I went to the hospital to give birth and tested positive for meth
narrative.ly
narrative.ly
Anyone who has a basic understanding of Bayes' Theorem can tell you that testing all new mothers for X (where X is relatively rare among new mothers) will lead to a large number of false positives even if the test has high specificity and sensitivity, simply because the prior probability for X is so low.
More screwed up is the fact that it took weeks to get the correct result, and that innocent people have to live in fear of CPS coming and taking away their newborn.
According to Healthcare Triage, home births have an overall lower risk of complications. It's only in the cases of things going spectacularly wrong that being in the hospital helps.
https://www.youtube.com/watch?v=xHWvSPhENtk
It fits with my view of things: If there's something really broken, go to the hospital to get it fixed. However, if you're fine, you're better off avoiding the place. (Do get checkups from a doctor you have a good relationship with.)
Also, the overall chance of pregnancy with unprotected sex involving a man and a woman of childbearing age is 1 in 4. So, would you engage in such sex knowing that there was a 1 in 40 chance it would lead directly to your own death? (Or your partners? Bees be Krayton!)
I wonder if that's where some of our cognitive biases around risk come from? It benefits our genes that we're cavalier about certain kinds of risk.
Also unprotected sex does not necessarily equal procreative sex, which I realize is a somewhat controversial statement, but nonetheless true.
[0] https://www.plannedparenthood.org/learn/birth-control/withdr... (there's no fragment, it's under the effectiveness section of the accordion)
[1] https://www.plannedparenthood.org/learn/birth-control/condom...
I knew that when I posted it. When I posted it, I thought I had clearly indicated it, but looking at it again, that must have been forgotten before it could be enacted. My intention was to play with the two wildly inaccurate figures together.
1 in 20 (~50 in 1000) in the UK until 1940/1950. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1633559/
and lots of interesting reading here: https://www.google.co.uk/webhp?sourceid=chrome-instant&ion=1...
but 1/180 times your baby got a Staph Infection they would not have gotten at home and died?
The numbers are obviously bogus, but there are dangers to anyplace you choose to give birth... As long as people are well informed, seems they should be able to choose their own adventure.
Drinking a hot beverage is much more dangerous than drinking a cold beverage.
Life is full of dangers and risks. Why should birth be any different?
I could post many stories of people who had their first kid in a hospital and had a horrible experience, ends up getting a C section when not really needed, etc (See american C-section rates vs European for example). Then they chose to have a kid at home and had a 100x better experience and a more healthy baby (due to lack of C section and all the problems that leads to).
What you are doing here, is glossing over the underlying logic and falsely reasoning by resemblances. I find this sort of false reasoning flat-out stupid. It needs to be called out so others do not imitate it. (Which is a more meaningful resemblance to anti-vaxxers your comment is exhibiting.)
I'd be very surprised if that was a controlled study accounting for people who are at risk of complications making sure to deliver in a hospital.
> It's only in the cases of things going spectacularly wrong that being in the hospital helps.
Which you wouldn't really know in advance as it comes up during the delivery itself.
Yep. My wife had a perfectly normal pregnancy, and everything went perfectly until something went spectacularly wrong. When my daughter was born, and didn't breath on her own for the first 3 minutes. If she hadn't been in a hospital, it would have gone down as still born. She was in the hospital, immediately received resuscitation and numerous other treatments which maintained her blood oxygen level sufficient to prevent brain damage, and now at the age of 4 is ahead of every developmental measure.
"It's only in the case of things going spectacularly wrong" that any risk mitigation activity actually provides value, and in every other case is essentially worthless. YMMV, but I tell everyone I can the story of my daughter whenever they talk about home birth.
One of my daughters too didn't breathe when she was born. The midwives grew very very ernest very very quickly, and the little child was rushed off to hospital in an ambulance. All went fine. I was a little shaky that first night.
Yes, midwives (in some jurisdictions) are trained, qualified practitioners. That said, they are not equipped to deal with many, many complications other than by calling an ambulance and hoping for the best.
Choosing to have my daughter born in a hospital instead of a home birth was most likely the difference between having a healthy baby girl and something in the range of severe mental handicap to stillbirth.
Having a child is a huge risk and investment (by every measure, emotionally, financially, socially, economically, etc). Why would you risk having a stillborn child, life with a mentally or physically handicapped child (this is not a shot against handicapped children - it's a shot against people who refuse to apply critical thinking skills to emotionally charged high risk decisions) so that you can satisfy some foolish ideal that being born at home is better than being born around people who have trained for much of their adult lives to keep your kid alive in its first few days?
It ranks right up there with the foolish parents who refuse to vaccinate children against common ailments or choose naturopathy or homeopathy because of "toxic western medicine".
by whom? That's an easy claim to make if you don't have to test it.
Just doesn't seem worth the risk to me.
EDIT: And for the record, there was zero prior indication that something was wrong. The first sign was when the water broke and was green.
(not that it gets used much -- your case is far from the norm -- but they DO actually come prepared)
Is this not commonplace in the larger hospital markets (where I would assume most HN'ers live)?
"Complications" is a broad categories and includes many things that may not lead to adverse outcomes if managed appropriately, and which hospitals may be more prepared to manage.
According to this study of Oregon births in the NEJM, planned out-of-hospital births studied have substantially higher rates of infant death and neonatal seizures than planned in-hospital births (and these results are, per the study, in line with other studies of out-of-hospital vs. in-hospital births.)
