Written on my youngest son’s 11th birthday (July 2019). Click to read the story of how Lead impacted his birth (I almost died in childbirth.).

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Wait. What?
Your third baby was poisoned too?
Tamara, you never talk about that!

The tiny human in the picture above (born just 5 lbs 10 ounces) is now almost 130 lbs and 5′ 6″ inches tall! (And he’s just 11 years old today!)

He was my smallest baby – and we had a very difficult pregnancy (likely – at least in part – because I was probably Lead-poisoned in the summer of 2005 at the same time his older brothers were.)  

No one thought to test me for Lead in 2005 when Avi and A.J. (my two older boys) were Lead-poisoned. I was solely nursing Avi (who was just 7 months old at the time) and even with that understanding the doctors did not suggest I get tested. In fact, their pediatrician was initially reluctant to test any of my children at the time (3 boys – then ages 7 months, 3 years and 9 years old) — ignorantly buying in to the industry constructed (CDC perpetuated) myth that as a white, middle-class family we weren’t “at risk”(!).

In 2008, though, when I was pregnant with Charlie I demanded the midwives give me a Blood Lead Level (BLL) test both before and after Charlie’s birth. They didn’t have any of the lavender topped vials (typically used for blood lead tests) in stock at the clinic and I had to wait several weeks before they were able to test me (after I initially made the first request.)

At the time the midwives in maternity clinic I was going to, a clinic that birthed thousands of babies each year, a clinic that was associated with a MAJOR hospital (Providence) – in a major metropolitan area (Portland, Oregon) told me that they had never once before gotten a request to carry out a Blood Lead Level test on a pregnant woman in their care (which is why they did not have the appropriate testing supplies for the blood draw when I requested it.) They were quite surprised by my request actually. Please understand – in context – how absurd this is.This is a city where, at the time, something like 92.5% of the housing units in the center of the city (the neighborhoods served by this particular hospital) had potential or active Lead hazards because they were built before 1978 (and most of those homes were built before 1940!)

As a result of demanding this testing be done (in spite of a significant level of resistance from the nurses at the clinic) I learned that I had a BLL of 1.0 (1.0 microgram of Lead per deciliter of blood) shortly before Charlie was born and a BLL of 1.1 while still in the hospital after his birth.

I wish I had known that I was positive for Lead in my blood BEFORE I got pregnant, or at least long before I was due, as this knowledge might have resulted in a different outcome for Charlie’s birth (and his longterm health prognosis for that matter!)

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What does a “BLL of 1.0” mean exactly?

While most would not consider a BLL of 1.0 in an adult woman “poisoned” it is a likely indicator that I was previously poisoned (given my body weight, the half-life of Lead in blood and the time that had lapsed since the acute exposure of my other children).

For context for what might otherwise seem to be a small number, it is important to remember that Lead is one of the most potent neurotoxicants known to man. Current public agency statements (CDC, EPA, USDA, CPSC, FDA, etc.) now echo the scientific consensus that there is “no safe level of Lead exposure for children.”

One point of reference for understanding what a BLL of 1.0 means is looking at the “pre-industrial revolution” average human blood lead levels, which were found to be in the range of 0.016 micrograms of Lead per deciliter of blood. That means that a BLL of 1.6 is (for example) 100 times the level found in people from that time (and a 0.8 is 50 times the pre-industrial-revolution average BLL.)

More recent research (in the past few years) from Harvard has shown that “natural” blood Lead levels of humans (not just from before the industrial revolution, but from before the emergence of the human activities of mining and refining metal on this planet) was far below even the seemingly minute amounts found in pre-industrial-revolution humans. [Link].

For a bit more context for the specific concern for a BLL of 1.0 in a pregnant woman… please bear with me and read on…

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“Tamara, how do you think your BLL impacted Charlie’s birth?”

“You’re fine. Come back in two weeks.”

On about July 10, 2008 I had an appointment for a checkup with the midwives at Providence Hospital. I was in labor early at about 37 weeks 4 days gestation when I came in to that appointment. I was due (as usual) on July 30th (given 3/4 of my boys were conceived on Halloween!… but that’s another story! 😉 )

At this checkup the midwives said “You are fine, just go home and we will see you when things progress – in about two weeks.”

I knew things were not quite right — I did not feel fine.

This was my fifth pregnancy (I lost my first one – a girl – back in July of 1994) and I knew what a healthy pregnancy and labor felt like and this was not it.

That same day – after seeing the Providence Hospital midwives, I decided I didn’t trust them and didn’t want to use their services anymore. They had been completely dismissive of my concerns my entire pregnancy – and in my estimation, their standard of care rated about a “2” on a scale of 1 to 10, with “10” being the best and “1” being the worst! I also had a bad birth experience with them before – back in 2002, with A.J.‘s birth, so I felt those were enough warning signs that it was time to move on. 

A New, Better, Different Midwife!

