Once a Cesarean, Always a Cesarean : The Tides Must Change

CTBirthAdvocate

Until you have walked in someone elses shoes, you should always think twice about what you have to say about their personal experience. That goes especially to those who have never had children, or had a cesarean section.

As a mother who has had two cesarean
sections, and someone who deeply works in the birth community, the
rising numbers of cesarean sections across the country, as well as
across the state of Connecticut is deeply concerning. Not just as
someone who is educated about this, not just as a mother who hopes to
have more children some day (and not be forced to have unnecessary
surgery), but it is also becoming concerning to maternity care
providers nationwide.

This morning I read an article in one of my favorite parenting magazines, Mothering.
It was about the state of birth in the United States and the lack of
access to real education, information, and providers who will attend a
Vaginal Birth after a Cesarean Section, also better known as VBAC. 
Numerous studies, publications, and scientific evidence have proven
VBAC to be safer than elective repeat cesarean sections, which is
really a no-brainer. Cesarean sections are major abdominal surgery
which any surgery carries risks. There are some cases in which the risk
of the procedure is out weighted by the medical need for the procedure,
but certainly not at the numbers we are seeing them today. Connecticut
currently holds a 34.6% cesarean section birth rate. Meaning when you
step foot inside a hospital to give birth to your child, your risk for
a cesarean birth is 1 out of every 3 women that steps foot in that
hospital, some hospitals in the state have up to 45% cesarean rates
making your risk go up even higher.

In some hospitals across our state, there are something called VBAC
Bans. Hospitals that will simply not accept any woman who is planning
or wanting to have a vaginal birth after a cesarean section. Meaning,
either these women need to travel out of their area, opt for a birth at
home, or consent to a repeat cesarean which they have no desire or need
for.  Why is this all so alarming?   Below is a quote I took from the article about this subject in Mothering Magazine…

In 2002, 26.1 percent of US women gave birth by
cesarean. The majority of these were elective repeat operations and
first cesareans for dystocia, or failure of labor to progress, a highly
variable diagnosis. The cesarean rate is the highest ever for this
country. Eighteen percent of women had a primary cesarean, a rate also
unprecedented.2 Of concern is the fact that young women between the
ages of 18 and 24 have the highest number of first cesareans.3 A
cesarean rate of no more than 15 percent is recommended by the World
Health Organization,4 and a goal of the US National Health Service is a
cesarean rate of 15 percent for first-time mothers by the year 2010.5

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What stands out the most is the fact that after studying, running
statistics, surveying, researching, and publishing reports, The World
Health Organizations states for a country of our status, there should
not be a cesarean birth rate over 15% and we are OVER double that
number at this point in time.  Why again is this so concerning? In my
opinion, and again this is just my personal opinion. I am not a Doctor,
I am not a medical professional, I do not work as a medical
professional in any capacity at all. I am simply a mother, who has
extensively researched this, for the health and well being of myself,
and my children.  I do not believe that women are fully being informed
of their risks or even learning how serious this surgery truly is. It
is the most popular surgery among women today, women electing to have
cesarean’s with their first pregnancies, women electing to have major
abdominal surgery for no medical reason in the thousands of elective
repeat cesarean’s that are taking place today. Why? It completely
boggles my mind. As a parent, I can simply not wrap my head around
electing to put myself, and my baby at risk for no valid reason.

Below is another quote taken from the very well written and educational Mothering article.

Dangers for the Mother: Although cesarean section is
safer than ever before, it is still major abdominal surgery with
inherent risks. A woman who has one cesarean will always be at risk for
a uterine rupture in a subsequent pregnancy, whether she labors for a
VBAC or has an elective repeat cesarean delivery.With one prior uterine
scar, the risk of a uterine rupture is 1 in 500, compared to 1 in
10,000 for a woman without a cesarean scar. Each additional cesarean
increases that risk. Postoperative complications include risk of injury
to other organs (2 percent), hemorrhage (1 to 6 percent of women will
need a blood transfusion), blood clots in the legs (0.06 to 2 percent),
pulmonary embolism (0.01 to 2 percent), infection (up to 50 times
higher), and complications from anesthesia. A woman is four times as
likely to have a placenta previa (low-lying placenta) in her next
pregnancy, putting her at risk for miscarriage, bleeding during
pregnancy and labor, placental abruption, and premature delivery. One
birth by cesarean puts a mother at 10 times the risk for placenta
accreta (placenta grows into or through the uterus), for which women
often require a hysterectomy to stop the hemorrhaging. The incidence of
placenta accreta has increased tenfold in the last 50 years.