Where things went wrong and bad in the story is the attitude of the nurses.
The social worker who initially responded was no presumptive and did the smart thing of not escalating the issue.
That pretty clearly depends on the prior probability, P(M).
It doesn't matter what the prior probability is of a random person having used meth (or whatever you are testing for); it only matters how likely it is that someone who has not used meth will be given a positive result.
If that test is performed only on women, the false positive rate will be 100% regardless of accuracy. All positive results would be false positives.
If the test is preformed on any man leaving or entering the oval office, then the false positive rate will likely be significantly less then 100%, as there will be a president tested multiple times in that group, and when we test positive on him, it's not a false positive.
If we test the population at large, most positive results are going to be false positives, simply because we're unlikely to actually have a former president get tested. But in theory the false positive rate could be slightly less then 100% if we got lucky.
As the probability of an actual occurrence in the test group drops to zero, the rate of false positives approaches 100%, regardless of the accuracy of the testing method.
I think you might be talking about the rate relative to all positive trials. I think I am talking about the rate relative to all trials that don't meet the conditions of the test.
So, you survey 100 women and your test tells me that 10 of them have been president, I say that your test has an observed false positive rate of 10%.
If we test a group comprised of only former presidents, all positives must be true positives. So our false positive rate will be 0% while our female test set has been observed to have a false positive rate of 10%. This illustrates that the sample set effects the observed false positive rate.
As the rate of occurrence of what we are testing for approaches 100% in the sample set, the false positive rate drops to zero. Inversely, as the incidence of what we are testing for in a (sufficiently large) sample set decreases from 100%, the false positive rate will eventually increase to some non-zero percentage unless the test is perfect.
So if we only test meth addicts for meth, our false positive rate will be lower then if we test the population at large.
Also: There is no need to drive madly to the hospital. There will be no incentive to keep you for exactly how long your insurance will pay, nor to perform surgery. You get to sleep in your own bed, without constant beeping and light from the hallway. You can have as many visitors as you want. You will never be separated from your baby, not even for a moment. You won't be treated like a potential criminal. You get respect.
But hey, CPS didn't get to take your kid[2], so there's that.
[0] or the mother, or both
[1] which is anything but rare, even in the UK under obstetric care[3]
> The risk of dying on the day of birth (0.43 per 1000, or 430 micromorts) exceeds that of any other average day of life until the 92nd year.
and matches the risks of major surgery. Homebirth, especially with completely unqualified midwives (which is the rule in the US) is almost an order of magnitude more risky[4].
[2] the coroner did, to check for foul play
[3] http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.12544/f...
[4] https://olis.leg.state.or.us/liz/2013R1/Downloads/CommitteeM...
"Planned out-of-hospital birth was associated with a higher rate of perinatal death than was planned in-hospital birth (3.9 vs. 1.8 deaths per 1000 deliveries, P=0.003; odds ratio after adjustment for maternal characteristics and medical conditions, 2.43; 95% confidence interval [CI], 1.37 to 4.30; adjusted risk difference, 1.52 deaths per 1000 births; 95% CI, 0.51 to 2.54). The odds for neonatal seizure were higher and the odds for admission to a neonatal intensive care unit lower with planned out-of-hospital births than with planned in-hospital birth." [1]
"Midwife home births had a significantly higher total neonatal mortality risk than deliveries by hospital midwives (1.26 per 1000 births; relative risk [RR], 3.87 vs 0.32 per 1000; P < .001). Midwife home births of 41 weeks or longer (1.84 per 1000; RR, 6.76 vs 0.27 per 1000; P < .001) and midwife home births of women with a first birth (2.19 per 1000; RR, 6.74 vs 0.33 per 1000; P < .001) had significantly higher risks of total neonatal mortality than deliveries by hospital midwives. In midwife home births, neonatal mortality for first births was twice that of subsequent births (2.19 vs 0.96 per 1000; P < .001). Similar results were observed for early neonatal mortality. The excess total neonatal mortality for midwife home births compared with midwife hospital births was 9.32 per 10,000 births, and the excess early neonatal mortality was 7.89 per 10,000 births." [2]
[1] http://www.nejm.org/doi/full/10.1056/NEJMsa1501738 [2] http://www.ajog.org/article/S0002-9378(14)00275-0/abstract
Like, these are "am I willing to make this tradeoff" numbers similar to choosing to drive to work daily, rather than "fuck no, go to the hospital" numbers.
Look up earlier in the thread for my comment, but anecdotally, almost every parent that I have told my story to has changed their opinion on home birth vs. hospital birth.
It's an educated and sourced one, as opposed to your flippant comment.
> There are plenty of board-certified midwives
Not only are there plenty of midwives which are not that, how meaningful board accreditations are depends strongly on the board, CNMs are true professionals[0], CPMs are pointless layabouts.
> birthing centers
The comment I was replying to was about homebirth.
Birthing scenters are usually professionally staffed, attendant to hospitals, carrying necessary emergency materials and will immediately transfer to their linked hospital in case of complications. And good birth centers will plain refuse at-risk patients and direct them to hospitals.
> Importantly, a great deal of risk can be ascertained before labor
Which is already included in the statistics above.
[0] and even with CNMs homebirth mortality is significantly higher than hospital birth.
