Letters from the Issue of April 1, 2004

Foul-mouthed writers, fully trained midwives, and bunched-up panties

Behind the Scenes at Miami-Dade Public Schools

Weird dealings, Ralph Arza, and other scary things: In response to Rebecca Wakefield's article about state Rep. Ralph Arza ("Meet Mr. Arza," March 25), I say thank God for New Times and especially for Ms. Wakefield's ability to investigate and write. Her stories are easy to read and contain a lot of facts the average person would not know or have the time to research. She does a great service to our community.

There are a lot of very busy, well-intentioned people who work hard for Miami's public schools but are not aware of the weird dealings going on behind the scenes. Stories like hers, scary but also motivating, open our eyes and make us want to do more, not for our own gain or for special interests but for those who need our help: the students and our teachers.

Esther Castiglia

Coral Gables

Newspaper Flirts

with Ruination

Free weekly's new potty-mouth columnist spells doom: I enjoy New Times very much and I do not want to stop reading it. But I was very offended to come across a new column called "The Bitch" (March 25). I should be able to pick up a newspaper without the expectation of seeing foul language. In this venue, the F-word is totally unacceptable, but it too appeared in "The Bitch."

Other than "The Bitch" and its ridiculous attempt at getting attention, the newspaper is a great piece of work. Please don't ruin it.

Lance Wampler

Miami Beach

Storm in the Shelter

No wonder she lost her dog -- she wasn't there: I visited the Miami-Dade Animal Services shelter every day during my dog's "extended vacation," so I read with interest the "Dog Gone" story by Kirk Nielsen (March 18). But I found the article lacking.

The Miami-Dade Police Department's Animal Services Unit deserves more credit than the article gave it, and Lazara Betancourt, who lost her dog Ambrosio, deserves more blame. The shelter is crowded, smelly, and undersupplied, but it is the only animal shelter in the county that will take any animal immediately. Private shelters in Miami-Dade and Broward have waiting lists in excess of six weeks. Our local shelter is not funded by taxes but relies on fees, donations, and volunteers to support itself.

The Miami-Dade staff, despite the stress of working at the busiest shelter in South Florida, provides superior customer service, but owing to the busy nature of the office -- lines around the corner, many people talking at once, a mélange of dogs and cats in the lobby -- I understand how the Ambrosio mix-up happened. However, I do not understand why Ms. Betancourt did not notify the shelter that she would pick up her animal upon her release from the hospital, something well within their policy, rather than cause the confusion of two aborted pickups, which I'm sure contributed to Ambrosio's mislabeling and most likely reprocessing into the system as a stray and subsequent adoption.

Visiting the shelter every day from January 19 through February 14, I did not observe dozens of animals being euthanized. The only ones I noted being put to sleep were those with untreatable conditions, such as the basset hound dying from cancer. Even in the rooms for the sick and injured, where I visited each day, I noticed animals like the hairless Labrador being nursed back to health and released into the adoptable sections. The shelter's policy is clearly stated on its Website: "The Animal Services Unit is committed to adopting animals and will hold animals until adopted, or as long as they remain healthy."

Carsie Launey

Miami

There Are Midwives and There Are Midwives

Not all are trained equally, as expectant mothers should know: I am an RN who works in labor and delivery, and I read Celeste Fraser Delgado's article "Cuts You Up" (March 18) with great interest. It appears she is trying to educate the public about their choices in childbirth, for which I commend her, as knowledge is power. But I am concerned that she has attempted to do so in a biased and very dangerous way.

She fails to mention why Janessa Wasserman had a c-section with her first son, and implies it was unnecessary, stating that she was "failing to progress." Yet the fact that she had an internal fetal monitor indicates there must have been signs throughout her labor of some sort of fetal distress. Being an attorney, what would Mrs. Wasserman have done if the c-section was not done and she had delivered a baby with severe brain damage owing to lack of timely intervention? I think we all know the answer to that question.

VBACs (vaginal births after cesarean) are done successfully all the time, and patients must sign extensive consents indicating they are aware of the risks, which include uterine rupture, placental abruption/hemorrhaging that may result in fetal and/or maternal death, and possible hysterectomy for uncontrolled bleeding. If Mrs. Wasserman was willing to accept these risks, then more power to her. I just happen to feel that most people would rather have a repeat cesarean section and a healthy mother and baby than accept the guilt and responsibility if anything were to go wrong, all so they could have the "birth experience."

In my experience, when labor and birth go smoothly (which the majority of them do), the outcome is a healthy mother and baby. But when things go wrong, they go very wrong very quickly, and can cause poor fetal outcome or death, or even maternal death in some instances. This is why it is critical for physicians, nurses, midwives, doulas, and families to work together to provide families with their "birth experience," allowing room for medical intervention when necessary.

