One woman's path through doula training, childrearing, and a computer science Ph. D. program

Friday, October 5, 2012

Gaming and Mathematics: A Cross Curricular Event (Get Your Game On)

This is a post about Gaming and Mathematics: A Cross Curricular Event (Get Your Game On), a panel at Grace Hopper Celebration of Women in Computing, October 2012 in Baltimore, MD.

Sharon Jones, teacher
Renada Poteat
Beth Frierson

Agenda:

  • Common core overview
  • What is BYOB? (The gaming software)
  • After school workshop showcase
  • How to build a BYOB guessing game
  • Relating common core back to the workshop
Beth: There has been a big push in K-12 education to include a common core type of activity in STEM fields, including computer science. In doing common core training, we had brainstorming sessions where we investigated combining concepts in one class to another, so students can better relate what we are trying to teach them. Because CS and Math are so closely related, we decided to bridge the gap between these two related fields. We produced a review game for math, so that the math students could review for their final exams with it.

The benefit of math ability to academic performance in college computer science programs was confirmed in this study (Fan 2002)

RenadaBuild Your Own Blocks (BYOB) is an advanced version of Scratch, but lets you build your own function and blocks in an object-oriented way. Students learn to solve problems

Sharon: We have been working on a CS curriculum called "The Beauty and Joy of Computing." A few different colleges have picked it up.  At UNCC we wanted to take the college-level curriculum and scale it down to high school students. We wanted students to take something away from the three-day after-school workshop that they could call theirs. Also we gave them snacks.
  • Day 1: Pre-survey; play math games; begin BYOB
  • Day 2: Learn BYOB; start creation of math games
  • Day 3: Complete math game; play games; take post-survey
The questions were actual questions that we got from the math teachers, came from the curriculum and helped them prepare for their final exam. Students were very excited about computer programming, even if they had never interacted with computers before.
"I don't know how to create a computer game, and I came into the workshop to learn how to make a computer game." (TJ, football player)
Of the 20 participants in the workshop, 100% of the students did not know how to use BYOB or what it was. Also 100% of the participants agreed with "I am sure I can learn programming." UNCC students taught the workshop.

"It's not half-bad. I'm actually enjoying the creation of this. It's also a lot simpler than VisualBasic." (Aaron)

Now, we're going to call Antonio via Skype. Antonio learned BYOB and taught it to the other students.

Antonio: BYOB is a really good software. It's not complex; it's essentially drag and drop. It's a software you can use inside or outside of class. The students really adapted to what they were given. The whole concept of BYOB is a good foundation.


Questions for Antonio

Q: What does Antonio plan on doing after graduation?

Antonio: Attend East Carolina or UNCG to major in computer science.

Q: Have you used BYOB for areas other than gaming?

Antonio: You can use it as a tool to model mathematics. You can use BYOB for things other than entertainment.

Sharon: The whole concept of BYOB is for gaming.

Q: Have you used BYOB since the workshop?

Antonio: Yes, I programmed an algebra game for the algebra team; the teacher wants to see if we can use it again this year and see if I can make a game for geometry.

Q: Has BYOB inspired you to learn other languages?

Antonio: I am open to all languages. I will make things happen with all languages.

Renada: One of our students used BYOB to make a flash card language learning program to teach Haiti to English. So that's another way to use BYOB without making a game.

[ End call ]

Sharon: Antonio has begun to see the full circle as we've taught him different levels of programming

Beth: Learning programming through BYOB fosters critical thinking skills. Antonio has grown from an introverted person to the chair of the homecoming committee and helping with the prom. The knowledge this gives them is more than just academic.

Sharon: Post survey questions were all positive! Everyone enjoyed the workshop and found it useful.

Renada: I wanted to run a quick demonstration and give you an idea of how BYOB works.

[ Demo of prompting user for name ]

Sharon: Sounds are also really cool.

[ Demo of adding "Got Inspiration" song ]

Sharon: The kids really liked this game. [ Game with Alonso following the mouse cursor and being eaten by fire-breathing dragon.]

[ Handout of the Algebra Guessing Game tutorial ]

Beth: A computer is like a man. You have to tell it what to do, and you have to be very precise. For Valentine's Day I teach a matchmaking game. We use CS Unplugged, having students write directions to make a peanut butter and jelly sandwich. We have class debate on current events related to technology. We use GEO boards, which are building blocks using shapes.  We storyboard the program that they're working on to draw up algorithms they need to implement. We ask the students to write an editorial article to their local newspaper or technology journal. And we have students blog on specific thematic content.