From what I've seen, hospital-associated ones are bait-and-switch. If you show up early, then you take longer than allowed and they transfer you to the regular hospital. If you show up late, then they also transfer you!!! (this shockingly lame excuse was actually used on a friend) Clearly, there is a purposely narrow window because the hospital makes more money if you end up in the regular hospital area.
I find it strange that you think homebirth midwives don't carry necessary emergency materials. Just considering the obviously visible example, every one I've seen lugs around an oxygen tank.
"You people"?
Unrelated stuff going on in the birthing center?
I am describing a situation where the midwife/ doula was MORE CONCERNED with maintaining a "positive and serene energy in the birthing space" (her words) than she was about what we would do to take care of a critically ill neonate.
I can assure you, my methodology on such a call is not to "stay and play" but to "stabilize, ideally while transporting". Let alone a fishing trip. To wit, I could not care less what else is going on in the home, be it legal or illegal, unless it directly affects the care I am or need to provide. My reference to DOH was not a "fishing trip", but in regards to a provider who, in my professional opinion, was being actively negligent in caring for what was their patient, until transferred to me.
I think your biases are showing.
You realize paramedics are qualified in neonatal resuscitation, right? While "scoop and run" is absolutely the right thing to do in some cases, if I'm handed a blue baby, I'm going to spend some time in stable, well lit environment getting an airway established. The sooner that happens, the better the baby's outcome is going to be (and it's much harder to do bouncing down the road in the back of an ambulance).
What in god's name are you talking about? Infant mortality is the one primary risk of childbirth and the primary measure of perinatal and neonatal care alongside maternal mortality, the risk of the child dying is the very first thing you compare when talking about childbirth.
> with completely unqualified midwives
And that is a very common risk in the US because most states don't require any formation (let alone certification) to call yourself a midwife.
I was very clear, I do not see how you could genuinely be confused.
>And that is a very common risk in the US
It is not a risk, it is a choice. You don't call up the midwife store and say "send me a midwife" and hope for the best. You choose one. People can choose one that is trained and certified.
In a hospital, all that was easy to access. If this had been a home birth, it may have been catastrophic.
Driving to the hospital and not being in your own home is an unfortunate reality. We do not live in hospitals.
Disrespect, misalignment of insurance incentives, and inflexible criminal treatment are all bad things. But their damage is amplified because the alternative - homebirth - lacks the medical advantages of being in a hospital. Draconian policies like this literally kill children at the margins.
That's about as reliable as:
"The dog moved funny, indicating it found drugs, so we have to search your car."
(it's totally normal for the heart rate to drop)
The sad reality is that the facility for C-section is not financially viable unless you use it on a regular basis. There is an incentive to use it. When used, it is profitable.
Doctors who push back on profitability find themselves replaced.
In any case, those who have trouble at home can get emergency C-sections. Since prepping takes time anyway, there is no added delay if you call ahead. Situations where mere minutes matter are rare to the point of being pretty much non-existent.
Much of the 'prepping' requires the mother to be present (administration of anesthesia, monitoring, etc). The prep of the OR is generally done in parallel with those tasks. If it takes you 30 minutes to the to the hospital, you are delaying a c-section by at least 30 minutes.
Additionally, measure that can be taken to reduce fetal stress (while waiting for the OR to be prepped, in the event that is delayed) are _much_ easier to accomplish in a hospital, rather than in a car, or the back of an ambulance.
No it is not!
We are not talking going from an exercise heart rate to a resting heart rate. We are talking about a resting rate to a lower-toward death rate.
Uh no, it's really not.
I trust my smoke alarm - to probably give me extra warning. I don't trust it to unlock the door and let me out.
Maternity ward infant abduction is an ongoing thing, though now fairly rare (and even more rarely successful, with dozens of attempts stopped within the ward for each successful abduction) because of the security measures that have been instituted by hospitals in the last few decades.
But that's a success of the security measures, not an indicator that they aren't necessary.
But in this case there's a rather large negative of being trapped.
It's not enough that there be some theoretical benefit, but that the benefit outweighs the costs.
It can cause a positive meth test (thank you Google):
https://www.labcorp.com/wps/portal/!ut/p/c1/04_SB8K8xLLM9MSS...
Q: What do the percentages mean in methamphetamine "d" and "l" isomer test results? A: In order to help determine whether a methamphetamine positive may be due to an illicit source, it is helpful to determine the percentage of "d" isomer. For example, following an individual's use of Vick's Vapor Inhaler, the expected result would be 100% "l" methamphetamine. However, there is a possibility that trace amounts of "d" isomer may be present in the quantitative analysis. Laboratory guidelines have been established to allow for trace presence of the "d" isomer. If the laboratory report indicates more than 80% "l" methamphetamine, the results are consistent with Vick's Vapor Inhaler use. If the laboratory reports more than 20% "d" methamphetamine present, the result indicates the use of "d" methamphetamine other than the inhaler. Illegally produced methamphetamine and amphetamine may contain mixtures of "d" and "l" isomers. LabCorp recommends use of a medical review officer (MRO) to review all non-negative test results.1
https://en.wikipedia.org/wiki/Levomethamphetamine
She was using an albuterol inhaler. It's prescription only and operates on the lung passages.
But this leads to the obvious question: can Salbutamol confuse the drug test?
Google seems to say yes to several chemicals that look similar (both the chain and the name), but not getting a direct hit.
