healthcare

Healthcare: Injustice for All

By Rev. Mindi 

A four-year-old classmate of my son’s has cancer, very advanced, and the insurance company has deemed his treatment “experimental” and will not cover it.

A friend is stuck paying thousands out of pocket for a procedure that was not covered by her insurance company but deemed vitally necessary for her health by her doctor. Hospital refused to consider her for their low-income payment plans because she didn't qualify.

A friend’s father had a stroke. The doctors at the local hospital refused to consult with his neurologist because he was part of a different hospital group and therefore critical information was not passed on.

This is wrong. This is injustice.

In the U.S., healthcare reform is coming into play. One can no longer be denied insurance coverage due to a previously diagnosed condition. Families can carry young adults on their insurance plans until age 26. Many forms of birth control are now available without extra cost through insurance providers (though there is a religious exemption that is still being debated).

But it’s not nearly enough. The gap between those who are so poor they have to be on state insurance and those who are just able to afford to pay for insurance or have an employer who will do so is widening. The gap of those who will slip through the cracks, who will pay a penalty and not have any health insurance is a chasm no one should have to fall into.  And even wider still will be those who will have insurance, but like my son’s classmate, the insurance will fail to cover many expenses.

My own family, on a denominational health insurance plan, pays much out of pocket to cover our son’s therapies and various appointments, not to mention dental coverage that is extremely costly and not covered. We are stretched so thin that we have had months where we have decided what bills to pay and what bills to put off.

And even those on insurance find themselves victims of hospital for-profit corporations whose doctors have to play politics to keep their job rather than consulting with one another across the same field, thus resulting in misdiagnosis, misinformation, and at times critical injury or death.

This is wrong. This is injustice.

Where is the church in all of this? In the news, the “church” is the one arguing for religious exemptions from having to provide coverage for birth control. Within our denominations, our churches vary at providing good coverage or poor coverage. I was on one denominational plan before I was pregnant with my son that provided so little maternity coverage (as I have found few mainline Protestant denominations do) that I switched to a private plan. We paid a little more per month for premiums, had a higher deductible, but almost everything was covered for our son’s birth. This turned out to be good news, as I ended up with an emergency C-section, a massive infection and extended hospital stay, plus home health care. I can’t imagine the thousands of dollars we would have paid out of pocket had I been on the previous plan, or how soon I would have been sent home from the hospital.  The church plan would have left us scrambling to pay the bills.

Churches, we can lead in this.

We can demand better coverage from our insurance companies for our staff and employees.

We can work to organize people in our congregations to speak out for better healthcare coverage from their employees and from insurance companies.

But most of all, I believe we need to change our system. We have to confront the idea that employers are the best dispensaries of healthcare coverage has got to change. Healthcare cannot be a benefit that is earned by a few.

We need to challenge the idea that healthcare is a privilege, and lifting up healthcare as a universal human right.

We must change the notion that anyone is expendable, whether they have a disability, an illness, a genetic condition, are poor, are sick, are elderly, are not documented, or any other way people have been devalued by our system of health care.

We must speak out for a new vision of healthcare, one in which people are valued over corporate rules and politics. One in which doctors and experts are free to speak to one another and share information easily to reduce miscommunications and mistakes.

What if churches were to lead the way? What if we were to bring together doctors and nurses and hospital officials in our communities and say, “How can we change healthcare in our community so that no one falls through the cracks?”

What if we were to group together and provide low-cost health insurance to our members (imagine the memberships piling in!) and provide basic medical services (such as regular health screenings, flu vaccinations, and other prevention-based services) to the community?  What if we didn’t just have blood drives but had basic first-aid drives and gave away basic first-aid needs to the community? What if we got a dentist and a hygienist to offer free dental cleanings once a month?  What could we do together?

If we as churches are concerned about the well-being of those who are part of our community, then we must step up to bring change about to health care. And I believe we can start that transformation of the system by rethinking our role. We don’t have to just speak out for one form of health care reform or another. We can act. We can support local clinics, or begin one. We can do our part to transform the conversation, to transform the system, if we dare to dream about our role in healthcare differently.

Are any among you sick? They should call for the elders of the church and have them pray over them, anointing them with oil in the name of the Lord. ~James 5:14

SCOTUS Decisions—Reflections Part 2

By Rev. Mindi

This morning on the West Coast I quickly turned to the news at 7 a.m. just in time for the breaking news to be revealed that DOMA had been struck down, and in the revealing of the decision and the minority opinion it was clear that Prop 8 would also be struck down.

I rejoice in that there is no federal reason for denying people the right to marry or to deny benefits for certain types of marriages. However, the ruling leaves it still up to states to pass equal marriage laws.

