persons with severe depressive symptoms take antidepressant medication.” And of those Americans who take anti-depressants, more than 60 percent have taken it for at least two years, and about one in seven have taken the medication for 10 years or more.

Another reason for concern is that, “Less than one-third of Americans taking one antidepressant medication and less than one-half of those taking multiple antidepressants have seen a mental health professional in the past year.” This could mean that those who are continuing with their meds may not be getting timely advice from a mental health professional, especially for those who are combining drugs.

It deserves pointing out that the study indicates the frequency of antidepressant drug use at any one time. It stands to reason that over the course of a lifetime, a lot more than one in nine adolescent and adult Americans will be candidates to take these drugs for depression and/or anxiety.

We wonder how many would-be parents take the odds of producing contented kids into account before deciding to procreate.

 

Parents can be Hurt by Their Offspring in More Ways Than One

              Thirty-year-old Margo Steines wrote an achingly personal essay in the October 27, 2013 Sunday Review section of The New York Times. “Recalling Painful Lessons in Forgiveness” begins with Margo ministering to her mother’s wounds after Margo’s Rottweiler attacked her. Apparently, Mom had reached her hand into the car and the dog bit it, but good. The result was a bloody mess. This incident is a lead-in to the daughter’s guilt over the pain she caused her mother through the years, triggered in the present by her failure to warn her parent “not to reach her hand into the car.”

            By her own admission, Margo was a problem child.  She recollects a “scrap of loose-leaf paper” on which her mother wrote “You were our dream,” during a family day at one of her rehabs.  Far from being a dream, the list of Margo’s nightmare behaviors is daunting:

  • Stealing from her mother before the age of 10
  • Running away from home at age 17, leaving no trace
  • Hanging out at New York’s  S-and-M clubs with “hookers,” “johns,” and “addicts”
  • Becoming a drug addict and alcoholic
  • Attempting several drug overdose suicides

            It’s clear in the essay that this Marlboro-smoking daughter is conscious of her own wish to have a “beautiful child who will love me and grow strong, proud and capable. . .  .” Isn’t that every would-be parent’s vision?  Things do not, and will not, always work out that way, however. That is a message we promulgate in our book, Enough of Us.

            Having a drug-addicted, acting-out child is a “smasher” as Steines describes it. She remembers her mother searching for her in downtown S-and-M clubs; at home on her hands and knees “scrubbing up my messes, wondering if I’d ever be O.K.”; dealing with the frustrations of the insurance system related to “the fancy Connecticut rehab center she sent me to”; and her mother arriving at the hospital “while I was getting an overdose pumped from my stomach … knowing I had tried to throw away the life she had given me.”

            This story is not uncommon. Considering the most recent statistics, more youngsters seem to be turning to drugs and therefore to some seriously dysfunctional behaviors.  The National Institute on Drug Abuse reported this development in the Monitoring the Future (MTF) survey of 2012 in the article, “Drug Facts: High School and Youth Trends.” The report states: “Marijuana use by adolescents declined from the late 1990s until the mid-to-late 2000s, but has been on the increase since then.  

Kid smoking pot

Photo: Marijuana-addict.com

           “6.5 percent of 12th graders now use marijuana every day, compared to 5.1 percent in 2007.” Furthermore, 22.9 percent of twelfth graders used marijuana in the month prior to the survey, compared to 14.2 percent in 2007.

            Nonmedical use of prescription and over-the-counter medication is also on the rise among teens and contributes significantly to their drug problems. The most commonly used prescription drugs by young people are Adderall (stimulant) and Vicodin (pain reliever).

            And while fewer teenagers smoke cigarettes, other forms of tobacco used in hookah water pipes and small cigars continue to raise concerns about high-schoolers. More than 18 percent had smoked a hookah in 2011 and almost 20 percent had smoked a small cigar, both of which exceed the percentages of those who smoked cigarettes.