It is a weird situation because on one hand, they should trust the actual tests over the word of someone who has a motive to lie if they were actually on the stubstance. However, on the other hand tests are super inaccurate sometimes and treating people like a criminal before a confirmation is just wrong.
i'll go on a limp here (as fortunately has never had any even close to such experience) and speculate that may be he should have called a lawyer. Especially considering that in bunch of states it is a crime of endangering child or something like this.
Everybody going into situation with possible drug test should carry a printed copy like just in glove compartment with car insurance to avoid (or at least to clearly understand where it stems from) such "false positive" experience.
What made it especially bad was the fact that my daughter was in the middle of a medical emergency, and the staff at the hospital were wasting time on a ludicrous "meth" hypothesis.
New onset seizures (particularly a string of seizures) are unusual for a kid. Methamphetamine causes seizures. There are ways a child could have been exposed to meth that a parent wouldn't know about (another caretaker left it lying around, a preschool friend brought it in for "show and tell" and no one noticed, etc...). It was prudent on their part to consider it as a possible cause of your daughter's seizures. A positive meth test for a seizure patient (of any age) would certainly raise my index of suspicion enough to thoroughly explore the possibility of intentional or accidental ingestion.
I totally get why you would perceive them as "wasting time" (and obviously I wasn't there, it's entirely possible they were), but it's very likely they were running down all the other "normal" differential diagnoses in parallel.
I've seen multiple instances with family members where the doctor's dumbass hypothesis absolutely did not match the symptoms, but they persisted in trying the worthless treatment anyway. Took 'em months to find and start treating the slightly rare form of cancer. Bring on the diagnostic computers, I say.
I'll absolutely agree with you in terms of primary care docs... As someone who routinely transports patients out of doctor's offices when the doc is in over their head, there is a _much_ broader variation in competency...
I'm not outraged that it happened. But: we obviously knew for a fact that methamphetamine exposure was not involved in her seizures. We did, however, have to deal with ER staff entertaining it as their primary hypothesis. That was frustrating, and, in hindsight: indeed a waste of time.
I think the only real problem I have here is that whatever test they use to detect meth, it obviously falses a lot.
(Her seizures were idiopathic and never repeated; our working theory is that it was a reaction to a benzocaine medication she got a day earlier.)
No matter how many times it might seem stupid for me to reiterate that with my condition I can't have any blood thinners - no Aspirin specifically - I simply don't trust anybody new with being, well, competent enough to make the connection themselves. I police what goes into my body with pretty good results. I go out of my way, time and again, to discuss my specific treatment needs and precautions. Granted, not everything is in my control, but the things I can monitor, I do try to get a handle on.
We've found that many of these people take Zantac (aka ranitidine, used for acid reflux). This hasn't been studied since 1991[0] but it probably should be again, given increasing rates of meth use.
I wish the author had given the name of her prescription inhaler- Vick's Vapor inhaler has been shown to test positive but albuterol and other steroid inhalers are more common.
My husband scrolls through pages of information about albuterol inhalers and drug tests. He shows his phone to every nurse who steps foot in the room.
Cross-reactivity studies don't seem to be published often but searching for albuterol + 'cross reactivity' shows some drug tests are cross reactive with albuterol and some aren't.
I rode a bike without a helmet
I played outside, by my self, and would sometimes go MILES from my house.
We did stupid stuff, with fire, fireworks and the like.
My parents left me home alone after school, I was a latch key kid.
Today, the police would bring my kids home and I would get a visit from CPS for any of these things.
Welcome to having children in the new millennium.
Maybe we should stick kids in suits of armor Faraday cages too, just in case lightning strikes.
About 50% of all New York bike accidents, according to the article Jean_Claude linked.
> Maybe we should stick kids in suits of armor Faraday cages too, just in case lightning strikes.
I'm just baffled by all the people who think putting a helmet on is onerous and restrictive and destroys the experience of cycling. Why?
That's a straw man. Helmet advocates do not imagine them as some sort of invincible armor. They obviously will not keep you from being injured in a serious accident. What they do is reduce your chance of being killed. The large majority of fatal bicycle accidents involve head injuries. (One source: http://www.rospa.com/road-safety/advice/pedal-cyclists/facts...) I would rather be in traction than dead.
I agree that children cannot be wrapped in cotton wool; they should be allowed to roam without supervision and make their own mistakes, even if that does slightly increase their risk of injury or death. But getting a bike helmet for your kid does not restrict their mobility or their ability to learn. It has no downsides, only upsides.
You've made the choice not to wear a helmet; if you ride safely, in a safe area, the extra risk is probably quite small, and if you believe it's a fair trade-off for a little extra comfort, that's your prerogative as an adult. But don't pretend that wanting to feel the wind in your hair is taking a moral stand.
> But don't pretend that wanting to feel the wind in your hair is taking a moral stand.
Your words, not mine -- as most of your post by the way. However, there is value in not arriving to your destination sweating or stinking (i.e. going to a meeting, social event, etc). In cases like that it's perfectly fine not to wear a helmet as long as the rider is aware of the risk, and adapts his/her riding style to this situation. Mostly everybody does it in Europe and we're all fine.
Yeah, and then you go flying and your head hits the ground, or a lamp post, or another car. Not always, but often enough.