A US study found that mothers are four times more likely
to die from a cesarean unrelated to health problems, compared with
women who have vaginal births.

These are not small risks, they are not minor complications, and
some of the impacts on the infant can become lifelong issues especially
with the increased risk for breathing
problems in cesarean born infants.  These are not things I am making
up, I simply am not sugar coating them like some women would prefer
that people do. I knew going into the birth of my second child that
having a VBAC was important, not only to me, but to my child, while
that plan did not work out, he got several benefits of  attempting a
VBAC.  One being, he came when he was ready. Had I scheduled a repeat
cesarean, he may have been born prematurely given I had been given two
different due dates. One sooner than the other.  The March of Dimes has
also spoke out against elective cesareans before 39 weeks gestation
because of the great risk for a baby that is simply not ready to join
the world.

One thing that many women neglect to talk about is the emotional
impact of a cesarean section on the mother. In the months after I had
my first child via cesarean I heard a lot of “Just be happy you have a
healthy baby”  of course I am happy that I have a healthy baby, but
that doesn’t change the fact that many women do feel negatively about
their birth experience, and even in some cases they are traumatized.

No, this does not only happen in women who have had surgical
deliveries, but it is so prominent in the cases of cesarean sections
that there is an international organization that aids these women in
their recovery, and offers them an amazing support system for their
recovery, and future births. ICAN also known as The International Cesarean Awareness Network
If there was no need for this group, it would not exist, nor would it
have thousands of members internationally. But people do not want to
really understand that there are negatives of the large number of
cesarean sections taking place today.  Another great quote from the
Mothering Article reads….

Emotional Scars of Cesareans: Personal accounts from
women who have had a cesarean, as well as emerging research, suggest
that despite a healthy baby and a timely physical recovery, some women
experience cesarean birth as a traumatic event. An unanticipated
cesarean is more likely to increase the risk for postpartum depression
and post-traumatic stress disorder (PTSD). As in other traumatic human
experiences, the symptoms of birth-related PTSD may emerge weeks,
months, or years after the event.9–11 Women re-experience the birth and
the emotions associated with it in dreams or thought intrusions. They
avoid places or people that remind them of the event. Some mothers have
difficulty relating to their infants, and some will avoid sexual
contact that may result in pregnancy. They will also exhibit symptoms
of hyperarousal, such as difficulty sleeping or concentrating,
irritability, and an excessive startle response. Untreated
post-traumatic stress often leads to clinical depression.12

A traumatic birth of any kind can leave a woman feeling
disempowered, violated, or betrayed. Unless she has had the opportunity
to process the event, in her next pregnancy a woman who has no way of
controlling what she perceives as events that are likely to reoccur
will sometimes choose to repeat a cesarean with a known physician in a
more controlled environment.

It is comforting today to see the emotional impacts of this surgery,
and the experiences being addressed in such a large scale publication.
In my time working with ICAN and running the chapter here in the state
of Connecticut, I have been contacted by numbers of women who are in
need of a shoulder to cry on, someone who understands when they say
they hated their birth experience, someone to talk to about them not
connecting with their newborn like they feel they should, someone to
just listen. If you think that all these women are ok, you are wrong.

Sure there are thousands that just go on with their lives, and there
are thousands who know their cesarean was medically necessary for one
reason or another, like I experienced with my second cesarean, which I
fully knew was necessary. But believe me, out of the circles of women
you may know, there is at least one that is hurting from her
experience, but is ashamed, scared, or intimidated to share how she
really feels for the fear of the oh so common, “Just be glad you have a
healthy baby” because that is hurtful.

Until you have walked in someone elses shoes, you should always
think twice about what you have to say about their personal experience.
That goes especially to those who have never had children, or had a
cesarean section.

Sorry for being kind of long today.

Analysis Politics

The 2016 Republican Platform Is Riddled With Conservative Abortion Myths

Ally Boguhn

Anti-choice activists and leaders have embraced the Republican platform, which relies on a series of falsehoods about reproductive health care.

Republicans voted to ratify their 2016 platform this week, codifying what many deem one of the most extreme platforms ever accepted by the party.

“Platforms are traditionally written by and for the party faithful and largely ignored by everyone else,” wrote the New York Times‘ editorial board Monday. “But this year, the Republicans are putting out an agenda that demands notice.”