Sharon: For some sports (e.g., NASCAR) the fanbase is shrinking because they're not engaging students. We had students write letters.

Q: Can we access the algebra game online?
Sharon: sjonespob.webs.com

Q from Leanda: You guys are selling yourself short. There is an entire modeling strand in the common core. Science teachers could really apply the National Academy common core standards much better. For example, recursion is an Algebra I standard. Writing journals is nice but let's be specific. Let's focus on the math skills specifically. 

Sharon: This is pilot work. It was hard to get this far.

Beth: We have a STEM team at our school that teaches forensics. We are working on other concepts as well and working to get the curriculum up to date.

Q: You are working on getting a CS course. If you were to do that, would you use BYOB or other formal languages?

Sharon: We're using principles from a pilot project from five college called the Beauty and Joy of Computing. BYOB is one of the platforms. We're going to do GameMaker, App Developer, Alice, and web development. We did a little bit in Photoshop (even though it isn't a language). We will talk about artificial intelligence in conjunction with FIRST robotics.

Beth: We will also teach Visual Basic (.NET) and entrepreneurial courses so that students can make their websites e-commerce ready.

Q: What about visual arts as a mathematics theme? I also do a workshop with similar results, but my observation is that I am attracting mostly boys that are all excited by games and computer science already. How do you recruit people that aren't necessarily in that demographic?

Beth: We struggle with that. We tried to do a weekend workshop to try to get girls in. You have to do a song and dance and feed them and have t-shirts and try to tie in how technology affects them on a daily level..

Sharon: We want to do a workshop that is girl focused (girl power). I try to promote NCWIT in my classes in particular. That has worked really well. There's an article in Glamour magazine that ran in October of last year. I've given it to every girl and that seems to work. Glamour does blogs about fashion and they say, "Oh, I can do that."

Q from Miko: My question is related. There was a successful Kickstarter called Goldiblocks that found that narrative is really strong with young girls -- that's what they're interested in. Do you see girls making different things and what are they making?

Renada: The girls would use it more to make plays or sketch out a scene, change the backgrounds, and tell a story. The boys wanted to create war and warcraft.

Sharon: Mine loved the music. They would play songs. They liked the idea of changing the color. But I agree that it's about plays, there's lots of color and flowers. That's what I like too. But then you go next door and "BAM!" and then a red screen.

Miko: Your experience supports that.

Sharon: We took the Alice course. One of the things the instructor said is that Alice works well with girls because it's more about narrative (it's not so much about the killing and the warcraft). It's more like a play stage.

Audience member: We have a girls camp and boys camp for middle-schoolers. We used Alice. The boys did shoot-em-ups and the girls did stories.

Miko: You could do choose-your-own adventure. Like a book.

Q: As a parent, I think it's great that you teachers are doing this. I've come across a discrepancy between younger teachers who are really trying to do this stuff, and older teachers that are resistant to it. How should I get involved?

Sharon: That's my dissertation work. The majority of teachers is over 40. What I have found is that if you can show a teacher one element -- one thing -- that they incorporate in their curriculum then they will reach out to you asking if you have other ideas. I once had 25 e-mails from teachers: "Can you show me that again? Do you have any other tips?" SlideRocket. Prezzi. PuppetPals. The kids were ecstatic about it. It's gotta be free, though. The other problem is that we teachers can be blocked from downloading things, so it should be free and in the cloud.

END

Thursday, October 4, 2012

What I wish I Knew When Applying To Graduate School

This is a post about What I wish I Knew When Applying To Graduate School, a session at the Grace Hopper Celebration for Women in Computing, October 2012, in Baltimore, MD.

Judy Hoffman at University of California, Berkeley in Computer Vision. She went to the same school for undergraduate.

Katya Gonina at University of California, Berkeley in Parallel Computing. She originally applied as a MS student but switched to PhD.

Kristin Stephens at University of California, Berkeley in Computer Networking and Online Learning Education. Her undergraduate studies were focused in industry.

Aude Hofleitner at University of California, Berkeley in Machine Learning. She did her undergraduate education abroad in France, and last year served on the admission committee.

Elena Caraba at University of Illinois, Urbana-Champaign in Scientific Computing. She was on the admission committee at UIUC for both PhD and MS, and she switched advisors in her 3rd year of PhD work.