Head injuries are pretty common in car-pedestrian or car-cyclist accidents even though the average car is much lower than the average head. Collisions don't end at the moment of impact.
I get it, you're advocating for people's safety -- that's noble. But, sometimes you have to live and let it die. In other words, you have to respect people's choices, or move to a nanny state and stop judging the people that decided not to live under the same rules as you.
No offense, but that's what will happen when poorly educated riders bike in the door zone. See: http://www.bikelaw.com/2016/02/18/door-zones-a-dangerous-gam...
Biking amongst traffic on roads requires skill, knowledge of biking laws, good situational awareness, knowing how to posture and when to take the lane to protect yourself.
Oh, and a bit of luck that the people next to you in their steel cages aren't homicidal towards bicyclists.
What do you propose a well-educated rider should do, when all the bike lanes are in the door zone and bikes are legally required to stay in the bike lane?
> Oh, and a bit of luck that the people next to you in their steel cages aren't homicidal towards bicyclists.
Yup. Which is why you wear a helmet.
Well that's the usual poor planning I see in America. Sharrows or "share the road" signs are much better than many of the dedicated bike lanes I've seen here.
First, find another route, if possible. Second, start going to your city's public meetings and/or complain to the city about the clear danger that poorly planned bike lanes inflicts upon the public. Learn the law specific to bicycles for your area and get involved with a bike advocacy group if you really care.
As far as helmets go, I like to keep my brains intact, so I wear one, and have the abrasions on an old helmet to prove it. Front tire blowout and dumping at 45 KPH downhill on a recumbent was an experience that could have been worse sans helmet. That said, a pound of plastic and foam can only do so much for you. Good luck!
I have no doubt that a study would find there were more then than there are now, but things don't exist in isolation. We make trades for everything.
For example, we've traded relatively rare (and usually treatable) skin cancer for more widespread sunlight deprivation and Vitamin D deficiency that's implicated in a number of different conditions. I don't think this was a good trade, personally.
In this case we've traded our kids' childhoods and parents' exercise of discretion--this is part of their life cycle too, keep in mind--for what I'm quite convinced is a minimal increase in safety. Mandatory bicycle helmets? Sure, if it stopped there. But we've gotten way more paranoid than that. I don't think that's a good trade either.
My second son was premature... when we were in the NICU... there was a lady there, whos child was born premature because the taxi she was riding in from the airport was involved in an accident. She came from california... where her gyno was pro-mj, and she used MJ to manage her Hyperemesis gravidarum... so its in her system, clearly... but this is Texas... so even though her doc recommended it, not only was her child in the NICU, but when he got out, he didnt get to go home with her... because of stupid laws that pay no mind to actual scientific evidence...
Arguably, the only thing they did without consent was drug test the child, but I bet they consented. She consented to her own drug tests. All of them.
It also really underscores an extremely critical question with society: When the system is inflexible, and uncaring, what recourse do you have when it fails you? Imagine the hopelessness, the bleak future, of the world turning its back on you because of a mistake. I can only imagine this is what it's like to be falsely convicted of a crime... or failing a drug test that you shouldn't have failed.
I think there's even a lesson for us technical folks here: When the systems we design are too automated, and too rigid, we are removing all compassion. Now if the system is "perfect" there's no problem, but even Google hasn't been able to completely perfect their systems. People still become the victim of false DMCA takedowns, etc.
I guess at the end of the day, the moral is to "Remember the person."
In this case it appears that the social worker had enough of the full picture to inject some measure of sanity, but I really wonder if the nurses understood the statistics related to the tests well enough to treat her like shit over them.
Maybe a lawsuit is going too far, especially if this incident isn't in some permanent CPS record. But if it is, the hospital has them set up for some serious problems down the road.
That's quite a bit more than merely unprofessional. Something like a stray sarcastic comment or slightly distasteful joke might be unprofessional. This sort of behavior, on the other hand, quite possibly should be illegal and should have consequences.
Previously: https://news.ycombinator.com/item?id=10883282
murica!!
You know what else causes a positive test? Using meth. They got a positive, they followed up with further testing to clarify.
I almost want to flag this post off the front page due to how goddamned useless that article is. And the thing is? It's actually pretty decently written. It was engaging enough to finish reading it.
Or rather, not finish reading it: there is at least two paragraphs left that have not been published. Was it a lab fuckup? The inhaler (which also indicates a lab fuckup, since they should have looked at her medical records to deal with known false positives)? Is she going to sue for mental distress, malpractice, whatever?
What the hell.
Edit: Oh, and like half the HN community are asthmatics and are on inhalers. Can one of us be whisked off by the government for lab fuckups? Can this go on our permanent record due to their incompetence?
And as for that woman, can she get this expunged off her record? Once you're tagged by CPS, unless you deal with them with a firm hand, they love to fuck up children's lives.
Disclaimer: I grew up in Maine, I've seen repeatedly what CPS has done to families due to their incompetence, I have no reason to think that CPS in other states are any better.
If you're a parent, and you care about your child, treat the CPS like a terrorist threat. Do not talk to them unless you're with your lawyer, do not answer their questions, and teach your child the same. Their job is to make you guilty to justify their budget, not protect children.
I added the link on the root level.
The point is that when "the system" is too uncaring, these are the kinds of consequences. A false positive from a mediocre field test caused this woman no end of grief. The takeaway is that when we, as engineers, design systems, we have to remember edge cases like these, we need to remember the person.
