Comment

On “Staying Healthy …”

The article “Staying Healthy: Welfare Services Suggests How” stated that “lives have been saved and much suffering and expense prevented by treating problems early” (January 1981, p. 17). In the list that followed, it was recommended that a breast examination should be performed by a physician once a year. This is correct. But equally important, if not more so, is for a woman to practice breast self-examination (BSE) monthly.

Breast cancer will strike one in every eleven women this year. Early detection is the best weapon we have, and BSE is an extremely important part of the fight.

Esther R. Nelson, coordinator
Reach to Recovery Program
American Cancer Society

I would like to comment on the following statement in “Staying Healthy …” (p. 11): “Meat, except for very lean meat, is high in cholesterol, saturated fat, and calories. The American Medical Association and the American Dietetic Association list these items as top contributors to the cardiovascular diseases so prevalent today.”

While cholesterol and saturated fat do form plaques and impair the flow of blood in the arteries, it is not the cholesterol which a person eats that is responsible for this buildup.

After 30 years and millions of dollars spent in the attempt, the cause-and-effect relationship between dietary cholesterol and cardiovascular disease (CVD) remains unproven. (See “Toward Healthful Diets,” a 1980 report by the Food and Nutrition Board, National Research Council, National Academy of Sciences.)

For the more than 95 percent of healthy people in the Western world, the concern should be more about exercise, smoking, emotional stress, genetics, obesity, etc., than about dietary cholesterol and saturated fats such as found in eggs, butter, and meat.

E. Grant Moody, Ph.D.
Tempe, Arizona

Thank you for much excellent information in “Staying Healthy. …” There was, however, an inaccurate statement on page 17: “Head lice cannot survive in clean, frequently shampooed hair.”

The truth is, lice not only survive in clean hair, they can thrive there. Regular shampoos do not kill lice or their eggs. Special shampoos are necessary to treat this problem.

Many people are unnecessarily ashamed and embarrassed to discover lice in their own or their children’s hair due to the misunderstanding that only “dirty, unclean” people have lice. Anyone can get lice in any of several ways—from combs, hats, scarves, coats, or close head contact with a person who is infected.

The infection is most easily cleared up by prompt treatment with a special shampoo that is available with or without a prescription.

Jody Packard
Pleasant Hill, California

The last column of the article “Staying Healthy …” dealt with the question “How often should we have medical and dental checkups?” Included was a journal citation to the effect that after about age 20, women should have a pap smear two years in a row, and that if these tests are negative, a test every three years up to age 60 is sufficient. This is a new recommendation of the American Cancer Society, which until early 1980 had recommended a yearly pap smear.

It should be noted that much controversy has surrounded this change in the recommended frequency for pap smears. It was made by the American Cancer Society after what many consider to have been inadequate consultation with the rest of the medical and scientific world. Many articles have appeared in other medical journals opposing the change, and in fact the position of the American Professors of Gynecology as well as the American College of OB/GYN is that women should still be encouraged to have a yearly pap smear until further conclusive study indicates that less frequent pap smears can safely be recommended.

I thought you should know that there is a second opinion.

Lynn S. Farnsworth, MD, FACOG
Mesa, Arizona

On home deliveries

One of your readers has called my attention to the note on home deliveries (January 1981 issue, p. 14). That note cites an article by Burnett et al. on experience with home deliveries in North Carolina during 1974–76. I was involved as co-author of that study.

The note places an interpretation on our findings which I think is not appropriate. Our study showed that home deliveries which were 1) carefully screened for low risk, 2) were attended by trained people, and 3) had supervision and consultation readily available were associated with less neonatal mortality than hospital deliveries. The data show that home deliveries which might be hazardous are those which are unintentional, unplanned, and unattended by trained personnel.

Many comparisons of the relative safety of hospital and home deliveries have been made. Home deliveries appear more dangerous only if data on the unattended and unintentional home deliveries are included.

An appropriate interpretation of our study would be that childbearing among healthy, well-cared-for women is a happy and reasonably safe experience, but it is not free of risks. Some risks are associated with well-planned home deliveries; different risks are associated with deliveries in hospitals. Women might best become well informed about both kinds of risks and then elect which they desire to assume.

C. Arden Miller, M.D.
Professor and Chairman
Department of Maternal and Child Health
University of North Carolina at Chapel Hill

I am a registered nurse with experience in the full range of hospital obstetrics and midwife practices as well, and I would like to respond to two statements regarding home deliveries that were made in “Staying Healthy …”:

1. “Sudden hemorrhage certainly cannot be handled at home nor can life-threatening toxemia” (p. 14).

This is not true. I have had experience in handling episodes of sudden heavy bleeding without the need for transport to a hospital, and have successfully managed other very serious hemorrhages at home until transport could be provided. Certainly no reputable practitioner would encourage a woman with the potential for such problems to attempt a home delivery, and careful prenatal care and screening have been very reliable tools in predicting this kind of serious complication. In homebirth, specific emphasis is placed on excellent nutrition as one means of preventing problems such as anemias (a contributing factor to uncontrolled hemorrhage) and toxemia.

2. “Many advocates of home delivery emphasize that the birth process is a natural one and simply a matter of faith.”

I have had two children myself with a midwife in attendance, one of them at home. My husband and I did not approach our decision casually or on “faith alone.” We chose homebirth because we had intelligently researched the subject, had carefully assessed my risk status during pregnancy, and had thoroughly prepared—via excellent nutrition and prenatal care—for the birth of our little one. We recognized that our baby’s birth was our responsibility no matter what the setting, and we determined through our own intelligence and by prayerful consideration that, for us, it was a safe alternative—at least as safe as, or safer than, a hospital delivery. The overwhelming majority of women I know—LDS and otherwise—who choose homebirth do so for the same reasons.