Application Components

  1. Standardized tests (i.e., GRE, TOEFL)
  2. Recommendation letters
  3. Research statement
  4. Personal statement, for some schools
  5. Transcript and GPA from your undergraduate institution
What makes a good application? This list is geared towards a PhD application
  1. Research experience, or industry experience that can transcend to research life
  2. Good recommendation letters
  3. Transcript and GPA
  4. Solid research statement
Research
  • By far, the most important thing to get involved in
  • Find out if you like doing research
  • Find opportunities early (in your sophomore or junior year); do internships
  • Try to get a publication, in any form, including a poster symposium in your school, a workshop paper, a poster in a conference, a conference publication, or a journal article
  • Reflect your research interests and experience in your research statements.
Recommendation letters
  • Typically professors at your university or managers from job/internship. 
  • Ask, "Can you write me a great letter?" You don't want a good letter. You want a great letter.
  • Find a person who knows you well
  • Ask professors who are in the area for which you are applying -- and include 
  • Ask early, and follow up (e.g., weekly: "By the way! Did you get to that letter for me? It's due XXX.")
Transcript
  • Also very important
  • Take higher-level calasses in topics in which you are interested
  • Great way to explore grad school topics
  • Do well in the classes you choose
Research statement
  • Your chance to tell: a) Why you want to go to this particular graduate school, and b) What you want to study.
  • Discuss your research or work experience.
  • Why do you want to go to this particular school? Why should they want you to go there? Tell them why you are a good match for each other. Look up the professors you want to work with, and name-drop in your applications.
  • Get feedback from other students that have written research statements. Then get feedback from the people writing your letters of recommendation.
Other components of your application
  • Standardized test (GRE and TOEFL) -- don't look illiterate in the verbal
  • Personal statement -- women in computer science already stand out, so go ahead and ride that wave. If there is anything else unique about you, use it to your advantage
  • Funding -- If you have applied for funding (even if you do not know if you got it), committees look favorably on students that take the initiative to seek their own funding. NSF has funding for graduate students (e.g., NSF Graduate Research Fellowship Program).
Rough application timeline
  • May -- August (end of Junior year)
    • Take GRE
    • Think about recommendation letter writers
    • Research schools and professors
    • Narrow down research focus
  • September -- October (beginning of Senior year)
    • Ask for recommendation letters
    • Write research statements
    • Fill out applications
    • Fill out NSF GRFP application
  • November -- December
    • Submit applications
    • Submit NSF GRFP
    • Follow up about recommendation letters
  • February -- March
    • Hear back from schools


Question and Answer

Q: For international students: When applying to graduate schools, how often is it that your application is rejected because of lack of funding (e.g., need-based funding)? Does applying for funding diminish your chances of getting in to graduate school?

Aude: It won't affect your chances of getting in. If you get accepted for a PhD you will get financial aid. At the MS level it's different: if you're good then they will accept you; if you're in the top 5% you may get financial assistance.

Q from Holly from University of Waterloo: What are some of the courses that you really really wish you had taken but didn't have the chance to, or didn't think to at the time?

Katya: It's never too late to pick up a topic that you feel you missed. I did not take computer science in undergraduate. If your interests change you can get back on it. It is good to get advice from graduate students in your school to find out what they feel the core classes are and who the good professors are.

Judy: If you really like something, don't be afraid to delve deeper and take a graduate course as an undergrad. It will give you a godo idea if you really like that topic, and will help you to look good on an application.

Q: When you ask a professor for letters of recommendation, do you have to tell them the list of schools they are writing the letter for? Do they have to write a separate letter for each school? What if I'm still in the narrowing-down process?

A: The professor can help you figure out which universities to apply to. You can have a conversation with your professor.

Q: How many schools should you have when you're applying?

A: I did it wrong. I applied to Top 3, and then Berkeley. Don't do just four. Remember when you were in high school they told you to apply to the really high ones, the middle ones, and the ones you know you'll get in to.

Judy: I applied to 9 schools. I think that was good. Because the schools are so specialized it's hard to know which one you'll fit in to, which one has nice professors, the school size -- you can't get a good sense of this stuff from just reading their website -- until you visit.

Katya: Apply for your dream school. You might as well. Dream school, middle schools, and safety schools.

Aude: You will likely live 5-6 years in the same location. So visit the school. If you can't stand the cold weather, don't go there, because you will be miserable.