As many have already noted, if one really is for civil rights, for human rights—we cannot rejoice fully. Voting rights have been restricted; Euro-American cultural values have been valued as the norm; we still do not acknowledge the T in LGBT. Trans rights are often ignored or scoffed at, though there are currently several court cases for trans teens fighting for their rights in state courts. Teenagers are the ones speaking out for their own rights because teachers and administrators have failed to do so.  And as a parent of a child with special needs, even though we have had the IDEA act renewed in 2004, we find our rights and our son’s rights violated everywhere we turn in the public school system. And we are Euro-American—add in other cultural differences and different languages, and we find that even Supreme Court rulings do not guarantee rights for all will be granted.

As people of faith, we must lead the way on human rights. We must listen to the minority voices in our congregations and beyond in our communities, and work for justice for all. It’s easy to take a quick look at one’s congregation and see some of the issues they face, whether it’s the right to marry, the right to receive disability benefits, the right to get a driver’s license; it’s much harder to know whose rights are violated with the lack of a comprehensive immigration law, who doesn’t have access to adequate health care, and other rights that may be violated or ignored. If we assume a certain issue does not apply to our congregation so we can ignore it or evade it, we are failing the community at large.

SCOTUS Decisions: Reflections, Part 1

By Rev. Mindi 

 Due to the SCOTUS decisions of Tuesday and pending Wednesday’s decisions, I thought I would forgo my usual Wednesday article and reflect on some of the court decisions made on Tuesday, with the idea that others may contribute reflections following the decisions announced on Wednesday morning. For a comprehensive list of the decisions made, go to http://www.supremecourt.gov/  These decisions impact us as Americans, but are often not mentioned on Sunday morning. As clergy and church leaders, I feel that it is imperative that we reflect within our faith communities on these issues and offer some way of responding, through word, action, and prayer.

Tuesday’s decision on the Voting Rights Act http://www.supremecourt.gov/opinions/12pdf/12-96_6k47.pdf was a split decision, with the court upholding the 1965 act in that voting procedures must be approved by the federal government (preclearance) in areas where racial discrimination in voting practices has taken place. However, the court struck down the part of the law that dictated which states and jurisdictions were affected by this, stating that the coverage formula needed to be readdressed to be up with the times.  The Supreme Court is sending this part of the act to Congress to decide.  Seeing how it’s been difficult to get Congress to act on anything, this is frustrating to those of us who know how prejudice is still used in discriminating at the voting booth.

As people of faith, what can we do? How can we respond? I think of the number of churches that have partnered together with other organizations for voter registration drives and work to make sure those in our communities are registered to vote. Secondly, we also need to listen to those who have experienced prejudice at the polls, for those whose registrations were considered to be illegitimate, for practices that deterred others from voting. We need to make sure that we speak out for fair voting procedures in our own communities and be involved in voting rights for all citizens. And we need to speak up and take action against unfair voting practices.

Another decision on Tuesday was about adoption http://www.supremecourt.gov/opinions/12pdf/12-399_8mj8.pdf This was a hard case. This story gained nationwide attention in the news, and so it’s easy to take sides and feel sympathetic with all parties involved. But what we need to keep in mind is the history of white governing officials making decisions for American Indian children, and the continued intervening and taking children away from their family and culture of origin. It’s important for us as people of faith to be mindful of our history, to be aware of how Euro-American culture is still perpetuated as American culture and that Euro-Americans still push values associated with that culture on to others.

Finally, I want to end with some reflections on a situation not in the Supreme Court but in Texas. Senator Wendy Davis, as I write this, is standing for thirteen hours without a chair or ability to lean on anything to filibuster a law that would basically prevent abortion clinics from operating in Texas http://news.yahoo.com/texas-senator-filibusters-against-abortion-bill-164526586.html  (side note: my husband pointed out that these rules by the Texas Senate make it so that anyone who has a disability in which they cannot stand is inherently discriminated against from being able to do their job, but I digress… somewhat).

This ban on abortion clinics and restrictions on clinics and doctors ignores Roe V. Wade, ignores the laws that protect a woman’s right to choose and places women’s health and responsibility to make choices about her health.  I have written in the past about the need for both sides on the issue of abortion to come together and find some common ground in reducing abortions, but laws like these will not reduce abortions. Many women will be forced to go out of state, possibly into Mexico where the health regulations for such clinics are not at the same standards in the United States, and many more will probably receive unsafe, illegal abortions. Besides abortion, many of these clinics provide health screenings, birth control, counseling and other vital services to low-income women, and they will be shut down because of one procedure they perform that is controversial. Also, all abortions would be banned after 20 weeks. Seeing how the 20 week mark is the screening ultrasound date that is covered under most insurance policies and not before that, many women and doctors do not know that there is any health risk to fetus or mother until that point, and under Texas law if it passes, it would be too late.

As people of faith, we may differ on the issue of abortion, but we need to stand up for women’s health in the case of extreme measures. The Texas law will go too far, will ignore the Constitution and will trample on women’s health.  I’ve shared in previous articles about the need for conversations on health, birth control, and sex in general in the church to reduce abortions and raise the level of women and men’s health.  As leaders, we cannot be afraid of speaking out on these issues, when people's very lives and health are at risk.

