One argument you may hear against health care reform concerns cancer survival rates. The United States has higher cancer survivor rates than countries with national health care systems, we’re told. Doesn’t this mean we should keep what we’ve got and not change it?

Certainly cancer survival rates are a critical issue for people suffering from the deadly lung cancer mesothelioma. So let’s look at this claim and see if there is any substance to it.

First, it’s important to understand that "cancer survival rate" doesn’t mean the rate of people who are cured of a cancer. The cancer survival rate is the percentage of people who survive a certain type of cancer for a specific amount of time, usually five years after diagnosis.

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Going green used to be considered expensive and a luxury for those who could afford the trend. Now it appears that we are learning that not only is adopting more environmentally conscious attitudes good for our economic situation, but also our….health? Yes, if we dig a bit deeper we can see that dirty industries and backwards policy is actually harming the health of the earth for our children and the health of her inhabitants today.

There are two levels of health consequences associated with dirty industry, both direct and indirect. The direct consequences are examples like increased asthma rates in areas with high smog indices. Chlorofluorocarbon release into the atmosphere has shown to decrease the filter of direct sunlight on the planet, resulting in more concentrated ultraviolet light reaching the surface of the earth. Perhaps it is no surprise then that in countries with depleted atmospheric gas, skin cancer rates are among the highest in the world.

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I don’t get to go to births much anymore. My midwifery practice closed in July. Our consulting doctors merged with another group and in the merger were forced to stop accepting our referrals and collaborating on VBACs. As a result of that we had to forfeit our hospital privileges. We would have continued offering only home birth services but one of our three midwives left to join another practice with 9-5 hours and we couldn’t recruit another midwife to replace her. As much satisfaction as the work brings, home birth is hard and the pay isn’t great. That’s because insurance reimbursement is a joke. It doesn’t cover things that are fundamental to our work, like home visits for mother-baby check-ups or having a skilled birth assistant present. And if we spend hours supporting a woman in labor, use our well-honed assessment skills to diagnose a complication, and facilitate a timely transfer of care so a baby can be safely delivered? We probably won’t get paid a dime if the doctor performs the delivery.

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This year, one in three babies will be born by cesarean section. The cesarean rate in the United States has hit a historic high every year for nearly a decade, and shows no signs of abating. Research from the World Health Organization suggests that when a cesarean rate is higher than 15% in any population, cesarean surgery begins harming for women and babies than it helps. That means that each year, as many as half a million cesareans could be safely prevented in the U.S. each year.

These aren’t all unnecessary cesareans. By the time they’re performed, many if not most are necessary. But somewhere in the chain of events leading up to the cesarean there may have been a different policy, choice, or approach that could have prevented the need from arising in the first place.

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Blogs, Facebook, and Twitter were bustling last week with back-to-back stories of doctors putting the kibosh on women’s right to self-determination in their birth. First, The Unnecesarean reported on a doctor who preemptively gives his own (awful) birth plan to all of his patients, and one woman’s triumphant experience firing him and hiring a midwife. Just a few days later, the internet lit up with a zillion copies of this picture of a sign in a Provo, Utah Ob-Gyn’s office:
 

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Pop quiz: what is the most important factor determining whether a woman has a cesarean or not? How healthy she is? How big her baby is? Whether she has pregnancy complications? These all seem like reasonable answers, but the research tells a different story.

A large body of literature suggests that where a woman gives birth is one of the strongest - or even the strongest - predictors of whether she’ll have a cesarean. Yes, you read that right. The same woman could walk into two different hospitals and walk out having had either a vaginal birth or abdominal surgery. The same is true with care providers. Some have high cesarean rates and others have low cesarean rates, and most of that difference has little to do with how many women in their care actually need cesareans to give birth safely.

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If you had your baby in a United States hospital in 2005:

• There’s a 1 in 3 chance you had cesarean surgery.
• There’s less than a 2% chance that you experienced a package of evidence-based care practices known to ease labor and prevent complications.
• You most likely were separated from your baby during the first hour after giving birth.
• There’s a 1 in 5 chance (1 in 4 if you are black) that you had symptoms of childbirth-related post-traumatic stress disorder (PTSD) in the months after giving birth.
• There’s a 7% chance you had to be rehospitalized before your baby was 18 months old.

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1. Educate yourself about endocrine disruptors, and educate your family and friends. Read the novel or other books (like Our Stolen Future: www.ourstolenfuture.com) and share them with others. I wrote a fact-based eco-thriller, because I wanted to share these issues with people in a way that was entertaining as well as informative and that allows readers to experience the reality we face emotionally and not just factually. My goal was to help us understand the real threats and find an inspiring way back into a relationship with the natural world that will allow our children to inherit a healthy world.www.douglascarltonabrams.com

2. Buy organic food and eat as low on the food chain as possible since pesticides concentrate as animals eat other animals.

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Why do some children and adults get sick from these chemical contaminants and others do not? This is an important question that has to do with genes, chemical cocktails, and even possibly stress.

While I was researching my novel, I posed this question to John Peterson Myers, co-author of the pioneering and now classic, Our Stolen Future: Are We Threatening our Fertility, Intelligence, and Survival? (an excellent expose on endocrine disruption). Pete replied, “An absolutely vital point is that not all people nor all animals respond in the same way. This is one place where inherited genetics comes into play. For example, work on organophosphate pesticides shows that there can be as much as a 40-fold difference in sensitivity.” In short, our genes have a lot to do with our sensitivity to toxins, just like some people develop allergies while others don’t.

But it’s not just genes. A big factor is that while clinical studies are done with one chemical at a time, we are exposed to great chemical cocktails that can often exacerbate the effects and overwhelm our immune systems.

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On June 27, 2009, Nicholas Kristof of The New York Times reported that over 80% of the male smallmouth bass swimming in the Potomac River had eggs. You read that right, male fish having eggs. Well, unless a lot has changed since my biology class, males are not supposed to have eggs. Unfortunately a lot has changed.

While you can see a humorous interview of Kristof on the Colbert Report, this is not really a laughing matter. (It’s worth pointing out, however, that Stephen Colbert and John Stewart are increasingly proving that the really important news is being covered by these two brilliant comedians.) You might think maybe it’s freakish, but this is just about fish, right? Unfortunately not. The endocrine disrupting chemicals that we are putting into our environment at a staggering rate are creating fundamental changes in the physiology and even anatomy of our children.

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