            What does all this mean? The underlying message is that bearing and raising children can cause great strife, especially in an age where drug use is common; and especially during a time when medical marijuana, although helpful for the sick, is not great for young people whose brains are still developing. Would-be parents who believe that bearing children will make their dreams come true should think twice, and then think again. While their kids are likely to bring more pleasure than pain, the odds are not overwhelmingly in their favor. They need to ask themselves: Am I really up to the task?

 

Pass It Forward: Fertility After Pediatric Cancer

Years ago, a female friend was diagnosed with breast cancer weeks before her wedding. Her fertility was uncompromised, so a year or two after a double mastectomy, she remained determined to have children. Her first baby was a boy. No problem. Before her second child was born, she shared with us that she feared having a girl because she didn’t want to go through what her mother had suffered through with her, that is a daughter who contracted breast cancer. Our friend did give birth to a female.  Davida is still young, in her third year of college, and to our knowledge she has not yet been tested for the breast cancer gene.

            In an article on the New York Times blog, “After Cancer, Fertility is Often Within Reach,” a 39-year-old working mother, Karen Cormier, revealed that after developing a “rare form of kidney cancer” at age 5, she assumed she wouldn’t be able to become pregnant due to her doctors’ counsel that the treatments damaged her reproductive organs. Three years after adopting a child, Ms. Cormier became pregnant and had Ryan, “a walking biological miracle.”

            The Times blog post makes the point that many adults who survive childhood cancer struggle to conceive, especially if they had received pelvic radiation treatments, a certain class of chemotherapy drugs, high doses of radiation, or stem cell transplants. After the two latter treatments these youthful patients became completely sterile. Nowadays, though, fertility treatments for both male and female childhood cancer survivors increase their chances of overcoming clinical infertility, leading doctors to surmise that young patients’ ovaries and testes may be more resilient than originally believed.

           Cancer trade magazine According to the Times article, a recent large study in The Lancet Oncology found that about two out of three female survivors who turned to fertility treatments did become pregnant – “a rate of success that mirrored the rate among other infertile women.” Other recent studies found that many adult men with low sperm counts after having childhood cancer (due to side effects of chemotherapy) “undergo procedures that harvest viable sperm, allowing them to father their own children.”

            Although this article holds out hope for many would-be parents who had pediatric cancer, it fails to mention the possible consequences for their biological children, specifically, what about the hereditary cancer that parents with their own early history of the disease might pass on to their child?  

            According to the American Cancer Society, only about 5 percent to 10 percent of all cancers are inherited.  In spite of this low percentage, “cancer in a close relative like a parent or sibling . . .  is more cause for concern than cancer in a more distant relative.”  Also, a family member that had a very early onset or rare cancer should consult with a genetics specialist for their children’s sakes.  

            Due to the widespread media coverage of Angelina Jolie’s recent double mastectomy, many Americans have become aware of

Angelina Jolie inherited her mother's predisposition for breast cancer.

Angelina Jolie. Photo courtesy Georges Biard

some women’s predisposition for breast and ovarian cancers. Had Jolie had genetic testing a few years earlier, she might have decided against having biological children. Indeed, her daughter Shiloh, with a grandmother who had contracted breast cancer and a mother who carried the gene for same, is most probably at high risk for the illness.

            Over the years, in some of Cheryl’s conversations with would-be parents about adoption, many expressed a concern that if the adoption isn’t “open,” meaning that if the biological parent isn’t in the picture (and/or cannot be reached), the adopted child’s unknown health and psychological history could lead to serious medical problems. Yet, some of these same would-be parents seem willing to pass an inherited illness like cancer onto their own biological child!

            So, here’s the message to doctors who specialize in fertility, and to would-be parents who suffered from childhood cancer but yearn to have biological offspring: Think twice before making children. The genetics you pass along may be dangerous for the kids.

Caring for Our Elders – Do We Need More Children?

[Sonia Burke lives in Portugal. She writes this essay in response to our September 4, 2013 column, “No Progeny Necessary – The Boon of Boomer Communities.” (http://www.enoughof.us/no-progeny-necessary-the-boon-of-boomer-communities). For background, we suggest you to read that column first.]

