in Saratoga County discover that hospitals in their region
may no longer offer women the option of VBAC
Christine MacLellan arrived for her routine prenatal checkup
at Saratoga Obstetrics & Gynecology Associates in Saratoga
Springs in November 2001, her visit was anything but routine.
Then four-and-a-half months pregnant and planning a vaginal
birth, which had been encouraged and supported by her doctors
after a cesarean five years earlier, MacLellan was told something
she did not want to hear.
don’t know if you’ve been told yet, but we no longer offer
VBACs [vaginal birth after cesarean]—so we’re looking at another
cesarean,” said the physician assistant.
was shocked—stunned—because in the beginning of my pregnancy
I received complete support from my doctors, and now, a 180-degree
turn,” MacLellan said. “I just nodded and listened while the
PA spoke to me. At that point I almost accepted that I’d have
another cesarean—maybe I did accept it.”
MacLellan is one of many women in Saratoga County who are
finding out that, if they had cesareans in the past, they
will be forced to have major abdominal surgery to deliver
their next babies, whether or not they need it. Glens Falls
Hospital has stopped providing vaginal birth after cesarean,
and Saratoga Hospital does so only on a limited basis: According
to Ellen Kerness, manager of marketing and community relations,
Saratoga Hospital has fewer VBACs now than before November
2001. So many women in Saratoga County who want vaginal births
are forced to have repeat cesareans if they cannot find doctors
and hospitals to support VBACs.
been so pleased up to then,” MacLellan said of Saratoga Obstetrics—especially
with Drs. Karen Schick and Katja Bock, who performed her earlier
cesarean when her daughter, Katherine, was breech.
In her cloud of shock, MacLellan remembers hearing the PA
reveal that the changes in VBAC support had to do with Saratoga
Hospital—she was told that the hospital does not have an anesthesiologist
on premises at all times in case a patient should need an
emergency cesarean, and that it is more of a risk than the
hospital wanted to take on.
Late last year, Susan Parrillo also received unwanted news
during her regular gynecologist appointment at Saratoga Obstetrics.
The mother of two—Katie, 4, born by cesarean, and 1-year-old
Drew, born vaginally—was told the practice no longer offered
VBACs. If she wanted another baby vaginally, she would have
to go to Albany Medical Center.
was horrified—in complete disbelief,” Parrillo said. “Having
a cesarean was the worst surgery of my life, and I’ve had
plenty. I didn’t heal properly, had an infection, and couldn’t
lift my child or even breast-feed without pain for weeks.”
In contrast, her son’s vaginal birth, assisted by Dr. Peter
Cole of Saratoga Obstetrics, was “very satisfying and positive,”
Parrillo said. “Healing was amazingly wonderful. I was again
rowing competitively four weeks later, something I couldn’t
do for a year after my cesarean.”
MacLellan said that after she returned home from her prenatal
appointment, she started thinking about the unpleasantness
of the cesarean procedure, the long recovery period, and how
she would take care of her daughter along with the new baby.
cesarean was nothing like TLC television portrayed it,” MacLellan
said. “I wasn’t expecting to have my arms tied down and a
curtain blocking my view. I like to see what’s going on. .
. . And it was painful when they cleaned out my uterus around
my rib cage.
didn’t enjoy the cesarean section, and I don’t expect labor
to be pleasant either, but I’m looking at the big picture—shorter
recovery time,” MacLellan added.
When Parrillo heard again and again that “it’s for your own
safety not to have a VBAC,” she probed further; her research,
she said, showed that cesareans are more risky to mothers
and babies than VBACs. It made her raging mad, she said, that
women were not being told the truth.
According to A Guide to Effective Care in Pregnancy and
Childbirth, by Marc Keirse, Murray Enkin and others, “The
rate of maternal death associated with cesarean section (approximately
four per 10,000 births) is four times that associated with
all types of vaginal birth (one per 10,000 births). . . .
Most forms of maternal morbidity are higher with cesarean
section than with vaginal birth.”