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As people of faith, we watch and wait in earnest for Wednesday’s decisions on DOMA and Prop 8. We pray for justice to be done, for freedom to be upheld, and most of all, for love to prevail. Check back for reflections here after the decisions are released.

Election 2012: So, What's the Takeaway?

By  Derek Penwell

The election is over. But what election would be complete without the valedictory, the “take-away,” the things we learned (or should learn)? I have some thoughts about the election in no particular order:

  • Healthcare—The Presidential election made a statement about, among other things, what we think of people’s access to healthcare. Whatever else Obamacare does (or fails to do), it makes the case that people’s access to healthcare is a moral issue—and not simply an economic issue, or a personal freedom issue, or an assertion about the dangers of “creeping socialism.” Allowing corporations motivated by profit to deny coverage to people in their darkest hour, preventing coverage of people who need it most because they have pre-existing conditions, dropping people’s coverage when it becomes too costly—these are moral issues. I know people who believed that their lives (literally) depended on the election yesterday, because of the implications for the Affordable Care Act. The election results speak to our country’s belief that people should fear getting sick because of sickness, not because they lack the financial resources. Nobody should have to say, “I’m too poor to be sick.”

  • Class—Another thing this Presidential election brought into stark relief is the extent of our division over wealth. Comments like the ones Mitt Romney made concerning 47% of Americans, and Paul Ryan’s remarks about the country being made up of “makers and takers,” make our political discourse meaner. I realize both sides speak ill of one another. But that misses the point. In this case, the issue turns not on snarkiness, but on a partisan narrative that paints a significant portion of the population as unworthy of our concern. Why? Because they’re moochers, parasites, free-loaders who only suck the system dry without giving anything back to it. Unfortunately, I can’t figure out a way to get Jesus to occupy the assumptions that position entails—that is, that people are lazy, dishonest, and disposable. By repudiating that framing of our common life, this election allows us the room we need to find opportunities to address the real (often systemic) problems people face in ways that don’t continue to enable those problems. Whether we’ll always get it right is another question; but we certainly ought to be a people capable of resisting the sinful impulse to throw people away just because they can’t figure out anywhere else to find the help they need.

  • LGBTIQ Rights —Ballot initiatives in Maine, Maryland, and Washington give the citizens of those states the right to marry, regardless of sexual orientation, putting an end to 32 straight defeats of same-gender marriage at the ballot box. In Minnesota voters defeated a constitutional amendment banning same-gender marriage. In Wisconsin, Tammy Baldwin, became the first openly lesbian Senate candidate in the country. Yesterday’s election results indicate a sea change in our culture’s attitudes toward LGBTIQ people. The inexorability of this eventual shift seems stronger today than it did the day before yesterday.[1] I don’t want to over think it, but it seems to me that mainline denominations were put on notice yesterday that the world is going to continue to move forward—with or without progressive Protestant denominational approval.
  • Who owns the Government?Citizens United … the Supreme Court decision that extended the individual right of free speech to corporations, allowing them to give almost unlimited sums of money to influence elections … was tested on a national stage during this election. Since that decision was handed down in January of 2010, the fear of many has been that Citizens United would allow those with the most money to buy elections. Over 1.5 billion dollars was spent on this election by outside groups on campaign advertising—the bulk of which was negative. One of the conclusions we may draw from this election, it seems to me, is that the immunity of the body politic appears much more robust than many of us feared. I suspect that Karl Rove will have an uncomfortable meeting, trying to explain to his nameless investors why it is that, even with the enormous amounts of money he expended, he couldn’t deliver some key victories—not least the Presidency. Our democracy is healthier than we imagined, and certainly better off than those who grouse that the country needs “taking back.”

  • Truth Matters—One of the important principles revealed by this Presidential campaign season is that, contrary to the dire predictions of many, we are not yet a “post-truth” society. That is to say, given the stunningly bold nature of the dissembling Mitt Romney’s campaign embraced (almost always with impunity), conventional wisdom suggested that we had turned a corner on the nature of truth-telling in our culture. Romney’s chief pollster, Neil Newhouse, admitted as much when he said at the Republican National Convention, “We’re not going to let our campaign be dictated by fact-checkers.” Romney lied about his own past positions on everything from abortion and gay marriage to immigration and the auto bailout. He misrepresented the positions of the President on a host of issues—from charges that the President removed the work requirement from welfare to the President’s “apology tour.” And before you get all defensive, I know that politicians have always tended to “mold and shape” the truth to fit the current narrative—President Obama included. However, there’s never been a candidacy predicated on such a brazen disregard, not only for the truth, but for the consequences of not telling the truth. This election rejected the idea that politicians can knowingly lie and not be held accountable for prevaricating.