When your automated spam detection system flags an account, are you going to outright lock/delete it with extreme prejudice, or are you going to allow the account owner some recourse, and a chance to explain themselves to a real human?
I think this article highlights some huge problems with systems that have too much confidence in their tests / checks. Definitely a useful story for all of us to know.
Well said.
I'll only add that this concern needs to extend all the way back to the initial decision to start designing a system. Technology can have a large impact on people simply by existing; it's worth taking the time to consider what that impact will be and how it will affect people, even the edge cases.
This is becoming increasingly important as the effects of technology start to reverberate through the foundations of society. This makes the popular attitude of only considering the technology increasingly irresponsible; there is "No Neutral Ground in a Burning World"[1].
[1] https://media.ccc.de/v/30C3_-_5491_-_en_-_saal_1_-_201312272...
If just reading about it frustrates you this much, imagine how the mother must have felt.
Ring ring, hello, so you're not on drugs after all, have a nice day, bye.
This is how the system apologizes, and it's not humane.
And no, throwing lawyers at the problem is not a solution.
Then again, this is par for the course in the drug war.
One day I got a call at work from an ex. "What's up?" "You need to come home, we need to talk."
I duly do.
"So I went to the doctor earlier today. Had an issue. They swabbed me and told me I have an STD. So they did a full STD and blood test, we'll see how that goes. In the mean time, who did you cheat on me with?"
"Uh, nobody."
Back and forth, arguing etc. Me insisting I'll go get tested.
Doctor rings back the next day. "Looking again under the scope, not an STD, just a yeast infection."
Relationship relief.
A month later, call from the clinic: "So about this bill for $290 for a full workup and testing, can you pay that today."
No. Not a chance. You not only misread a test, you gave my girlfriend factually inaccurate information that you -knew- was going to be controversial, and on the strength of that told her "if it wasn't you, you really need to get fully tested if you don't know where he's been".
And then send me the bill? No.
Drug tests are not a "magical black box", there's a process that goes on. And they aren't always right. They usually first start off with immunoassay test on the urine which attempts to measure substances in urine through the use of antibodies. These are "okay" tests -- not bad per se, but they are definitely subject to a wide variety of false positives (http://jat.oxfordjournals.org/content/38/7/387.full). The reported false positive rate I can Google is all over the map, but I've seen articles suggesting as high as 10% (http://www.webmd.com/news/20100528/drug-tests-often-trigger-...).
Drug testing uses these first because they are quick and relatively cheap. The gold standard, however, is GCMS testing. Very accurate, but expensive and time consuming. I assume that's the test performed in the article that took three weeks to resolve the false positive to the negative.
Assuming the story as reported is true, I'm a little bit peeved that there was a de facto assumption by the nurses that the test was correct. The meth / amphetamine test in particular seems to be one of the more problematic immunoassays in the literature in that it false-positives with all sorts of prescriptions, along with some non-prescription drugs (http://www.medscape.com/viewarticle/726897_2). 90% correct is not correct enough in my opinion when it comes to messing with people's children by threatening CPS.
It's most likely the inhaler but how is she supposed to know exactly what caused the hospital tests to fail? She's not a technician.
It is _very_ common in medicine to use a very sensitive test to screen for conditions, and then cross check any positives with a more specific test (which is what should have been done in this case, prior to taking any action).
It's fighting law with law. If they were draw a sword, I would draw mine too.
That would be idiotic, nonsensical and a very good way to make current and future interactions even worse. Hospitals are mandatory reporters, if they don't report suspicious situations (such as a pregnant mother failing a drug test) they're on the hook for it, and they must prepare for a possible NAS case which is anything but fun, or a walk in the park.
And despite the completely one-sided report, it looks like much of the antipathy came from her insisting on her "experience" and on e.g. breastfeeding the child.
So, yes, a lawsuit would be in order (IMO). I wouldn't ask for a huge payday, but at the very least that they clean up their testing procedures and follow protocols.
The tests were not known to be spurious by the hospital.
> neither of which were blood draws which are vastly more accurate.
Blood draws tests are also much longer (that's the 2~3 weeks test whose results they got afterwards).
> I wouldn't ask for a huge payday
Not that you'd get any even if you did.
> at the very least that they clean up their testing procedures and follow protocols.
Is there any protocol you know them to not have followed?
Keeping in mind that the one account we have is the one-sided version of the parents, consider the hospital's point of view: what they have is an expectant mother who has twice failed a drug test and thus a NAS risk, a nearly DOA newborn from emergency C-section and the possibly drug-addicted mother thereafter insists on breastfeeding.
Then the hospital is negligent. It is their responsibility to know the failure modes of any technology they use.
They gave multiple chances for retests. The results were consistent.
A blood test four weeks prior to delivery would be a good start, but still leaves a window.
There are two suboptimal possibilities at that point:
1) err on the side of the mother, who has failed (incorrectly as it may be) multiple drug tests and allow her to breastfeed her child, or
2) err on the side of the child, who is exhibiting symptoms that could point to NAS, bradycardia and the like, who is delivered by emergency C-section (so she would not have had the bonding experience immediately post partum, as it was, anyway)
They did know the failure mode.
They evaluated.
They held off on calling CPS. They allowed contact after the baby's urinalysis.