What I feel the public also doesn't understand is that there is a difference between "lay midwives," who have minimal medical background and training, and "certified nurse midwives," who are RNs with graduate-level training in labor and birth. They are trained to recognize the early warning signs of things going wrong and defer care of the patient to their backup physician when necessary. I can't tell you how many cases I have seen where high-risk patients are laboring at home or in a birthing center with a lay midwife, and then come to the hospital at the last minute with obvious signs of prolonged fetal distress, and I have to tell you, the outcome is often very poor. But then who gets blamed? Not the midwife with no medical training or malpractice insurance.

Celeste quotes Cher Durham as saying, "Why would you want to be medicated if you don't have to? Why would you want a needle in your spine?" The answer is simple: You don't! Hospital nurses and physicians are there to make the experience what you want, within the policies of the facility. If you don't want an epidural or intravenous narcotics, nobody is going to hold you down and give them to you. It's all about informed decisions and choice, but sometimes the power is taken away from everyone involved in order to prevent a poor outcome. If a baby tells you it's in trouble, you'd better do something about it before it's too late.

With regard to "elective c-sections," you must consider the Hispanic culture here in South Florida. I can't tell you how many patients come in from South America wanting to "schedule my c-section," only to be horrified to be told that no, we do not just schedule c-sections for no reason and that they will be having a vaginal delivery. Sure, some doctors are willing to do this, but very few will promote unnecessary and risky surgical intervention.

The answer to all of this: education, education, education. Explore your options, know your rights, and go into the experience empowered with knowledge. But please, if things go wrong and you need a c-section, understand that it's not your fault and it's not our fault. Things happen. Look at your beautiful new baby and realize: This is what it's all about.

Just a final observation: Celeste states that during Cher Durham's delivery, "For a moment the baby is stuck, snagging her mother's insides with her left hand." Hmmm.... She must have x-ray vision! That would be really useful in hospitals so we could see what's going on inside the womb.

Samantha Roher, RN, labor and delivery

Hollywood

Home Is Where the Birth Is

At least it was in my case, without problems, two times: I would categorize myself as a very safety-conscious nerd. I am not a risk-taker, and I do not think of myself as brave. I also have several family members who are doctors, so before I became pregnant the first time, I did a fairly extensive review of the mainstream medical literature. (If I was going to go through nine months of pregnancy, I wanted to make sure my decision about where and how to give birth was the safest one for my child.)

After much reading, I chose to have a home birth (and have since had another) with trained and licensed midwives precisely because of the conclusion reached by the studies I read: Healthy, low-risk women who give birth at home have no increased risk either to themselves or to their babies. Since health outcomes are equivalent in home birth vs. hospital birth for women classified as having a low-risk pregnancy, the deciding factor should be where women feel most comfortable having their baby.

The emotional aspect of feeling safe and relaxed (as much as possible) facilitates delivery and birth, which is healthier for baby and mom. Some women might feel more comfortable in a hospital. Other women, like me, feel more comfortable in their own home. If hospitals and doctors are only concerned about safety issues and health outcomes, they should not mind (nor create obstacles) if women with low-risk pregnancies choose to give birth at home.

Susannah Troner

Pinecrest

We're Here to Help the Kids

So don't believe those nasty things they're saying about us: In response to the recent article by Rebecca Wakefield regarding children's Medicaid dental coverage ("Cavity Depravity," March 11), we agree that all children deserve quality care and that preventive care, education, and early intervention are vitally important.

Atlantic Dental is a Florida-licensed, prepaid, limited health-service organization. We would like your readers to know that we are committed to providing quality dental care to the children of Miami-Dade County while simultaneously fulfilling the state's goal of reducing Medicaid fraud.

We are proud to have been selected by the State of Florida after participating in their rigorous approval process. We intend to provide greater coordination of patient services as well as an emphasis on customer service and outreach programs. In the past, many children did not have access to quality dental care. Atlantic Dental's program in Miami-Dade will be the first of its type in the state and we are working very hard to make sure we provide a model for others to emulate. Our quality-assurance efforts will include detailed systems, specialized computer software, and skilled staff to review and monitor care. Children will be conveniently matched with providers in their area and we welcome any qualified, licensed dentist to join our program.

Leila Chang, chief executive officer

Atlantic Dental

Coral Gables

Q: Want to Know

What's Funny?

A: "BuzzIn" haters whose panties are all bunched up: You know what's even funnier than Humberto Guida's column "BuzzIn"? All the haters who get their panties up in a bunch about it. I've been reading New Times for a few years and love it when the scammers and crooks you guys expose (and their supporters) write in to complain about being exposed.

But what's with these touchy nightlife people complaining about this little column at the end of the paper, defending things like the DanceStar awards of all things? "BuzzIn" is good fun, and often right on the money in its own unique way. When describing the last year of Level, for example, Humberto said it was filled with all the people he bought drugs from in high school. Hey, that line right there makes me a fan. If there's a more accurate description for the makeup of that club's old crowd, I'd like to read it. And what's even funnier is what Humberto is admitting about himself.

The column might be trite, but it's goddamn hilarious. Give it more room.

Ed D. Ponce

Miami Beach

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