After a bunch of calls and some online research, I found another midwife. His name was Dr. Edwin Hoffman Smith. He was a magical person it seemed — especially in comparison with the near-abuse (through a consistent pattern of repeatedly dismissing all of my concerns) that I had suffered at the hands of the Providence Hospital midwife team! My husband and I have often joked that “Dr. Ed” was the “embodiment of Mr. Rogers as a midwife” (if Mr. Rogers had been a midwife in another incarnation)! He’s the kind of person that actually remembered the names of most (if not all!) of the babies he helped bring in to the world! He took the practice of midwifery very seriously, and also brought a human element to the birth process that I had never seen in the “baby mill” atmosphere provided by hospital births attended by hospital midwives.

Dr. Ed was also probably single-handedly responsible for saving my life that week (as well as saving Charlie’s life)!

I borrowed the $2,200 from my mom so I would be able to do a home birth with Dr. Ed. Seeing a midwife for a home birth was not covered by our insurance at the time. Later that afternoon, we went to Dr. Ed’s birthing facility for our initial check-in and to sign up with him.

Dr. Ed asked me: “When are you due?”

I responded: “July 30th, but I’m in labor right now, and we are switching to you and would like to have a home birth – maybe later tonight!”

Dr. Ed responded: “Oh! Okay!” (!!!!)

Later that evening I called him from home and said that I felt labor was progressing.

I think it was close to midnight when he came to the house. I was really determined that this – likely my very last birth was going to be a home birth — and was super-excited to have found Dr. Ed!  He did an exam, and said he did not think things were quite right. He said my body seemed tired and that labor was exhausting me but was actually not progressing as it should be and (since it was very late at night) he asked me to come in to his office first thing in the morning (after a little rest) to have a full work up and be observed for a bit.

Not fine… actually – “almost dead!”

It was in that visit the next morning (less than 24 hours after the Providence Hospital midwives sent me home and said “come back in two weeks”) that Dr. Ed determined I was in advanced stage kidney failure as a result of preeclampsia and that I needed to get to the hospital immediately or I would risk dying in childbirth (a common outcome of preeclampsia in third world countries, and a likely outcome for me, had I listened to the Providence Hospital midwife team!)

I went to the hospital straight from his office (with “do not stop at home to collect your birthing bag or anything” level urgency)… and then I was “observed” for three days, three days that felt like an eternity.

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Fun Fact / Side Note: On the 15th in the morning I learned that this would be the day I was going to be on the Today Show! The film crew had recorded the episode when I was 7-months pregnant (back in May) and it was finally airing.  

That morning, after I found out I was going to be on the Today Show (only by chance because someone had a TV on in the background!) the nurses came in with doctors and hospital midwives and the hospital midwife essentially threatened me… she said something along the lines of “Either we break your water or you have a c-section right now.”

I responded…”Can we just wait until the Today Show is over?” I think she thought I was lying or insane (she didn’t seem to really believe I was about to be on the Today Show!) and then the Today Show came on and there it was… my interview… So the midwife agreed to wait just a little bit longer to take any additional action.

Here’s the Today Show clip from July 15, 2008 if you want to watch it now – as I did while I was in Labor!

We all watched the Today Show. There were about 10 people in the room if I remember correctly: my husband, my mother, my three older sons, some close family friends, a couple of nurses and midwives, and Dr. Ed!). When it was over the hospital midwife made me make a choice (which I did only after discussing things with Dr. Ed…”unofficially”.) I chose to let her break my water. Even though I was terrified of any interventions at all at this point I was willing to try anything before going in for a c-section! And then…

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In the afternoon of July 15th – after more than three days in the hospital being monitored (with some visits, advice and coaching from Dr. Ed – in an unofficial capacity since they would not allow him to practice in their hospital) and with the threat of a c-section hanging over my head, I allowed the hospital midwives to break my water and Charlie was born moments later (two weeks early, a vaginal birth with no pain meds – and the most painful experience I have ever been through, given how very weak my body was at the time).

To cap off my perception of the consistency of the incompetence of the Providence midwife team, I submit the following final detail: I decided to go in for my two-week post-natal at the hospital clinic (since it was covered by my insurance.) At that visit, the nurse asked to check on my c-section scar to see how it was healing! (WHAAA – they didn’t even bother looking at my chart to see that I had had a natural vaginal birth!)

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Years Later – Connecting The Dots…

It was not until nearly four years later (in early 2012) when interviewing Dr. Felicia Rabito (of Tulane University) for my film that I learned that the average Blood Lead Level (BLL) in an adult American woman of childbearing age was about 0.43 micrograms of Lead per deciliter of blood (see study link below), and that even at this “very low level” there were correlations with negative birth outcomes, fertility/conception issues, low birthweight in newborns, pre-term birth and other birth complications (like preeclampsia) outcomes that fluctuated in relation to BLL variations as low as 0.1 micrograms per deciliter!

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Abstract from Dr. Rabito’s study
(full study linked below):

Links to summaries of Dr. Rabito’s research:

• https://tulanesphtm.wordpress.com/2015/06/22/low-maternal-lead-levels-associated-with-adverse-birth-outcomes/
• https://www.aspph.org/tulane-researcher-finds-low-maternal-lead-levels-associated-with-adverse-birth-outcomes/
• https://www.sciencedirect.com/science/article/pii/S0890623814002597

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Prenatal testing for Lead in blood is far from routine in 2019, but was practically unheard of eleven years ago in 2008. Back then no one on my prenatal team would have thought to check my BLL without my prompting – and in fact – I actually had quite an argument on my hands (with the midwives at Providence Hospital) in convincing them to test me.