“It is as though, rather than trying to reconcile Mr. Trump’s heretical views with conservative orthodoxy, the writers of the platform simply opted to go with the most extreme version of every position,” it continued. “Tailored to Mr. Trump’s impulsive bluster, this document lays bare just how much the G.O.P. is driven by a regressive, extremist inner core.”

Tucked away in the 66-page document accepted by Republicans as their official guide to “the Party’s principles and policies” are countless resolutions that seem to back up the Times‘ assertion that the platform is “the most extreme” ever put forth by the party, including: rolling back marriage equalitydeclaring pornography a “public health crisis”; and codifying the Hyde Amendment to permanently block federal funding for abortion.

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Anti-choice activists and leaders have embraced the platform, which the Susan B. Anthony List deemed the “Most Pro-life Platform Ever” in a press release upon the GOP’s Monday vote at the convention. “The Republican platform has always been strong when it comes to protecting unborn children, their mothers, and the conscience rights of pro-life Americans,” said the organization’s president, Marjorie Dannenfelser, in a statement. “The platform ratified today takes that stand from good to great.”  

Operation Rescue, an organization known for its radical tactics and links to violence, similarly declared the platform a “victory,” noting its inclusion of so-called personhood language, which could ban abortion and many forms of contraception. “We are celebrating today on the streets of Cleveland. We got everything we have asked for in the party platform,” said Troy Newman, president of Operation Rescue, in a statement posted to the group’s website.

But what stands out most in the Republicans’ document is the series of falsehoods and myths relied upon to push their conservative agenda. Here are just a few of the most egregious pieces of misinformation about abortion to be found within the pages of the 2016 platform:

Myth #1: Planned Parenthood Profits From Fetal Tissue Donations

Featured in multiple sections of the Republican platform is the tired and repeatedly debunked claim that Planned Parenthood profits from fetal tissue donations. In the subsection on “protecting human life,” the platform says:

We oppose the use of public funds to perform or promote abortion or to fund organizations, like Planned Parenthood, so long as they provide or refer for elective abortions or sell fetal body parts rather than provide healthcare. We urge all states and Congress to make it a crime to acquire, transfer, or sell fetal tissues from elective abortions for research, and we call on Congress to enact a ban on any sale of fetal body parts. In the meantime, we call on Congress to ban the practice of misleading women on so-called fetal harvesting consent forms, a fact revealed by a 2015 investigation. We will not fund or subsidize healthcare that includes abortion coverage.

Later in the document, under a section titled “Preserving Medicare and Medicaid,” the platform again asserts that abortion providers are selling “the body parts of aborted children”—presumably again referring to the controversy surrounding Planned Parenthood:

We respect the states’ authority and flexibility to exclude abortion providers from federal programs such as Medicaid and other healthcare and family planning programs so long as they continue to perform or refer for elective abortions or sell the body parts of aborted children.

The platform appears to reference the widely discredited videos produced by anti-choice organization Center for Medical Progress (CMP) as part of its smear campaign against Planned Parenthood. The videos were deceptively edited, as Rewire has extensively reported. CMP’s leader David Daleiden is currently under federal indictment for tampering with government documents in connection with obtaining the footage. Republicans have nonetheless steadfastly clung to the group’s claims in an effort to block access to reproductive health care.

Since CMP began releasing its videos last year, 13 state and three congressional inquiries into allegations based on the videos have turned up no evidence of wrongdoing on behalf of Planned Parenthood.

Dawn Laguens, executive vice president of Planned Parenthood Action Fund—which has endorsed Hillary Clinton—called the Republicans’ inclusion of CMP’s allegation in their platform “despicable” in a statement to the Huffington Post. “This isn’t just an attack on Planned Parenthood health centers,” said Laguens. “It’s an attack on the millions of patients who rely on Planned Parenthood each year for basic health care. It’s an attack on the brave doctors and nurses who have been facing down violent rhetoric and threats just to provide people with cancer screenings, birth control, and well-woman exams.”

Myth #2: The Supreme Court Struck Down “Commonsense” Laws About “Basic Health and Safety” in Whole Woman’s Health v. Hellerstedt

In the section focusing on the party’s opposition to abortion, the GOP’s platform also reaffirms their commitment to targeted regulation of abortion providers (TRAP) laws. According to the platform:

We salute the many states that now protect women and girls through laws requiring informed consent, parental consent, waiting periods, and clinic regulation. We condemn the Supreme Court’s activist decision in Whole Woman’s Health v. Hellerstedt striking down commonsense Texas laws providing for basic health and safety standards in abortion clinics.