 

          In Europe there has been considerable debate about aging population and the sustainability of the welfare state. The question is, can nations afford pensions and national health care? But instead of presenting people with real solutions, we continue to hear that the solution is breeding more people.

          I’m childfree and I am sticking to that. What troubles me is the lack of will to put forward ideas that will accommodate the ever-increasing number of senior citizens and ensure their care. It doesn’t have to come from the public sector. In fact, it probably shouldn’t. But I am sure government incentives could give the private sector reasons to create appealing spaces in which those at the later stages of life can live and socialize, in contrast to the depressing elderly care homes that none of us would like to see their parent in.

          Ironically, while opting out of motherhood was very clear to me, I failed to realize that I should have a say when it comes to looking after my own parents. My parents were both 40 years of age when I was born. Having had my maternal grandmother living with us–and my paternal grandmother living at my aunt’s – this idea should have at least crossed my mind. Still, perhaps my mind was assuaged by the fact that my mother vowed never to put me through what her mother had put her through. And, let’s face it, if someone was difficult in their younger years they won’t have cute and cuddly personalities as they age. You can tell a child to go to their room, scold them for misbehaviour and expect they don’t repeat whatever they did wrong again. You can’t do that with a parent.

          I love my mother and my late father. When my father died we invited my mother to come live with us (we live around three hours away from her village). As you can imagine, when a death happens suddenly you don’t have time to think about such sensitive issues with a clear head. I lost my father when I was 25 and my life was just starting to unfold. His death brought it all to a halt. Neither my husband nor I imagined this would be a permanent thing. But at the time we felt the right thing to do for my mother was to invite her to live with us. Without much thought I was repeating what my mother did with her own mother, thus ensuring that I brought into my home and my marriage the very same atmosphere I’d experienced growing up. It was not pretty. Luckily, not having children stops me from any possibility of doing the same to someone else. Phew.

          After 10 years living with us, and a marriage that came far too close to ending, I had to tell my mother the arrangement wasn’t working.  Since she continues to be very healthy in every way, she’d have to split her time between our house and hers for all our sakes. This was heart-breaking and still is. No child, and no young couple, should be put through this decision.

           My mother used to say she’d go to a nursing home when she needed one, although now it’s a whole different story; it’s a taboo subject. If I try to discuss the future with her, we don’t get anywhere. I need to leave my country soon (as many are doing throughout southern Europe to find work) and I ask when are the governments going to start helping adult children and face the issue that many seniors need to make arrangements for their future? Many of these elderly, like my mother, are still perfectly capable of making decisions. But nothing  worth considering is being offered to them. You’d have thought that investors would gather around this new demographic reality and together with the government start promoting co-housing options. What we’re currently witnessing is that everyone is brushing the dirt under the rug and preferring to anticipate more babies, when what we’re really giving birth to, as a society, is millions of eventually aging citizens who may not have anyone to care for them.       

A senior residence in Ohio

Senior village in Columbus, OH

   I’m in my mid 30s and my husband is in his early 40s. Even if we did want children, we would not be able to afford them. If you consider that most of my friends who went to university are currently in the same predicament as we are (long periods of unemployment, low-paid jobs and therefore no stability) … how can we look after the elderly? I’ll still have a mortgage to pay when I get to the age of 70. My mother was financially independent in her 30s and retired at 55. My friends who have stable jobs barely make it to the end of the month with money in the bank, thanks to the high cost of living. How can my generation, and the one that’s right behind, care for the elderly when they have to work to survive? (Not to get rich… to survive). Most countries support parents with children to raise. But for adults who need to support their parents, there is no such assistance.

          Many of the elderly continue to enjoy their lives into their 90s. I know many who do and who don’t expect to live with their respective families. But even they are not really planning for the day when they can no longer be independent. I am sure these elderly would, if only there were choices presented to them.

          There are currently only two senior villages (as we call them) in my country, where the elderly can still have their own homes, cook, clean and have assisted care if they need to. The advantage is that they can have their family over to visit anytime, unlike what happens in care homes. Unfortunately no other projects have emerged. Wouldn’t this be good for the economy? It could create jobs. Healthier people in old age have fewer health issues and are less of a burden on national health, surely? Plus, their children are free to pursue their lives.  