  • Everybody Counts (The Triumph of Demographics)—One of the things that shines brightest from this election involves the emerging reality that previously ignorable demographic constituencies are ignorable no longer. Race, ethnicity, gender, sexual orientation, age—all these categories of people that have historically hovered at the edge of social relevance just crashed the cultural party in a politically significant way. No longer is it possible to win elections based on the calculation that “if we can just get enough white guys to back us, we can pull this out.” Moving forward, politics will increasingly be forced to reckon with groups of people who used to be political non-factors. As the percentage of white voters decreases, the concerns of previously marginal groups will become more and more central to the public debate. As somebody who claims to follow Jesus, I take this new concern for others to be a good thing. 
  1. See Jennifer Rubin’s advice to Republicans to just “move on”.  ↩

Post-Electionacalypse

By Rev. Mindi

It’s over. It’s over.

Of course it’s not totally over, but it’s over enough for now.

I was sick of the commercials, sick of the rhetoric, sick of the Facebook status updates.  But yet I stayed up and watched the returns, the projections, the predictions and the announcements. Because this election was incredibly pivotal.

Equal marriage has prevailed, though civil rights should never have been on the ballot to begin with.  But the people have affirmed that marriage should be for all committed couples.  (note: I'm writing this before Minnesota and Washington's returns are in, but hearing that Maine and Maryland have spoken, I'm feeling good about the prospects). Surprisingly, marijuana use was approved of even more than equal marriage in some states—which leads me to believe that this is a lot less about decriminalization for law enforcement’s sake and more that marijuana use has gained greater acceptance.  I still haven’t wrapped my mind around the margins in the votes on marijuana use compared to equal marriage in my mind.  

And yes, our president was re-elected. And the discussion of the electoral college may come up all over again, as it did twelve years ago, but somehow I imagine the fact that Gore won the popular vote will be lost in the discussion.

So where do we go from here, post-electionacalypse?

Where do we go from here on the struggle for equal marriage?  How do we overturn constitutional amendments in other states and get legislation passed at the national level to guarantee the rights of all couples to legal marriage?  How do we take up the call for justice and move on the momentum?

Where do we go from here in the separation of church and state?  We know the violent rhetoric from the right that has become infused with religious jargon will intensify.  How do we continue to speak out for religious freedom?  And how do we claim our space and voice as Christians when others have held such a tight grasp on Jesus and the Bible?  

And finally, where do we go in giving voice to the voiceless?  I think of all the issues that were never addressed in this election: yesterday as people went to the polls, another mass shooting took place.  We have not addressed gun violence and the accessibility of weapons.  We have not spoken up enough about this nor have we demanded that our candidates address it.  While healthcare, mainly “Obamacare” was addressed, there are still so many people who will be without healthcare even after the reforms are put in place.  How do we continue to push for healthcare as a right, and not a privilege for a few?  How do we continue to raise the issue of women’s rights and health as people of faith?  And immigration: how do we continue to work towards equality and justice for all of God's children?

I could go on and on.  I’m glad it’s over, and yet, the work has just begun, Christians. The work has just begun.  

NOW I KNOW HOW MY FREEDOM IS BEING TAKEN AWAY!

By Craig M. Watts

For a while now I’ve been hearing from some folks I know and who love tell me that “our freedoms are being taken away.” In particular they have insisted that the health care reform measures were stripping away freedom. I confess I wanted some different kinds of reforms. Still, I hadn’t noticed that any of my freedoms were missing. I certainly hadn’t felt less free. My behaviors weren’t being restricted in any ways that were new or unusual, so far as I could tell. Yet I didn’t doubt the sincerity of my friends, though they had a hard time explaining just how I was being deprived of my freedoms.

I didn’t worry about this too much because the Supreme Court was likely to declare the Obamacare unconstitutional. But that didn’t pan out.

Finally, I decided I should do a little research. After all, I sort of like freedom. I’d hate to lose it. So even though I hadn’t detected any missing freedom, I thought it wise to check, just in case. Here is some of what I discovered, among a long list of others disappearing freedoms.

  1. We are losing the freedom to have our employers burden us with higher and higher deductibles in order to increase their profits. Now deductibles can’t be higher than $2,000 for individuals and $4,000 for families. How oppressive!
  2. We are losing our freedom to have insurance that has no preventive care, something that may have been less costly in the short run but much more costly in the long run. But now I can make sure I’m healthy before I get sick and I don’t have the choice of just getting seriously ill without an opportunity to avoid it!
  3. We are being deprived of the freedom of having an employer provide insurance that won’t include my “slacker children” up to age 26. Surely, that is an onerous restriction of liberty!
  4. We are having the freedom stripped from us to have insurance companies raise the premiums we pay however much they want without a review by the Secretary of Health and Human Services who might disallow them if the increases are considered “unreasonable.”
  5. We are being cruelly deprived of the freedom of having an insurance company board or its stockholders give its CEO –whose average salary is about $30 million dollars a year- more than $500,000 in deferred compensation.