The idea that TRAP laws, such as those struck down by the recent Supreme Court decision in Whole Woman’s Health, are solely for protecting women and keeping them safe is just as common among conservatives as it is false. However, as Rewire explained when Paul Ryan agreed with a nearly identical claim last week about Texas’ clinic regulations, “the provisions of the law in question were not about keeping anybody safe”:

As Justice Stephen Breyer noted in the opinion declaring them unconstitutional, “When directly asked at oral argument whether Texas knew of a single instance in which the new requirement would have helped even one woman obtain better treatment, Texas admitted that there was no evidence in the record of such a case.”

All the provisions actually did, according to Breyer on behalf of the Court majority, was put “a substantial obstacle in the path of women seeking a previability abortion,” and “constitute an undue burden on abortion access.”

Myth #3: 20-Week Abortion Bans Are Justified By “Current Medical Research” Suggesting That Is When a Fetus Can Feel Pain

The platform went on to point to Republicans’ Pain-Capable Unborn Child Protection Act, a piece of anti-choice legislation already passed in several states that, if approved in Congress, would create a federal ban on abortion after 20 weeks based on junk science claiming fetuses can feel pain at that point in pregnancy:

Over a dozen states have passed Pain-Capable Unborn Child Protection Acts prohibiting abortion after twenty weeks, the point at which current medical research shows that unborn babies can feel excruciating pain during abortions, and we call on Congress to enact the federal version.

Major medical groups and experts, however, agree that a fetus has not developed to the point where it can feel pain until the third trimester. According to a 2013 letter from the American Congress of Obstetricians and Gynecologists, “A rigorous 2005 scientific review of evidence published in the Journal of the American Medical Association (JAMA) concluded that fetal perception of pain is unlikely before the third trimester,” which begins around the 28th week of pregnancy. A 2010 review of the scientific evidence on the issue conducted by the British Royal College of Obstetricians and Gynaecologists similarly found “that the fetus cannot experience pain in any sense prior” to 24 weeks’ gestation.

Doctors who testify otherwise often have a history of anti-choice activism. For example, a letter read aloud during a debate over West Virginia’s ultimately failed 20-week abortion ban was drafted by Dr. Byron Calhoun, who was caught lying about the number of abortion-related complications he saw in Charleston.

Myth #4: Abortion “Endangers the Health and Well-being of Women”

In an apparent effort to criticize the Affordable Care Act for promoting “the notion of abortion as healthcare,” the platform baselessly claimed that abortion “endangers the health and well-being” of those who receive care:

Through Obamacare, the current Administration has promoted the notion of abortion as healthcare. We, however, affirm the dignity of women by protecting the sanctity of human life. Numerous studies have shown that abortion endangers the health and well-being of women, and we stand firmly against it.

Scientific evidence overwhelmingly supports the conclusion that abortion is safe. Research shows that a first-trimester abortion carries less than 0.05 percent risk of major complications, according to the Guttmacher Institute, and “pose[s] virtually no long-term risk of problems such as infertility, ectopic pregnancy, spontaneous abortion (miscarriage) or birth defect, and little or no risk of preterm or low-birth-weight deliveries.”

There is similarly no evidence to back up the GOP’s claim that abortion endangers the well-being of women. A 2008 study from the American Psychological Association’s Task Force on Mental Health and Abortion, an expansive analysis on current research regarding the issue, found that while those who have an abortion may experience a variety of feelings, “no evidence sufficient to support the claim that an observed association between abortion history and mental health was caused by the abortion per se, as opposed to other factors.”

As is the case for many of the anti-abortion myths perpetuated within the platform, many of the so-called experts who claim there is a link between abortion and mental illness are discredited anti-choice activists.

Myth #5: Mifepristone, a Drug Used for Medical Abortions, Is “Dangerous”

Both anti-choice activists and conservative Republicans have been vocal opponents of the Food and Drug Administration (FDA’s) March update to the regulations for mifepristone, a drug also known as Mifeprex and RU-486 that is used in medication abortions. However, in this year’s platform, the GOP goes a step further to claim that both the drug and its general approval by the FDA are “dangerous”:

We believe the FDA’s approval of Mifeprex, a dangerous abortifacient formerly known as RU-486, threatens women’s health, as does the agency’s endorsement of over-the-counter sales of powerful contraceptives without a physician’s recommendation. We support cutting federal and state funding for entities that endanger women’s health by performing abortions in a manner inconsistent with federal or state law.