          I can’t imagine anything more unethical than expecting people to breed for the sake of economics and to ensure their own care in old age.

 

Is This how the U.S. Loves its Children?

            As we point out in our book, Enough of Us, Americans extoll the making of children as a great creative act.  Commercials show mothers hugging the cutest kids with the rosiest complexions. Pregnancy is presented in articles and movies as a path to true happiness. As in much that is American, the light and cheery external look of things belies what happens inside countless family homes for so many children: the darkness of child abuse goes on in shocking numbers.

Leg fracture resulting from child abuse

Fractured tibia in infant. Photo: National Institutes of Health.

            Economist Seth Stephens-Davidowitz, Ph.D., wrote an opinion piece based on his doctoral research at Harvard, in the July 14th issue of The New York Times in which he begs to differ with reports that child abuse and neglect decreased during the our recent Great Recession. In “How Googling Unmasks Child Abuse,” Stephens-Davidowitz explains that by looking at “an analysis of anonymous, aggregate Google searches,” from 2006 to 2009, he learned that mistreatment of children did not in fact drop during the recession. The categories he examined were:

  •           Child fatality rates – Increased during the financial downturn in states hardest hit by the recession
  • “My dad hit me”  key words – Most likely from recent abuse victims old enough to use Google
  • Common classes of Google queries like “child neglect” and “child abuse” – Relevant searches from those who saw something that worried them, so they asked Google about “signs” or “effects” of child abuse.

          Stephens-Davidowitz claims that the number of these Google queries is so large that the “overall rates are telling,” in that they are enormously “larger than in any survey or poll.”

          “I used a novel technique for studying such child maltreatment: an analysis of anonymous, aggregate Google searches … Online, often unobserved, we tend to be very honest.” He examined searches that he analyzed as being likely to have been made by recent victims of abuse.

          So, why were fewer cases of child abuse and neglect reported during the Great Recession? One answer Stephens-Davidowitz gives is that social program budgets were severely slashed in many states.  That had a domino effect that led to overworked mandated reporters such as doctors, nurses and teachers being less likely to adhere to the reporting process. Likewise, staffs at child protective services agencies were stretched thin and worked shorter hours, which affected their abilities and inclinations to report cases.

          In tough budgetary times, it seems the programs that protect children are some of the first to be set back financially, which leads to staff cutbacks.  This is a major way the United States fails its children, especially when they most need government protections. Many factors contribute to this lack of love. To name a few:

  • According to the article, even in so-called normal times, primary care doctors “admit in surveys that they do not report 27 percent of suspicious incidents.”
  • According to the Department of Health and Human Services, most victims are maltreated by their mothers.
  • Children in low socioeconomic families and children in households where both parents are unemployed are at high risk for abuse or neglect.  
  • Neglectful families tend to have more children and/or a chaotic lifestyle where, say, a mother and her children live on and off with others.

          America needs the help of social services agencies that are well funded and staffed to the max.  In 2011, approximately 681,000 children were abused. True societal love for children requires that would-be single parents and parents who are chronically unemployed be educated about the option to avoid, or stop, making kids, in spite of the fact that many get tax credits for each child they produce. If we fail to fund these kinds of programs, let’s admit to our societal, cultural, and political lack of love for children. There are too many young people living in terrible circumstances.  And there are Enough of Us in general.

 

The Latest Trend in Risks to Newborns – Part II

Last week, in Part I, we began this discussion of Judith Shulevitz’s The New Republic article, “The Grayest Generation,” in which she lamented the societal and biological risks of older parenting.

 

Men over 50 are three times more likely than men under 25 to father a schizophrenic child.

Fertility doctors do a lot of things to sperm and eggs that have not been rigorously tested, including keeping them in culture media teeming with chemicals that may or may not scramble an embryo’s development.

Commonly used, “Clomid . . . came out particularly badly in a recent New England Journal of Medicine study that rang alarm bells about ART [assisted reproductive technology] and birth defects,” reports Shulevitz. “ICSI (intracytoplasmic) sperm injection shows up in the studies as having higher rates of birth defects than any other popular fertility procedure.”