President Kimball’s medical problems were cited in order to “attest that present scientific knowledge is a companion to faith in saving and protecting lives.” However, pregnancy is not a “medical problem” or illness per se, but a normal function of the female body. And secondly, choosing homebirth is not a rejection of scientific knowledge; it is simply choosing one medical alternative over another. The problem comes in placing absolute faith in one alternative without due consideration.

The real question, of course, is safety. Hospital birth has never been proven to be safer than homebirth for low-risk women. Indeed, there is much evidence to the contrary.

Many Church members living in other countries—in Scandinavia, The Netherlands, and Great Britain, for example—give birth at home by choice, and midwives have for many years been established and valued members of the obstetrical community. Several of these countries have perinatal death rates much lower than the United States. Would anyone advocate that the norms and customs of these countries be changed to be in accordance with the relatively recent trends on American obstetrics?

There are also doubtless many Church members in less-developed areas of the world (and indeed in the U.S. as well) who choose homebirth because of financial considerations. Should those among them who are low-risk have to make a financial sacrifice to give birth in a hospital? Or would it not be better to bring excellent prenatal care and nutritional counseling to every woman so that she could maximize the health and safety of herself and her unborn child?

Marla Webster, RN, CCE
Registered Midwife
League City, Texas

Where a birth takes place—at home, in a free-standing birth or maternity center, in a homelike birthing room within a hospital, or in a hospital delivery room—has very little to do with whether it is or is not a safe and a joyful occasion. What does matter is whether certain conditions are met:

1. A mother in the best possible state of health at the time of birth. This requires careful prenatal care from a qualified professional to ensure diagnosis and treatment of any medical or obstetrical problems that may exist.

2. A maternity care provider with the knowledge, skill, and judgment to conduct normal birth safely and effectively and to handle the immediate aspects of common mother and baby emergencies. Throughout the developed countries of the world, such qualified professionals as physicians (general practice, family practice, and obstetricians), certified nurse-midwives, and professional midwives are recognized by their respective governmental authorities as having the specialized education, experience, and competence to practice as birth attendants.

3. Immediately available basic emergency equipment and supplies for the trained attendant.

4. Ready access to acute-care services and specialized personnel should they be needed.

5. A prepared and knowledgeable couple willing to accept the demands of the birth experience.

6. A clean, pleasant, relaxing physical and emotional environment.

7. Trust in one’s health care provider, through open communication and mutual participation in decisions.

8. Judicious use of obstetric drugs and technologies when necessary.

If these conditions can be met, any of the four “where” alternatives can provide both a safe and joyful experience. Prospective parents should plan carefully and prayerfully no matter what their individual circumstances.

Joyce Cameron Foster, RN, CNM, MSN
Associate Professor of Nursing
University of Utah

A great home teacher

The article entitled “Brother Braden, Our Great Home Teacher,” by Sharon Elwell (January 1981, p. 22), touched me greatly. I know that many of us have had Brother Bradens in our lives, but few of us pay such tribute to them. Our Brother Braden is Brother George Rider of the Exeter Ward, Visalia California Stake.

Brother Rider captivated our children immediately with his stories and the attention he gave them, and they eagerly looked forward to his visits. It wasn’t an easy task for him to visit us, because our ward included several towns and he lived in a town away from us. For this reason, we debated about calling him to assist in giving me a blessing when I had to have surgery. I’m so glad we called, because he brought such a reverent, caring feeling with him that we knew the Spirit was truly there with us.

After several visits he began bringing Sister Rider with him, and we grew to love her, too. We went to the temple with them when they were sealed, and a few months later they attended the temple with us to witness the sealing of our adopted youngest son to us.

Although we have moved from the Exeter Ward, Brother Rider still considers himself our friend and looks after us as best he can from a hundred miles away. We truly love him and Sister Rider with all our hearts.

Marilyn Smith
Taft, California

Copying copyrighted material

My wife and I have been in a dilemma since reading the “Church Policies and Announcements” statement on copyright laws (March 1980, p. 79). We have a good collection of stereo records, and most of the selections on those records are acceptable according to Church standards. But we find some individual selections to be objectionable. We had planned to record the songs we like on cassette tapes and delete the rest—until we read the copyright statement, that is.

We enjoy good music in our home, and we are trying to improve the quality of it by removing these objectionable things. It isn’t a matter of economic savings, because (1) we have already bought the records, and (2) it costs quite a bit to buy quality cassette tapes for recording the selections we want to retain.

Can you advise us on this matter? We want to do what is right.

Jim D. Olson
Fairview, Alberta, Canada

The law permits “fair use” of copyrighted material without obtaining the permission of the copyright owners. While the extent of “fair use” is not clearly delineated, making a copy for personal or family use, in order to delete objectionable material and not to avoid the cost of purchasing a copy, should be considered “fair use.”

To volunteer libraries

I would like to share an idea for really putting the Ensign to work: Each month after we have read and devoured the Ensign and taken notes for talks, etc., we give it to our local volunteer library here on Orcas Island. I find that people of all faiths gladly read it every month.

It’s really not that hard to share the Ensign with nonmember neighbors, community groups, or friends. Pass it on! When it comes to the Church magazines, recycling is better than home storage!

Catherine Chaney
Olga, Washington