Studies, however, have overwhelmingly found mifepristone to be safe. In fact, the Association of Reproductive Health Professionals says mifepristone “is safer than acetaminophen,” aspirin, and Viagra. When the FDA conducted a 2011 post-market study of those who have used the drug since it was approved by the agency, they found that more than 1.5 million women in the U.S. had used it to end a pregnancy, only 2,200 of whom had experienced an “adverse event” after.

The platform also appears to reference the FDA’s approval of making emergency contraception such as Plan B available over the counter, claiming that it too is a threat to women’s health. However, studies show that emergency contraception is safe and effective at preventing pregnancy. According to the World Health Organization, side effects are “uncommon and generally mild.”

Commentary Politics

Is Clinton a Progressive? Not If She Chooses Tim Kaine

Jodi Jacobson

The selection of Tim Kaine as vice president would be the first signal that Hillary Clinton intends to seek progressive votes but ignore progressive values and goals, likely at her peril, and ours.

During the 2016 presidential campaign, former secretary of state and presumptive Democratic presidential nominee Hillary Rodham Clinton has frequently claimed to be a progressive, though she often adds the unnecessary and bewildering caveat that she’s a “progressive who likes to get things done.” I’ve never been sure what that is supposed to mean, except as a possible prelude to or excuse for giving up progressive values to seal some unknown deal in the future; as a way of excusing herself from fighting for major changes after she is elected; or as a way of saying progressives are only important to her campaign until after they leave the voting booth.

One of the first signals of whether Clinton actually believes in a progressive agenda will be her choice of running mate. Reports are that Sen. Tim Kaine, former Virginia governor, is the top choice. The selection of Kaine would be the first signal that Clinton intends to seek progressive votes but ignore progressive values and goals, likely at her peril, and ours.

We’ve seen this happen before. In 2008, then-presidential candidate Barack Obama claimed to be a progressive. By virtue of having a vision for and promise of real change in government and society, and by espousing transparency and responsibility, he won by a landslide. In fact, Obama even called on his supporters, including the millions activated by the campaign’s Organizing for Action (OFA), to keep him accountable throughout his term. Immediately after the election, however, “progressives” were out and the right wing of the Democratic party was “in.”

Obama’s cabinet members in both foreign policy and the economy, for example, were drawn from the center and center-right of the party, leaving many progressives, as Mother Jones’ David Corn wrote in the Washington Post in 2009, “disappointed, irritated or fit to be tied.” Obama chose Rahm Emanuel as Chief of Staff, a man with a reputation from the days of Bill Clinton’s White House for a reluctance to move bold policies—lest they upset Wall Street or conservative Democrats—and a deep disdain for progressives. With Emanuel as gatekeeper of policies and Valerie Jarrett consumed with the “Obama Brand” (whatever that is), the White House suddenly saw “progressives” as the problem.

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It became clear that instead of “the change we were hoping for,” Obama had started on an impossible quest to “cooperate” and “compromise” on bad policies with the very party that set out to destroy him before he was even sworn in. Obama and Emanuel preempted efforts to push for a public option for health-care reform, despite very high public support at the time. Likewise, the White House failed to push for other progressive policies that would have been a slam dunk, such as the Employee Free Choice Act, a major goal of the labor movement that would have made it easier to enroll workers in unions. With a 60-vote Democratic Senate majority, this progressive legislation could easily have passed. Instead, the White House worked to support conservative Democrat then-Sen. Blanche Lincoln’s efforts to kill it, and even sent Vice President Joe Biden to Arkansas to campaign for her in her run for re-election. She lost anyway.

They also allowed conservatives to shelve plans for an aggressive stimulus package in favor of a much weaker one, for the sole sake of “bipartisanship,” a move that many economists have since criticized for not doing enough.  As I wrote years ago, these decisions were not only deeply disappointing on a fundamental level to those of us who’d put heart and soul into the Obama campaign, but also, I personally believe, one of the main reasons Obama later lost the midterms and had a hard time governing.  He was not elected to implement GOP lite, and there was no “there, there” for the change that was promised. Many people deeply devoted to making this country better for working people became fed up.