A child with trisomy-18

Trisomy-18 child. Photo: Emilyscookiemix.com

While she recognizes that women do not want to cut their careers short for the sake of having kids, Judith points out that if they don’t have children, they’re denying themselves s full life.

But older parents have emotional disadvantages. “Procrastinators” become members of the “sandwich generation,” caught between toddlers tugging on one hand and elder parents sharing the latest updates on their ailments. Elderly grandparents provide less support than their younger counterparts.

What haunts her about her own kids is the gamble of dying before they’re ready to set out on their own.

And these problems could proliferate if  “aging parents are, in fact, producing a growing subpopulation of children with neurological or other disorders who will require a lifetime of care. Schizophrenia, for instance, usually sets in during a child’s late teens or early twenties. [British psychiatrist] Avi Reichenberg sums up the problem bluntly. ‘Who is going to take care of that child?’ he asked, ‘Some seventy-five-year-old demented father?’”

The birthrate has dropped by a significant 45 percent around the world since 1975. By 2010, the average number of births per woman had decreased from 4.7 to 2.6.

While Shulevitz is making compelling arguments about older parenting, ones with which we agree, the goals of her arguments are where we part company. She makes the case that society needs to reform itself so that parents become parents at earlier stages of life. That way there will be fewer disabled children, more individuals to care for older generations, and enough workers to replace the aging people who will be better able to adapt to new technologies. She concedes that fewer people means less demand for food, water, land and energy.

Let’s start with the latter first. As we have written on several occasions, when societies move into the middle classes, their per capita consumption of food, water, land and energy skyrocket. Bigger homes, conspicuous consumption, wasted water, cars, heating and air conditioning; you get the picture.

It seems to us that there are three choices for the career-focused. Have your career or your kids. If you want them both, do as many others have done, and burn the candle at both ends earlier in adulthood. But making kids in order to provide preceding generations with a support system is selfish, reckless, and the world’s ultimate Ponzi scheme. We have to stop at some point. Are the projections of 10 billion-plus devourers of natural resources, clean air, and water by the end of this century not enough to scare the bejeezus out of us?

 

The Latest Trend in Risks to Newborns – Part I

The average age of first-time mothers has increased by four years over the past half century, according to science editor Judith Shulevitz in the December 20, 2012 issue of The New Republic. Many professional urban couples are postponing making babies until their 30s and early 40s. The downside is, as Shulevitz herself has experienced, recent rises in developmental disorders.

            Some examples: The average new mother from Massachusetts is 28; in Mississippi it is 22.9. The Asian American first-time mother is 29.1; African American 23.1. A college-educated woman has a better than one-in-three chance of having her first child at 30 or older.

           Shulevitz decries late-in-life reproduction, due to the amplified risks to the child and because delayed childbearing will result in a shortage of younger people to support, and replace, their progenitors. While we agree with the former, we dissent from the latter because of its societal self-serving motives. 

Judith Shulevitz

Photo: jtsa.edu

           Judith and her husband weren’t ready for parenthood until she was in her mid-30s and her husband was “forty-something.”  The doctor started her on a regimen of ovulation-stimulating hormones. The most popular fertility drug is clomiphene citrate, marketed as Clomid, or Serophene.

            If the Clomid didn’t work, she might move on to: IVF (in vitro fertilization), ICSI (intracytoplasmic sperm injection), GIFT (gamete intrafallopian transfer), or even ZIFT (zygote intrafallopian transfer). The Clomid and IVF worked.

            “My baby boy seemed perfect. When he was three, though, the pediatrician told me that he had a fine-motor delay.”  He needed occupational therapy for his mild case of “sensory-integration disorder.”

            She soon found what she describes as, “a subculture of a subculture: that of mothers who spend hours a week getting services for developmentally challenged children. It seemed to me that an unusually large proportion of these women were older.”

            Subsequently, the couple had a “natural” daughter. But Judith found herself meeting women of approximately her age with kids who had Asperger’s, autism, obsessive-compulsive disorder, attention-deficit disorder, and sensory-integration disorder.