There is no negligence here. The father showing by their own words anecdotal forum posts and such is not reason for the hospital to say "Well, what do we know, here you go".
You mean by sending away for a more accurate test which cleared things up?
rights to have a "birth experience" according to a wishlist, possibly at the expense of the child? At more or less every point I would assume.
OK, it's UnitedHealthcare® if you want silly capitalization.
On what grounds? She failed a drug test and the hospital are mandatory reporters, I'd see the case instantly thrown out, and we only got her own side of the story.
I've no idea where you read that from. Her only accounts are that the nurses changing shifts warn their followers she's tested positive, that they repeatedly warned her about the breastfeeding risks and that the social worker doesn't believe she's a user, that's about it.
> I'm sure a good lawyer will know how to spin it.
And I'm sure even a bad lawyer would know how to dismantle that.
The nurses at shift change noted that she had failed two urinalyses. That is a statement of fact, not a derogatory assassination of character.
> The bulk of my produce was organic, my drinking water purified through a reverse-osmosis system. I used clove oil on a persistent toothache instead of visiting the dentist, because I didn’t want any anesthetic to pass through my body and into the placenta. During all 42 weeks, the hardest drugs that entered my body were prenatal vitamins and puffs from my prescription asthma inhaler.
"But... I'm white! I'm middle-class! I have a doula! It's patently absurd that these nurses could think I did drugs! Just look at me! What do you mean that's exactly what a drug user would say?"
From her point of view she's a perfect mommy, but as far as the nurses and doctors know, she's just somebody who showed up pregnant with meth in her system and an unlicensed hippie who's smearing lavender oil around the place.
edit: If the answer is "will someone think of the children!" why isn't the state randomly drug testing all parents?
It's obviously a thorny question, but what should a facility that treats children do when it notices a conflict between the interests of the child and the interests of the parent? It's clearly going to happen.
HN appears to support Unicode://news.ycombinator.com/item?id=9105273
I fully realize that the ellipsis is a code point/glyph/character/whatever in its own right, and that the rendering of it using three periods is not correct.
The existance of that rendering is what makes the proper one seem "fancy", from some points of view.
Also, one should never explain jokes I guess.
I am sorry she went through that, it is very unfortunate that statistically some tests will come back with false positives. Arguing that they should have treated her different is much like arguing babies should not to be vaccinated because there is a very slight statistical chance they might have a bad reaction.
There are no useless parents, only parents who need help.
Whether you want to parent, and how much you're able to parent, are completely different states.
You honestly belive all parents, even child abusing parents are just good parents that need a little help?
My mother was an abusive alcoholic who abandoned our family because she couldn't get the help she needed. She wasn't a bad person, just someone who couldn't get the medical and counseling services needed to cope with previous life experiences that enabled her addiction.
Have to give people the benefit of the doubt. To hold onto the coal of anger only burns yourself.
I am not the OP, but my guess is s/he benefits more from it than the parent does. As the old adage says ...
"Anger/hate/unforgiveness is like drinking poison, expecting the other person to die."
Please understand I am not judging you at all. To be honest I don't know if I would look after an abusive parent or spouse. I would like to say I would ... but truth be told I don't know.
What I do know forgiveness is a wonderful thing, and the forgiver gets way more out of it than the person who is forgiven. So much pain and conflict in this world is stems from humankinds seemingly innate inability to forgive, sometimes even after centuries have passed.
Edit: I don't know why you were downvoted and don't think you should have. If it helps, my posts in this thread have been heavily downvoted.
Also upvoted both of you FWIW.
Compassion, and peace with the way life occurs. I hope you find peace one day as well.
> All three days, the nurses are reluctant to hand over the baby, saying my actions are irresponsible.
> Every shift change, two nurses stand by my bed and inform another two nurses of my status as a combative patient. “This woman tested positive for methamphetamine,”
This does not strike me as very professional. The medical staff should have considered the possibility of a false positive, and given the mother the benefit of the doubt when she said she wasn't taking methamphetamine. Telling the mother that she shouldn't breastfeed and that CPS have been called, while not stopping her from breastfeeding (presumably they have no legal power) is the worst of both worlds: increase stress/worry (which is something the child would pick up on), draw everyone's focus away from the actual birth and the child, while simultaneously allowing her to potentially pass this, presumably harmful, drug to the child. Madness.
Subjecting the family to un-needed intervention causes harm to those children. And it causes harm to the children that do need intervention, because child protection social workers are made busier dealing with cases that they need not deal with.
Something that was missing in this story was the lack of dialog between the hospital staff and patient. False positives is possible, so why not send a trained psychiatrist at a positive? They can talk to the patient and check if the result make sense, and if nothing else, start address issues such as postpartum depression.
Like looking out for a newborn by discussing with the mother the ramifications of breastfeeding in light of multiple failed tests?
A spontaneously aborted fetus because the stress of withdrawal during pregnancy was too much for the mother's body.
If an addict becomes pregnant and seeks treatment (which during pregnancy would likely consist of continued dosage of an opioid in the form of methadone) then there is the risk that she will give birth to an opioid dependent infant (or not - it's only something on the order of 1/3rd of infants born to mothers who use opioids who suffer from NAS).
But yes...treat the parent as subhuman. Rip the infant away from its mother. To punish the mother because she's bad.
Nevermind the fact that there has been a strong link demonstrated by neonatal bonding between mother and infant and lower rates of NAS as well as overall better outcomes for the child.