Parrillo said. “One more example for women—large establishments
are taking our rights away. There has to be a way to fight
the establishment, find a way to have a say about what happens
started chatting with girlfriends,” MacLellan said, “reading
articles about cesareans and VBACs, searching for doctors
and hospitals supporting vaginal births.” A girlfriend suggested
Mondragon, McGrinder Medical Associates, a group of four doctors,
a midwife and nurse practitioner with offices in Clifton Park
and Schenectady. She also received good reports for Bellevue
Woman’s Hospital near Schenectady; one of her friends gave
birth there and loved it.
staff—very accommodating, offered to schedule a special VBAC
class for my husband and me. They even have sibling classes
for my daughter.”
speaking, I have an 87-percent chance of having a successful
vaginal birth after my cesarean since Katherine was breech,”
MacLellan said. “However it goes, I’ve asserted myself and
didn’t accept what I was told at face value. I hope this helps
other women in my position to look into alternatives. I’m
the consumer. If the doctor or the hospital doesn’t provide
the service I want, I’m free to go to another provider.”
Mora is a freelance writer living in Saratoga Springs.Big
Business Beware—Little Brother Is Watching
Business BewareLittle Brother Is Watching
the new Corporate Flag of America waved in the wind (complete
with corporate logos standing in for the stars representing
the 50 states), a group of local activists convened outside
of the Business Council of New York State’s Albany headquarters
last Friday (April 5) to celebrate Big Business Day. The event,
organized by Citizens Work, a new citizens’ group started
by Ralph Nader, was part of a nationwide action against corporate
abuse and power. Protesters addressed issues such as raising
the state minimum wage, the Enron and Arthur Andersen scandals,
campaign-finance reform and the increasing corporate ownership
of the media.
of advocates gather in Albany to demand more funding for AIDS
and HIV programs, especially in minority communities
Johnson, an African-American woman
from Harlem, was just 31 when she was diagnosed with HIV.
At the time, she was homeless, living on the streets of Manhattan.
life was not about being healthy,” said Johnson. “I was too
worried about where my next meal was coming from and where
I was going to sleep. Forget taking medication, forget showing
up for doctor’s appointments, eating balanced meals, using
protection or sleeping right. Inevitably, more people on the
streets with HIV equals more infection rates.”
Johnson said that with the help of Harlem United Community
Aids Center, she was slowly able to get her life back on track.
just three years, I was provided with affordable housing,”
said Johnson. “I was given services that I needed to learn
how to live a healthy life with HIV.”
But Johnson is concerned that other people living with HIV
and AIDS will not have the same opportunity that she was given
unless more funding is provided from the state Legislature
for programs like Harlem United.
That’s why Johnson joined hundreds of HIV and AIDS advocates
on the steps of the Legislative Office Building on Tuesday
(April 9), to demand new state funding to fight AIDS in communities
takes money to save lives,” said Soraya Elcock, deputy director
for prevention at Harlem United. “People of color are disproportionately
affected by HIV and AIDS. Eighty-three percent of all AIDS
cases in New York state occur in communities of color, and
that number has been on the rise all across the state.”
According to the U.S. Centers for Disease Control and Prevention,
AIDS cases in New York state have increased by 58 percent
just in the past year.
than eight out of 10 people with AIDS are people of color,”
said Michael Kink, legislative council for Housing Works,
a nonprofit AIDS service organization. “Yet there have not
been adequate state resources directed at HIV and AIDS in
these communities for the past 10 years.”
Kink said that the protesters gathered at the LOB on Tuesday
would like $12.5 million in state funding to fight AIDS in
communities of color, as well as full restoration of $17.9
million in funding cuts proposed in Gov. George Pataki’s executive
The protesters came out in support of a $12 million initiative
in the state Legislature put forth by the Black, Puerto Rican
and Hispanic Legislative Caucus and the Assembly Puerto Rican/Hispanic
Task Force. They also support a Minority AIDS Initiative in
the Senate, sponsored by Sen. Kemp Hannon (R-C-I-Garden City),
chair of the Senate Health Committee. The Senate’s initiative
doesn’t yet have a price tag, but last year it pushed a proposal
that included $500,000 for AIDS services in minority communities.
Kink said that every year since 1994, Pataki has proposed
to cut millions of dollars in funding for AIDS in his executive
budget. This year, the cuts include $7.9 million in AIDS Institute
funding and $10 million in homeless-housing funds. However,
each year, advocacy groups have been able to get that money
restored in the budget. Still, advocates say that just keeping
pace with last year’s funding will not keep pace with need.
there have not been cuts,” said Kink, “there has not been
an increase in funding either. Yet the number of people infected
with HIV continues to increase. We have nowhere near the resources
we need to really fight the epidemic where it is today.”