            As we have previously discussed on this blog, and in our book, Enough of Us, according to the Centers for Disease Control, learning problems, attention-deficit disorders, autism and related disorders, and developmental delays are on the rise.  Between 1997 and 2008 there has been about a 17 percent increase in these disabilities. According to Shulevitz, one in six American children had a developmental disability between 2006 and 2008. That’s about 1.8 million more children than a decade earlier.

            Scientific evidence indicates that aging bodies of potential parents should elicit more cautious behavior than they apparently do. Would-be parents consistently underestimate how sharp the fertility drop-off can be for women after age 35. Inversely, the chances that children will carry a chromosomal abnormality, such as a trisomy—which includes Patau and Edwards syndromes—increase.  Patau syndrome gives children cleft palates, mental retardation, and an 80 percent likelihood of dying in their first year. Edwards syndrome, features oddly shaped heads, clenched hands, and slow growth. Half of all Edwards syndrome babies die in the first week of life. In previous posts we have given the examples of the unfortunate offspring of politicians Rick Santorum and Sarah Palin.

            The risk that a pregnancy will yield a trisomy rises from 2–3 percent when a woman is in her twenties to 30 percent when a woman is in her forties. When born to an older mother: spontaneous abortion, premature birth, being a twin or triplet, cerebral palsy, and low birth weight—leading to chronic health problems later in children’s lives—increase.

            Researchers suspect a link between the 78 percent rise in autism over the last decade and the rise of parental age. One theory “is that the same wised-up, more mature parents have had longer to absorb airborne pollution, endocrine disruptors, pesticides, and herbicides.”

We will continue this discussion next week in Part II of this post.

 

 

 

 

 

Disabled Children, Dedicated Parents, and the Uncertainties of Temperament

We are about to expound upon issues raised in the new book, Far From the Tree—Parents, Children, and the Search for Identity, by Andrew Solomon. Unfortunately, we have not read the book (because we have been closeted away trying to make the final, or shall we say the final, final, final edits of our own book, Enough of Us.) We understand that this is the epitome of chutzpah, but let us explain.

Author Julie Myerson reviewed Solomon’s tome in the November 25, 2012 New York Times Book Review. We feel it suffices to rely upon Myerson’s review because it is so supportive of Solomon’s work – it ends with the phrase “this wise and beautiful book.”  As reported in Myerson’s review, Solomon’s work provides object lessons for potential parents who might be in denial about the possible exigencies of reproducing.

Solomon argues that “there is no such thing as reproduction.” There is only production, meaning parents produce new individuals who may bear traits quite different from those of their progenitors. Often, as we have pointed out many times in our current ebook and on this site, those differences entail very difficult lives for both offspring and their parents. Myerson begins her review, “How does it feel to be the mother of a teenage dwarf who’s desperate to start dating? What if you love the daughter you conceived when you were raped but can’t bear to be touched by her? And, as the father of a happy, yet profoundly deaf son who’s forgotten how it feels to hear, how do you deal with your memories of the times you played music together?”

Solomon, a psychiatry lecturer at Cornell University, spent 10 years researching his book, and interviewing 300 families with disabled children. He likewise delves into his own depression earlier in life, stemming at least in part from coping with his homosexuality.

Myerson writes in referring to Solomon’s work, “…despite the fact that we never know quite what — or whom — we’ll produce, it’s one of the least bitter truths of human existence that, regardless of what pain and anguish they put us through, we never ever regret our children. ‘It is not suffering that is precious,’ he notes when recalling the depths of his depression, ‘but the concentric pearlescence with which we contain it.’”

In researching our own book we have found quite contradictory instances. An extreme example is Lionel Dahmer, father of madman and serial torturer-murderer Jeffrey Dahmer. Lionel’s book, A Father’s Story, expresses profound regret.And the younger Dahmer showed no childhood signs of his potential for hyperpsychotic behavior, so his parents had no idea how “far from the tree” their son had actually fallen.