And there are still other ways in which we are being robbed of freedom by Obamacare. It is going to be next to impossible to get insurance that will not provide ambulatory patient services, emergency services, hospitalization, mental health and substance use disorder services, and prescription drugs. We are being deprived of the freedom of getting inadequate insurance, even if we really, really want it! And, worse, people who are less healthy or poorer than many of us are going to benefit and that is intolerable and ungodly.

Now that I know what is really going on, I feel overwhelmed with a sense of oppression. So many of my freedoms have been taken away I can hardly breathe! I am now virtually a slave and I didn’t even know it. Oh my! This calls for a revolution!

 

Craig is minister of Royal Palm Christian Church (Disciples of Christ), Coral Springs, Florida, Co-Moderator of Disciples Peace Fellowship and a brand new Granddad who is willing to show pictures of his amazing Grandson if you want to see a few.

 

 

 

 

 

 

 

 

Following Jesus

A post from the archives.  This article first appeared June 14, 2010.

“If you follow Jesus and don’t end up dead, it appears you have some explaining to do.”

-Terry Eagleton, Reason, Faith, and Revolution

Following Jesus.  I think it boils down to that, really.  I have struggled for some time with the realization that when the church fails—as it often does—it fails most egregiously in giving people the resources necessary for the outrageously radical act of following Jesus.  My reading of emerging/ent theology has led me to conclude that there is increasing energy around the simple idea that followers of Jesus ought to embody the revolutionary spirit found in the Gospels.  I sense a growing dissatisfaction with the traditional view of the church as either a clearinghouse for heavenly bus passes, or as a respectable organization whose primary function centers on affirming middle-class American values.  People, especially young people, are having trouble squaring the Jesus they read about in the Gospels with the infinitely malleable Jesus they see placed on offer by popular Christianity—Jesus as personal genie, Jesus as chief security guard at the courthouse of private morality, Jesus as a cheerleader for free-market capitalism, etc.  Jesus, stripped of the layers of religious spackling used to domesticate him, is irremediably subversive.

Subversive.  That appeals to me.  Of course, I’d like to continue writing clinically, about the religious climate shift underway at the hands of restless “young people,” fed up with a tame Jesus.  I’d like to make it sound as though I’m just a disinterested observer of religious trends.  But the truth is that I too find myself growing dissatisfied with that image of Jesus.  After all these years of a Jesus who I thought would help make me _______ (holier? kinder? more spiritual? more self-actualized?), I’ve come to believe that Jesus has a more cosmic, more interesting agenda in mind than super-tuning my soul.  On my way to spiritual superstardom, I’ve found it increasingly difficult to squeeze past Jesus, who stands in the middle of the road pointing to the weak, the homeless, the sick, the widowed, the displaced and un-embraced.

I’ve tried.  I’ve put forth a valiant effort.  But I can no longer envision Jesus the way I once did.  I can’t, for the life of me, picture Jesus saying, “Healthcare isn’t a right; it’s a privilege."  I can’t figure out a way to get Jesus to say, “Homosexuality is a capital crime; but fleecing the poor is a misdemeanor.”    I’m trying to track down, but as of yet have been unable to find, where Jesus says, “If you fear someone will strike you on one cheek, dial in a Predator drone.”  The church has too often been asked to give religious cover to moralities that were conceived absent the theological reflection provided by the church.  I find that the chasm between the revolutionary Jesus of first century Jerusalem and the domesticated Jesus of twenty-first century America grows more difficult for me to span all the time.

In the final analysis, the good news of the reign of God is not first that the well taken care of will be even more well taken care of in the next life.  The good news of the reign of God is that God’s reign is present wherever the homeless are sheltered, wherever the hungry are fed, wherever the rich give away their money and power in defense of the poor, wherever the forgotten ones gather to be remembered and embraced, to be told that as long as we follow God not one of God’s children will be left to die alone and unloved.

The Intersection of Cesarean Sections and the Cross of Crucifixion

Here is the third in our series of “best of” articles for 2011, which first appeared on October.  It was written by one of our editors, Rev. Mindi Welton-Mitchell.  Enjoy!

The nurses called it the crucifix position.  Lying flat on my back, my arms were stretched out like a T, and I.V. lines were running out of each arm and out of my lower back where the epidural line was placed.  This was not what we had planned.  This was not how we imagined our son’s birth would take place.

I had an uneventful pregnancy.  No morning sickness, no complications, I was as healthy as a pregnant woman can be and so was our unborn son.  Every checkup was routine.  The baby was in the right position.  No concerns.

After our due date came and went and we neared forty-two weeks, the “eviction” date set by most obstetricians, I was told I would need a medical induction and that it would be handled by another doctor in the practice, since my doctor was now on vacation.  I was given instructions to call in on Friday morning at 7a.m. with assurance that I would be at the top of the list to come in for my induction.