In retrospect, this was especially annoying because our family had a history of acute Lead exposure with my other children, and so if anyone was a candidate for a BLL test during pregnancy (based on family medical history), I was.

My Blood Lead Level at the time of Charlie’s birth was “not concerning” to any of the prenatal team because medical professionals at that time either had no context for how to interpret the potential impact of blood lead levels or they considered a pregnant woman “fine” as long as her BLL was “under 5.0 micrograms per deciliter”. While my BLL was well under a 5.0, it was more than TWICE the level that would later be demonstrated by Dr. Rabito’s work to cause (or at least to be strongly-correlated with) birth complications.

In retrospect I believe that I was likely poisoned at the same time my boys were (August 2005) and that my BLL had steadily come down, in a pattern that was similar to how their levels dropped — although there is no way to go back and definitely demonstrate that, since I was never tested at the time of the initial exposure. Here’s a post showing Avi’s BLL levels over time after he was poisoned.

Looking at the conclusions of Dr. Rabito’s study, given my blood lead level – the complications with Charlie’s pregnancy and birth were (with hindsight) actually completely predictable:

• I had a premature birth (just short of 38 weeks)
• I had a complicated birth because of health issues that have been directly linked to lead exposure (kidney failure, aka preeclampsia)
• My baby had a very low birthweight (just literally one ounce above the hospital staff choosing admitting him into special care) coming in at just 5 lbs 10 ounces (the smallest, by far, of my four live births)
• My baby had health complications as a result of being born early and small – a host of complications actually, including breathing issues (that persist to this day) and an inability to latch/nurse (until he was about 5 weeks old.)

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The Importance of Preconception & Prenatal Blood Lead Testing

Since learning of Dr. Rabito’s work (and even before that!), I have fought for preconception Blood Lead testing awareness and encouraged expectant mothers I have met to get prenatal Blood Lead testing whenever possible. I also think the best course of action across the board would be to add simple Blood Lead Level (BLL) testing [even via the (less accurate) finger-prick test, as preliminary screening, at least] into the medical routine that women of childbearing age get with each Pap smear.

I cannot imagine a more impactful time to test for Lead in the blood of a woman than BEFORE she considers getting pregnant. Having this information (if her blood is positive for Lead even at trace levels) would give her the opportunity to:

1. take steps to detox her body prior to pregnancy,
2. identify any existing and potential Lead hazards in her home, and…
3. make sure her home is Lead-safe for her baby when the time comes.

It is also a critical information-gathering time for young women, a time when they are learning as much as they can about their bodies – and it would be a great opportunity to introduce an awareness for Lead exposure into their consciousness at a time that would have the most impact on their futures.

How has this impacted Charlie today?

Likely as impacts of his in-utero Lead exposure, Charlie has (to this day) several serious health issues, which impact our everyday life. These issues include difficulty breathing (Restrictive Airway Disease), especially when faced with even ostensibly “low levels” of particulates – in the “green” to “yellow” zone on the Air Quality Index scale (starting as low as AQI 25) – and a mental illness diagnosis, characterized as “EXTREME ADHD” — making it nearly impossible for him to attend school (or doing anything else that requires sitting still at all). He also has profound impulse control issues (a well-documented impact of Lead exposure – even at low levels – on the development of the frontal lobe).

On the upside, he’s a sweetheart (when he can be). He loves to jump, and run, and pogo stick, and trampoline, and ride bikes, and hike in the woods, and climb trees and mountains, and shoot hoops, and do all of the snow sports, and… if we had the resources, we would have a full-time one-on-one athletic coach be his buddy, someone who could keep up with his energy level and teach him new skills at the same time! He’s also a budding artist and is really quite skilled with colored pencils! (Check out his Facebook page here!) He is entrepreneurial — he loves selling his art, cookies, lemonade, hot cocoa, honey sticks, etc. at a stand on the corner; playing Monopoly and Life and similar board games; he dreams of starting his own YouTube channel some day, and also of of designing clothes for men (cut, sized and styled to fit man-bodies) that are “sparkly and pink and colorful” (like the cool clothes you can usually only buy for pre-teen girls!), he LOVES Pokeman, and My Little Pony, and dreams “of some day having a full-size trampoline in the back yard!”

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It’s amazing how time flies, and how much has changed in the past 11 years, and how much hardship this kiddo has been exposed to in his relatively short life [especially the past three years; he was there with me in the kitchen the day the sheriff came and illegally arrested me (on trumped up charges of crimes I had not committed!)… but we’re here and we are very thankful to have everything we do have – especially the love and support of the amazing community here on LeadSafeMama.com!

Thank you everyone for keeping our family together through what has otherwise been an unbearably difficult time.

Thank you for reading and for sharing my posts.

As always, please let me know if you have any questions.

& Happy Birthday Charlie!

Tamara Rubin
#LeadSafeMama