Pataki spokesman Kevin Quinn told New York Newsday
that, overall, the governor’s budget plan, including federal
funds, will make $2.3 billion available to fight AIDS, making
it, he said, “the highest level of funding in state history.”
But for the hundreds of protesters that gathered in Albany
on Tuesday, that is simply not enough.
am angry because people are sick and dying and they are being
forced to live on the streets because there is no money for
affordable housing,” said Stanley Jackson, from Harlem. “The
programs that save lives are the ones that are getting hit
the hardest. The bottom line is, AIDS cuts kill.”
More than 800 people attended the protest, and 61 activists,
including Assemblyman Roger Green (D-Brooklyn), were arrested
on Tuesday for blocking the entranceway to the state Capitol.
gives cell-phone companies until 2005 to equip cellular products
with Global Positioning Satellite tracking devicesTracking
devices once were a staple of old science- fiction and action
movies. One typical scene: The good guy slaps a tracer on
the villain’s getaway car and follows him—at a safe distance—to
his lair for the final showdown. Or a team of leering, white-coated
technicians forces a microchip-sized homing device into the
hero’s brain cavity.
These days, such scenarios aren’t so fantastical. For blanketing
the United States are 140 million human-tracking devices:
When you place a cellular phone call, your phone seeks out
the nearest receiving tower, which serves a discrete area
or “cell.” The tower routes the call to its destination. If
you leave the cell area before your call ends, the call is
bumped over to the corresponding cell tower, thereby tracking
your rough location.
is the operative word: While urban centers, which contain
many cell towers, can relay your location with some accuracy,
those odds go down in rural areas, where towers are fewer
and cell service is often spotty.
But in the coming months, the tracking ability of cell phones
will grow exponentially—not just in its power to monitor users,
but also in the way it can be used for commercial gain.
Last year, the Federal Communications Commission ordered cellular
companies to equip all new cell phones with Global Positioning
Satellite tracking devices that can pinpoint a user’s location
to within 300 feet, anywhere on the planet. The agency ordered
the move at the behest of law enforcement agencies, who have
long wished to be able to tell where 911 calls made on cell
To a degree, cellular companies have reacted to the FCC’s
order with distaste. The GPS chips will add about $20 to the
cost of each phone, which often are given away free with cellular
But the companies are also rubbing their hands with glee at
the potential profits. As regular Internet users know, marketers
believe there’s money to be made from information about people’s
daily activities and habits. Log on to a typical web site,
and it may plant a “cookie”—a piece of code that identifies
users—on your hard drive. With that information, web sites
can track your surfing habits and tailor the content of advertisements
Cell phone companies are aware of the potential backlash from
consumers; a Verizon Wireless spokesperson told the technology
news website CNET.com that it currently has no plans to release
information about customers’ day-to-day whereabouts to commercial
third parties. Still, none of the cell companies are saying
they won’t try to use the information for their own purposes.
One way cell companies could profit is by selling advertising
that would be displayed on cell phone screens. In the near
future, your cell phone could turn into a miniature billboard,
alerting you, for example, to nearby restaurants at lunchtime
or to sales at the local mall.
This won’t happen overnight. Cellular companies have lobbied
for and received a temporary stay from the FCC’s order to
install the GPS chips, although that reprieve is set to expire
later this year. The FCC ruling also allows companies to ease
into compliance, giving them until 2005 to make all cell phones
But in the meantime, you’re not safe from cell-phone marketing:
Some companies, such as marketers PangoNetworks, are already
making use of today’s more limited location-tracking technology.
Pango sets up zones called “hot spots” within businesses or
shopping malls. Hidden sensors can detect your phone or Palm
Pilot, upon which the system hums into life, sending ads for
merchandise you might be standing near and compiling data
about your shopping habits: What stores have you visited?
Did you linger near the wrinkle-free khakis or by the animatronic
Hello Kitty display? Boxers or briefs?
On its corporate web site, Pango says users who don’t want
to receive these messages will be able to program their phones
to remain undetectable by the system.
Of course, at the rate things are going, true anonymity may
soon be a thing of the past.
In fact, there’s only one foolproof way to beat the system:
Turn off your phone. But how likely is that to happen?
Kanaracus can be reached at firstname.lastname@example.org. This
story first appeared in the
Valley Advocate (Easthampton, Mass.).