That Friday morning at 7a.m., I called in to the hospital.  I was told that every room was full and they could not accommodate me at that time, as if I were a hotel guest and not an overdue pregnant mother.  I was told to call back at noon, and when I did, I was told to call again at 2p.m.  By the time we were admitted, it was 3:20p.m.  I was put on monitors and discovered that I was having contractions at this time, and was progressing somewhat on my own.  However, the on-call doctor did not see me until after 7p.m., twelve hours after I was supposed to have been induced.  When she reviewed my charts, it was clear she was not familiar with me or my pregnancy and upon reviewing the size of my baby and she suggested a Cesarean section.

I was a fairly open-minded pregnant mother-to-be. While other friends of mine were telling me how they were going to have a fully natural childbirth or a water birth and had written birth plans detailing what they wanted, I wanted to be open to the process and understanding that I hadn’t been through this before, I wanted to be open to the possibilities of intervention.  The only thing I wanted to avoid was a Caesarean section.  I had never had surgery, and until this pregnancy I had never even been admitted to a hospital.  I was determined I was going to have a vaginal birth, and had been assured previously by my doctor that there was no reason I would need a Caesarean section.

What I didn’t understand at the time was that I was on a clock that had been set from the time I was admitted.  This is common in most hospitals in the U.S.  A pregnant woman in labor is put on a clock in which if certain progress is not made in a certain amount of time, labor is augmented.  If this augmentation does not progress things fast enough, or causes maternal or fetal distress, a Cesarean section may occur.  And every hospital is different—most want you to deliver within 24 hours of your water breaking, and some want you to deliver within 36.  Some doctors say you must dilate one centimeter per hour, others are more relaxed.  Around 7:30p.m., the nurse administered Pitocin, the drug that starts or enhances contractions.  And so the minutes began ticking away.

I labored well until the middle of the night when I realized how tired I was and that I needed to sleep—at that point I had been up for almost 20 hours and knew it was going to be much longer.  I hadn’t expected to wait twelve hours before being seen by the doctor and beginning the Pitocin.  I asked for the epidural, and with my lower body numb tried to sleep.  I did not know at the time, as it was not explained to me by the nurse or the anesthesiologist, but the risk of my blood pressure dropping while on the epidural required that my blood pressure be monitored throughout.  So every fifteen minutes the blood pressure gauge would squeeze my upper arm keeping me up.

Every hour the doctor came back, and every hour Pitocin was increased and I would progress a little more, just enough to keep me ahead of the clock and long enough for a new on-call doctor to come on to the scene.  However, as I labored on until the afternoon after being fully dilated, and after pushing for an hour and a half, falling asleep in the middle of contractions, the nurse looked at me and said, “I don’t think you’re going to do this.”

Lying in the crucifix position, exactly twenty-four hours after I had been admitted at 3:20p.m., I was cut open, my son taken from me, and when I did not hear him scream and kept asking questions, they knocked me out with narcotics.  My son AJ ended up in the Special Care Nursery for a few hours, as he was not breathing regularly, and there were a few other concerns.  My husband was almost completely silent as he was not sure what was going on, if his son was fine or if his wife was going to survive.  After an hour I was wheeled into a recovery room all alone, no husband, no son, just a nurse checking in on me.  While I was in recovery I later learned my entire family was able to go into the Special Care nursery and see my son but I was left alone, until I  was finally taken to my postpartum room and they released my son at the same time.  Not only was this “birth” traumatic, frightening and shocking more than normal, after all of that, I ended up with an infection and was back in the hospital a week later, having my incision reopened and later placed on a vacuum machine for a few weeks.  It took me twelve weeks for my incision to heal, when the normal recovery for a C-section is about 2 weeks.

Since AJ’s birth, I have questioned what happened to me in the hospital, not only asking my doctor questions about what went wrong from my point of view, but also talked to friends who had traumatic C-sections and have done some research online.  I viewed the documentary The Business of Being Born (2007), which questions the way the United States has handled birth in the last century, making birth more institutionalized, where birth becomes more of a medical/surgical procedure, rather than a natural process that has been happening to women for as long as human beings have walked this earth.  Produced by Ricki Lake, Business reviews how the hospitals, fueled by insurance companies, attempt to speed up the process of birth artificially as a way of moving women through Labor and Delivery to keep beds open, and how many of these “sped-up” births require Cesarean sections in the end.   The documentary also interviews obstetricians who admit that many of their colleagues will recommend C-sections because it is more convenient for their schedule, at the end of the day or before the weekend begins.  I have read of obstetricians performing them in the late evening before midnight, as it is one less patient during the overnight hours to worry about.

In the months before AJ was born, I had attended childbirth classes and had read several different books on childbirth and some of the medical interventions that might take place, but I had known so little about what would happen once I was admitted to the hospital, how the doctors and nurses would make decisions that I would not understand.  I did not understand the power dynamic that would take place in my role as a patient, how helpless I and my husband would feel in the hospital system, where we were given as little information as possible.

Since I gave birth and recovered from the infection, I have researched labor, delivery, and Caesarean sections.  TheUnited Stateshas the highest Caesarean section rate in the industrialized world.  As of 2006, the C-section rate in the US was 31% of all births, or about one in three.  The risk of a C-section doubles for a first-time mother when a medical induction occurs.  The World Health Organization recommends that countries have a rate of 15% or less, and countries with rates higher than 15% are at greater risk of soaring maternal and fetal death rates.