Standing up for progressive principles is not so hard, if you actually believe in them. Sen. Elizabeth Warren (D- MA) is a progressive who actually puts her principles into action, like the creation against all odds in 2011 of the Consumer Finance Protection Bureau, perhaps the single most important progressive achievement of the past 20 years. Among other things, the CFPB  shields consumers from the excesses of mortgage lenders, student loan servicers, and credit card companies that have caused so much economic chaos in the past decade. So unless you are more interested in protecting the status quo than addressing the root causes of the many problems we now face, a progressive politician would want a strong progressive running mate.

By choosing Tim Kaine as her vice president, Clinton will signal that she values progressives in name and vote only.

As Zach Carter wrote in the Huffington Post, Kaine is “setting himself up as a figure willing to do battle with the progressive wing of the party.” Kaine is in favor of the Trans-Pacific Partnership (TPP), a trade agreement largely negotiated in secret and by corporate lobbyists. Both Sen. Bernie Sanders, whose voters Clinton needs to win over, and Sen. Elizabeth Warren oppose the TPP because, in Warren’s words, it “would tilt the playing field even more in favor of … big multinational corporations and against working families.”

The progressive agenda includes strong emphasis on effective systems of governance and oversight of banks and financial institutions—the actors responsible, as a result of deregulation, for the major financial crises of the past 16 years, costing the United States trillions of dollars and gutting the financial security of many middle-class and low-income people.

As Warren has stated:

Washington turned a blind eye as risks were packaged and re-packaged, magnified, and then sold to unsuspecting pension funds, municipal governments, and many others who believed the markets were honest. Not long after the cops were blindfolded and the big banks were turned loose, the worst crash since the 1930s hit the American economy—a crash that the Dallas Fed estimates has cost a collective $14 trillion. The moral of this story is simple: Without basic government regulation, financial markets don’t work. That’s worth repeating: Without some basic rules and accountability, financial markets don’t work. People get ripped off, risk-taking explodes, and the markets blow up. That’s just an empirical fact—clearly observable in 1929 and again in 2008. The point is worth repeating because, for too long, the opponents of financial reform have cast this debate as an argument between the pro-regulation camp and the pro-market camp, generally putting Democrats in the first camp and Republicans in the second. But that so-called choice gets it wrong. Rules are not the enemy of markets. Rules are a necessary ingredient for healthy markets, for markets that create competition and innovation. And rolling back the rules or firing the cops can be profoundly anti-market.

If Hillary Clinton were actually a progressive, this would be key to her agenda. If so, Tim Kaine would be a curious choice as VP, and a middle finger of sorts to those who support financial regulations. In the past several weeks, Kaine has been publicly advocating for greater deregulation of banks. As Carter reported yesterday, “Kaine signed two letters on Monday urging federal regulators to go easy on banks―one to help big banks dodge risk management rules, and another to help small banks avoid consumer protection standards.”

Kaine is also trying to portray himself as “anti-choice lite.” For example, he recently signed onto the Women’s Health Protection Act. But as we’ve reported, as governor of Virginia, Kaine supported restrictions on abortion, such as Virginia’s parental consent law and a so-called informed consent law, which, he claimed in 2008, gave “women information about a whole series of things, the health consequences, et cetera, and information about adoption.” In truth, the information such laws mandate giving out is often “irrelevant or misleading,” according to the the Guttmacher Institute. In other words, like many others who let ideology rather than public health guide their policy decisions, Kaine put in place policies that are not supported by the evidence and that make it more difficult for women to gain access to abortion, steps he has not denounced. This is unacceptable. The very last thing we need is another person in the White House who further stigmatizes abortion, though it must be said Clinton herself seems chronically unable to speak about abortion without euphemism.

While there are many other reasons a Kaine pick would signal a less-than-secure and values-driven Clinton presidency, the fact also stands that he is a white male insider at a time when the rising electorate is decidedly not white and quite clearly looking for strong leadership and meaningful change. Kaine is not the change we seek.

The conventional wisdom these days is that platforms are merely for show and vice presidential picks don’t much matter. I call foul; that’s an absolutely cynical lens through which to view policies. What you say and with whom you affiliate yourself do indeed matter. And if Clinton chooses Kaine, we know from the outset that progressives have a fight on their hands, not only to avoid the election of an unapologetic fascist, but to ensure that the only person claiming the progressive mantle actually means what she says.