Them, apparently omnipotent gods: silent shaking of head and look of pity
And if you don't believe in raising your kid the same way THEY want you to, watch out...
http://www.usatoday.com/story/news/nation/2015/04/13/parents...
http://insider.foxnews.com/2015/06/14/florida-parents-charge...
This is 100% absolutely false, but it's a misconception CPS agents love to abuse. CPS is NOT a law enforcement agency. If they want to remove a child from a house, they need to have the police and judge's order to do so. In fact, they can only enter your house with your permission or with a warrant with police present. However, some of their worse agents thrive on threatening parents with child removal.
If you ever, ever get wind of CPS coming to visit you, consult a lawyer, and record any conversations you have with them (on your property). You need to stand up to them. Source: I've been through this. Fortunately, the person I worked with understood she was entering a hostile environment.
CPS is like the police. In general, a large number of the agents are decent people who are trying to do what's best for the children. However, you will get some agents that tend to be over zealous and will abuse their position to threaten and force the parents into submission, under the assumed auspices of taking away the children. Most people who deal with CPS tend to be poor and do not realize a CPS agent is not a law enforcement agent, and thus need a warrant and police to take away children.
When my daughter was conceived her mother was addicted to opiates. We were both in a bad place. I was just out of a relationship with someone with Borderline Personality Disorder and she was coming out of her own abusive relationship. Needless to say this wasn't how either of us had envisioned conception.
But her pregnancy was a strong motivator to turn things around. But addiction isn't something you can just switch of. Especially something like an opioid. It is extremely dangerous to the fetus for the mother to detox during pregnancy. Miscarriage is common. But that doesn't mean that treatment isn't an option. That treatment is, however, most commonly something like opioid maintenance in the form of methadone.
Methadone is still an opioid (although longer acting and "harder to abuse"). It still comes with the same risk of NAS. But that risk is actually fairly low. In researching the risks around my daughter's birth I came to find that only about 1/3rd of all babies born to opiate addicted women suffered NAS, and the greatest correlation was tied to usage of multiple illicit substances (say opioids and amphetamines together)
So we dedicated ourselves to having a healthy pregnancy and a healthy baby and she started methadone maintenance at a local clinic.
In the end my daughter was born four weeks premature (premature birth is actual common in opioid addicts). The author of this story did an excellent job of capturing how the atmosphere changed as soon as it was discovered that my wife was under a maintenance dose of methadone. The derisive judgment. The loathing in the eyes of the nurses. That was a very new experience for me.
And the procedures and policies described in the article are actually in many ways detrimental to and harmful to the outcome for the infant.
Opportunities for bonding should be encouraged. And at least in the case of opiates it has been found that breastfeeding decreases the risk of NAS and should be encouraged (opiate concentration in breastmilk of a woman using opiates is measured in micrograms, far below the threshold to affect the infant, but the simple skin on skin contact and intimacy seems to make all the difference).
My daughter did not suffer from NAS and after three days of observation we were discharged when it was clear her lungs were fine and she was not going to suffer withdrawals. Thankfully the attitudes of the nurses changed within about the first day. I suppose we weren't typical of "addict" parents...but I can say that being on the receiving end of that sort of experience...the only effect is going to be to push addicts further down a hole with even less chance of being healthy, functional parents.
If you really want to feel injustice and helplessness, why not try getting arrested for something you didn't do. Spend a few nights in jail, and deal with police, lawyers, judges, lose your job and friends because of it, find yourself on a bunch of lists you've never been on before, etc. That's what "being crushed by a system" is like.
I think the mature thing to do would be to wait for the 2 week test to come back and not breastfeed your child in the meantime. Even if you know you haven't done meth, I would think the risk that you somehow have been exposed to meth should outweigh the desire to breastfeed.
The hospital is more concerned about the health of the baby than the desire of a new mother to validate their motherhood by breastfeeding. Seems okay to me.
She was treated like a criminal before giving birth, though.
>you somehow have been exposed to meth
How exactly do you get exposed to meth?
>than the desire of a new mother to validate their motherhood by breastfeeding
You're reading an awful lot into her desire to breastfeed her child.
I suspect you're male and don't have children, talk to mothers about the importance of breast feeding to them, you'll find this isn't a subject to be logical over.
Breastfeeding is monumentally important for some mothers. Mom has every right to insist on breastfeeding even in the face of a test she knows to be a false positive.
Their listed benefits of breastfeeding include resisting illness, lower % of SIDS, a correlation to higher cognitive function, and lower occurrence of other diseases. They then list benefits of formula, which all amount to convenience for the parents. Then they say don't feel guilty either way.
The higher correlations to health benefits are the closest to birth, with nearly all sources recommending breastfeeding for at least the 1st six months, if possible.
I don't know. If I was confident I wasn't exposed (the article said they were very careful, and were certain it was a false positive), I might go with breastfeeding in that case as well.
> The hospital is more concerned about the health of the baby than the desire of a new mother to validate their motherhood by breastfeeding. Seems okay to me.
That has to be one of the most idiotic things I have ever seen written on this site.
If she didn't do meth then she should nurse. What possible reason is there not to? Some mythical exposure to meth? What in the world are you talking about?
Have you ever even seen a baby? Have you seen one nurse? I suspect you have not, or you would not write such incredibly stupid things.