There are times C-sections are necessary: when the baby is presented breech and attempts to turn the baby fail, when there are risks to the mother’s health such as preeclampsia (high blood pressure), or risks to the baby’s health such as premature placental detachment, or prolapsed cord (when the cord emerges first in the birth canal).  However, there are many more C-sections that are made necessary due to standard medical practice in hospitals that are drawn on artificial conclusions, such as “the clock.”

The convenience of C-sections for doctors and/or hospitals is that C-sections are quick: from the time it takes to prep the room to the time the patient is sewn up and off to the recovery room is less than an hour and a half.  The procedure itself takes about twenty minutes.  Because every woman labors differently, from a few short hours to days, C-sections end the need of doctors and staff to constantly monitor the mother and baby’s health and progress.  In facilities with limited number of beds in a maternity ward, the need to turn over rooms can sometimes compromise the need of time for the mother to be in labor.  Things have to be sped up.  The clock is set.

Time ticks away.  Pitocin is started, increasing the strength and intensity of the contractions.  The contractions increase and the pain and intensity often become too much to bear, so the mother is given an epidural to numb the effects, but also makes it difficult, if not impossible, for the laboring mother to change positions to help the baby move further down the birth canal.  Often the epidural calms the effects of the Pitocin to a point that it slows down the labor, and so Pitocin is increased again.  This cycle continues, with the epidural or other pain-relieving drugs administered at a greater measure to combat the intensity of the contractions, all the while creating an environment in which a baby undergoes great stress.  That stress can manifest itself in drops in heart rates or other vital signs, causing an emergency which requires a C-section to save the life of the child.  And if that were not enough, after twenty-four hours of labor most women are taken in for a C-section anyway because “the clock” has wound down from twenty-four to zero.

There are many risks involved with a C-section, which are rarely explained because there isn’t time, though the patient is given a waiver to sign.  It is up to the patient to ask questions.  I was not informed that the C-section could actually cause great risk to the baby as well as me.  I was not told that one of the outcomes may be that my child would have difficulty breathing, as my son did.  I was not told about the risk of infection, nor was I ever told that one out of every two C-sections has complications.  However, as one doctor friend of mine said to me off the cuff, “No doctor has ever been sued for performing a C-section.”

I believe in the end, my C-section was necessary.  The second on-call doctor during my labor who delivered AJ said the reason for the C-section was my fatigue at the end, not his size.  I had labored for almost 24 hours after being up for 36 hours, and I was utterly exhausted after the Pitocin and the epidural which was supposed to help me relax.  I was falling asleep between pushes.  Once AJ was born it was clear he was having trouble breathing.  The C-section ended up being necessary, and I was left with an infection and a twelve-week recovery.

All in all, as the saying goes, if I only knew then what I know now.  If I had known all the risks of the medical induction process, I would have asked to delay my induction.  At my last ultrasound, there was no cause for concern.  If I had known that my induction would be delayed by twelve hours by the hospital, I would have asked to come back the next morning.  I cried when the doctors began the C-section because I felt set up.  I do believe my C-section was necessary, but I also believe it was entirely preventable.  It ought not to have happened.

Jesus’ death by crucifixion was also necessary, and it should not have happened.  When I prepared for Holy Week the spring after my son’s birth, I found myself wrestling with these questions with a wrench in the stomach feeling: Why did Christ have to die for our sins?  Why did Christ have to die on the cross?

Perhaps I had been reading the story wrong.  I remember going to camp as a youth and being explained in a formulaic way, that Adam’s sin caused God to put Christ on a cross, which equals our salvation.  At the same time I remember at the same camp learning the verse by heart:  For God so loved the world that he sent his only Son, so that whoever believes in him may not perish but have eternal life.  There seemed to be more to it than a simple equation of sending Jesus to die, much more than I could understand at that impressionable age.

It is clear in the Gospels that Jesus is innocent.  Jesus is falsely accused, there is no basis for the accusations, and Pilate even wanted to release him, but for fear of the crowds hands him over.  Jesus has done nothing to deserve death.  Jesus’ death does not appease a wrathful God but rather appeases the bloodthirsty crowd that demands his blood.

Jesus tells a parable during the events of Holy Week about the owner of a vineyard and his tenants (Mark 12:1-9). The landowner has sent servants who have returned beaten and abused.  It is clear that the landowner did not willingly send his son to die—that was not part of the plan of the landowner—but sent him because it was the necessary thing to do, the only thing to do, so that some would listen to him.  God sent Jesus to the world so that the world would learn and have relationship with God in a new way.  God knew, however, that our sinful ways would cause us to kill him.

When Jesus entered Jerusalemon that day, he knew what his end would be.  But the same crowds that would shout “Crucify him!” did not know this; they shouted “Hosanna!”  The same disciples that would flee from him, deny him and even betray him did not know this, they accompanied him.