Solomon enumerates just one disability that elicits no rewards – schizophrenia. “’The suffering of schizophrenics and their families,’ he writes, ‘seemed unending and singularly fruitless.’”

As Julie Myerson describes Solomon’s work, he makes the argument that in spite of the amount of sorrow, grief, anxiety, and the like, “most of the families Solomon describes are grateful for experiences they would have sacrificed everything to avoid.”

This reminds us of the classic horror movie Invasion of the Body Snatchers, in which large pods from space land on Earth. The pods foam open and issue forth replicated versions of nearby humans.  Then, when the people fall asleep, the replicated bodies absorb their respective consciences, leaving the humans emotionless, uncaring, and unsympathetic to any situation

Kevin McCarthy about to torch a pod in “Invasion of the Body Snatchers” – Allied Artists, 1956

that would normally have elicited emotions that make us human. Those in fear of the pods would go to any extent to prevent their emotionality from being stolen. But for those whose sympathetic emotions the pods drained away, their new personalities are so ideal to them that they now proselytize the conversion of their souls and join their fellow emotionless acolytes in victimizing their neighbors.

In other words, Solomon’s conclusions about never regretting one’s children may beg the question. Not many people would desire a child with severe disabilities. We guess that most folks, if they knew that pregnancy would deliver them a child with a pronounced debility, would opt not to get pregnant, or to have an abortion, if the latter was not objectionable to their values. But, like the victims of the pods, once the child is born, they would, perhaps instinctually, embrace and love the child. After all, he or she would be their child.

The case we are making is this. Producing a disabled child is not some far-fetched unlikely occurrence. Mental and physical illnesses and disabilities occur all the time. Think of how many such instances you know of. Add to that the children who grow up to be drug addicts, criminals, ne’er-do-wells and losers in general. That should give anyone pause who isn’t ready to cope with the potential dramatic difficulties of raising a child, Solomon’s research and “pearlessence” notwithstanding.

 

Men Can Parent Older than Women. Ain’t that Grand? Maybe Not!

Photo: CommunitiesForAutism.org

There is no news in the knowledge that men remain fertile almost indefinitely. And in this blog, as well as our book, Enough of Us: Why we should think twice before making children, we discuss the jeopardies for babies of older mothers.

Now, research is indicating that being an older dad has its substantial risks as well. It turns out that because men generate new gametes (cells that unite with other cells to produce the fertilized egg—oh, what the hell—sperm) for each fertilization, the chances of the sperm having gene mutations increase as the years pass.

You may know that in the United States one of every 88 newborns is inflicted with one of the disabilities on the autism spectrum. That number has been rising dramatically over the past few decades. While it’s true that some of that increase is due to improved diagnostic capabilities —Cheryl’s own brother being an example of that—there are other contingencies that need to be considered.

Researchers in Iceland analyzed the genetic makeup of 78 families in which offspring had been diagnosed with schizophrenia or autism. It was random mutations in the DNA of the fathers’ sperm that were the primary source.

Women develop their eggs very early in life, so there is not a significant ongoing opportunity for mutations. But since men are constantly producing new sperm, the opportunities for mutation present at each occurrence of genetic copying that is part of the sperm production process.

The study found that a 20-year-old father typically produces 25 mutations in his child’s genetic makeup. By the age of 40, that average rises to 65. The Icelandic geneticist who conducted the study tells the Los Angeles Times that the trend toward later fatherhood is “very likely to have made meaningful contributions to increased diagnoses of autism in our society.” The University of Iceland researcher, Kari Stefansson, attributes between 15 and 30 percent of all incidents of autism to genetic mutations from older dads.

Even so, the risk of a man in his 40s producing a child with genetic disorders remains a relatively low one in 50. That liability grows with the father’s increasing age.

The questions remain, is gambling on the wellbeing of a newborn—or the adult it is to become—ethically responsible? At what odds is the gamble worthwhile? And isn’t it an increasingly problematic ethical question if the father takes that gamble to ever-higher levels by inducing pregnancy as he ages?

The Affordable Care Act and Baby-making

How will American society pay for births to mothers who cannot afford to have children?