Joseph was told in a dream to name the child Jesus because he would save his people from their sins.  What we forget so often is how many times Jesus healed people, restored people, and said, “Your sins are forgiven.”  It did not require his death to forgive our sins, but through Jesus’ death on the cross, death was conquered forever.  The paradox is that Jesus’ death was entirely preventable, but entirely necessary.  He was innocent and yet his death subdued the violence brewing between the Romans and the people; it quenched the blood thirst of the crowd that was not satisfied with Barabbas.  We remember that it was only after Jesus was handed over for death that Pilate and Herod became friends.

Jesus died in a system of violence resolved by violence.  The priests wanted him arrested but didn’t want to be responsible for his death, so they handed him over to Pilate.  Pilate didn’t want to be responsible for this innocent man’s death, and in Luke’s Gospel he tries to send him back to Herod, but eventually hands him over to the soldiers to be crucified, to please the crowds.  No one wanted to claim responsibility, but they all wanted him to be killed, to be rid of him.  To bring peace to the crowds, the priests, and the government, an innocent man was killed.

However, before we get to death, there is another birth we speak of in the Christian story.  When Nicodemus came to visit Jesus, he was told that no one could see the kingdom of God without being born from above.  Nicodemus said to him, “How can anyone be born after having grown old?  Can I crawl back into my mother’s womb?”  Jesus told him he had to be born not only of flesh, but of Spirit.  There is another birth that happens, a birth that has no death, and that birth is triumphant because the cross conquers death.

I was exhausted when AJ was born.  I had slept very little in thirty hours and at the end, the Caesarean section was necessary for him to be born.  Despite what I went through and because of the research I’ve done I still believe it was necessary at that point, to give my son life.  But it ought not to have happened.  It was not at all what I expected when I became pregnant or when I prepared for the induction.  In the end, I have my son, born alive and healthy.  There are many women who have uncomplicated pregnancies that end up with Cesarean sections, surgical procedures that ought not to have happened, but because of the medical interventions that occurred, the artificial clock set up of the hospitals, the introduction of Pitocin and epidurals, many of those mothers and babies end up with complications requiring a life-saving Cesarean section, though not without its consequences.

All too often the decision to have a Cesarean section is made as a life-or-death decision.  It has to be made almost right away.  It has to be made to save the life of the child and/or the mother.  The responsibility of saving the life ends up upon the family caught in the process of birth, for ultimately they must sign the paper to give consent, even if not all the risks are shared.  However, had the hospital not put the laboring mother on a clock, had the doctor not decided that the contractions were not fast enough based on insurance policies and not medical necessity, had the anesthesiologist given all the risks to the patient ahead of time, perhaps a number of Cesarean sections would be avoided, and the health risks for both mother and baby could be reduced dramatically.

My hope is that as the World Health Organization puts pressure on the medical institution in the U.S.to prevent unnecessary cesarean sections, to get off of the artificial clocks placed by insurance companies and hospitals.  Perhaps in the future we will have learned from our past C-sections.  It is time to end the systemic way women and children are put in danger, created by an artificial clock placed by hospitals and insurance companies in a system more concerned about turning over beds than the risks involved.

My hope goes beyond the operating room in Labor and Delivery to the side of the hospital bed.  The entire time I was recovering from surgery in the hospital, I was never seen by a chaplain.  I was never asked the question, “Do you want spiritual support?”  My hope goes beyond the side of the hospital bed into the churches and homes where friends and clergy will ask how you feel, but rarely want to hear what you feel, especially if you have any negative feelings about the birth process.  “Well, your baby is healthy, that is all that matters.”  “Your son is alive, you can thank God for that.”  Those statements, however true, are hollow and empty and allow the caregiver to ignore the feelings of the mother.  And I have barely mentioned what my husband went through in all of this.  My hope is that pastors will learn how to reach out to mothers who have given birth by Cesarean section or who have had other traumatic birth experiences to understand that not every birth results in a happy experience.  My hope is that clergy will recognize the emotional pain and trauma that has occurred for all parents involved, to not only recognize but honor and give validity to the multitude of feelings surrounding birth.

I cannot tell the story of the birth of my son, Anselm John, without telling the story of my C-section.  There are many women who can identify with the experience of Jesus on the cross, when their arms are strapped down in a T, when they are told this must be done to save a life.  They, too, are caught in a system where responsibility is pushed off, where a scapegoat is created, whether it be the mother for not making quick decisions earlier, or even the child, for not descending the birth canal fast enough.

We cannot tell the Christian story without telling of the crucifixion of Jesus.  We cannot tell the story of God’s love for the world without the sending of his only son and his death on the cross, a scapegoat for the system of violence.  I am reminded of what theologian Mark Heim once said: “Jesus’ death saves the world, and it ought not to have happened.”  That is exactly how I feel about my C-section: it saved AJ’s life, and it ought not to have happened.