The current health-care “system” (hah!) is inefficient. That’s like saying heating your house with candles in January is merely inefficient. First, there is no system, at least not “a” system. We have lots of insurance companies skimming profits off the top and lots of people who can’t afford insurance premiums going to hospitals. That’s because hospitals provide services paid for by federal, state and county governments, meaning taxpayers.

Since doctors and hospitals like income, they frequently order tests that may be only marginally appropriate and then collect insurance fees. For instance, Ellis’s urologist likes to have him take a prostate PSA blood test and then come into the office so the doc can tell Ellis that it looks fine. Ka-ching! He could tell Ellis the news over the phone and not charge for an office visit.

One of the biggest criticisms of the current non-system is that rather than encouraging good health and illness prevention, it encourages procedures and visits. Health-care costs have risen 100 percent in the last decade.

"Obamacare"

Photo – law.upenn.edu

For the approximately 17 million folks who cannot afford insurance at all, the Affordable Care Act will expand Medicaid coverage starting in 2014 at a cost to the federal government of about $116 billion per year.

The cost controls built into the legislation are theoretical and experimental. These controls are based on the premise that about 30 percent of health-care costs are wasteful. In light of that, the law empowers a panel of medical experts to recommend reimbursements cuts to doctors and hospitals. There is also provision for evaluation of the effectiveness of various types of care.

It’s common knowledge that prenatal women should see their doctors to monitor the health of both the  mother and embryo/fetus. But lots of pregnant women are very young and/or poor. This frequently means they depend on the generosity of the state to pay for their care. Add to that the cost of birth and postnatal care. And if the baby is not well . . . well, you get the idea.

 Unfortunately for many families, policies frequently exclude maternity care for anyone other than the policy holder and spouse. That means a child of an insured individual may have to foot the bill herself. For more details on this click to the PBS News Hour site.

 According to the March of Dimes, the average cost for uncomplicated maternity care including prenatal care, a routine delivery, and three months postpartum care was $10,652 in 2007.

Teenagers, the report noted, are less likely to get early prenatal care, more likely to smoke and less likely to gain enough weight during pregnancy. Thus, they’re more likely to deliver prematurely, resulting in more complications, including a higher incidence of low-birth-weight babies. The medical costs for such an infant is nearly 10 times higher than for a baby of normal weight, the report found ($32,325 vs. $3,325, citing March of Dimes data from 2009).

There are many politicians who are trying to kill Roe vs. Wade, making low-cost or free abortions difficult, if not impossible, to obtain for the poorest among us. That would mean additional government expenses for the care and feeding of many unwanted children brought to term.

So how does the Affordable Care Act fit into this proposition? Bear with us. The act requires that beginning in 2014 anyone not poor enough to qualify for Medicaid must pay for some kind of insurance policy of their choice (from a select list on what are called insurance exchanges) or opt out of buying insurance and pay one percent of their taxable income as a penalty, and live without insurance. Those who opt out would be in the position of paying their own medical costs or “freeloading” off the government when an urgent situation necessitates their going to a hospital emergency room.

There is a quote circulating all over the news media from a self-employed woman in Texas: “I could much more easily afford a dadgum penalty than be saddled month after month after month with this kind of premium.” The woman, Laurie Tirmenstein, would only have to pay $250 annually instead of paying $1,800 for an insurance policy. Good luck to her if one of her kids comes down with a traumatic illness.

One way or another, the burden of low-income people bearing infants at the expense of our healthcare programs is scary. Some will get lots of care at almost no expense. Others will get very poor care, leading to the hazards of producing at-risk babies.

Right now the economy is depressing the birthrate somewhat. But sooner or later that is likely to change . . . big time! If and when the economy recovers, low-cost health care could provide incentives for Americans to get back onto the birthrate bandwagon.

The question for us is, considering there are already enough of us, should we be creating a healthcare program that encourages people to procreate, who might not otherwise be able to afford pregnancy and postnatal care?

We would like to see some funds be made available to teach high-school students the benefits of waiting and acceptability of not having children at all.