Audience professor: Some schools will let you continue modifying your online application even after the deadline.

Q: How do you know what's a safety school, what's a top school?

Elena: I went to my professor and asked. You should apply to just one safety school. It should still be a good school but not highly ranked.

Q from Jesse from Rice University: When is a good time to go to grad school? Work experience in industry or right after undergraduate?

Elena: Some people have a hard time going back to graduate school after having been gone for a while. You go to grad school, the stipend is not that great compared to industry pay. Having to do homework. It is good, though, to go to industry to get perspective on what you want to do

Judy: Some companies will sponsor you to go to school. There are companies that will send you to school with the understanding that you will work for them for a few years afterwards. Some schools offer a 5th year option that grant you a Master's degree.

Elena: It's something you should get lots of opinions about, so that you can form your own opinion from those.

Q: Thank you for being here to give us precious tips on how to apply for graduate school. I am a graduate student, but also: Surprise! I'm here to tell us about my school. I'm from University of North Texas. We have a dozen funded PhD positions in different domains and areas.

A: A plug for going to graduate school. It's awesome and where I learned to ski.

Q: Another general question related to the admission process. Should I get a MS before a PhD?

A: Having a Master's will increase the expectation that people will have of you. If you have an outside interest, you should take 

Q: Is it good to put things that make you stand out, for example, screenwriting?

A: YES. That's something that will go in the personal statement.

Q: Should you get a Master's and a PhD in the same school or in different schools?

A: You apply to an MS/PhD program in many schools. It's possible to get a Master's in one school and go to another school in a PhD. But in many

Q: Is there anything of value in getting a Master's degree? Would you recommend it?

A: You want the escape pod. If you decide that you don't want to do the PhD, getting the Master's is a way to show that you spent time in graduate school.

Judy: If you get there and decide you don't like it, you can leave after you have your Master's. So you can apply for a PhD and know that there is an option.

[ Break out sessions ]

END

Letter to my younger self: Things I wish I knew when I first started working

This is a post about Letter to my younger self: Things I wish I knew when I first started working at the Grace Hopper Celebration for Women in Computing conference, October 2012 in Baltimore, MD.

Moderator: Chiu-Ki Chan (Square Island LLC)
Panelists: Rupa Dachere (CodeChix.org), Christina Schulman (Google)

The audience in the session was about 50% undergraduate students -- and Chiu-Ki said that most of the material is intended for undergraduate students.

Christina: Learn from your co-workers.

  • Read their code, participate in code reviews. Do not work in isolation if you can help it. A fancy title does not count as leadership experience; strive for something more.
  • Ask about company and group processes in interviews. Companies with bad processes give you bad habits that are hard to break. Code reviews are a good sign. A lack of automated processes is a bad sign.
  • Work on things you do not already know how to do. Grow your abilities. Do not get stale. 
  • Even if you are the perfect person for the job, it doesn't mean that it is the perfect job for you.


Chiu-Ki: What is the difference between school and work? In school, you take courses and you do exams. You have a clear path and you know when you are done: there is an end goal: graduation. At work you may not have that end goal. It may be clear. Another difference is at school, you have an advisor and professors helping you; at work, nobody is making sure you are growing and taking charge of your career. At school, you get grades so you know if you need to work a bit harder -- for example, if you get a B. At work, you have to figure out how you are evaluated. Your work does not speak for itself. If you are working hard, make sure that other people know what you are doing. Tell people what you are doing. An e-mail, for example, saying "Just a quick update on X" or "Took me a while to figure out how to do X but I figured it out and here is the solution." Answer e-mails right away. Even if you are not 100% sure of the answer, and even if you should probably verify -- just outline the steps that you would take. As your name appears more and more in a team setting, people come to associate you as someone that knows the answers. Learn to say no. In school, you cannot say, "This week I will not do this project." But at work, you have a say in the work that you take on. Question your projects and make sure they align with your goals. Defend your position and you will earn respect with your team.

Rupa: I will tell you the lessons I have learned on how to grow yourself.

  • When I started programming, I thought that writing beautiful, modular, efficient code was the key to doing well. But writing code is not enough to get a project done end to end, but getting a project done end to end is incredibly important. You need to grow yourself from a sous chef to a head chef. Be the person that glues the project together by appeasing people on both sides of the project. 
  • Next, figure out your manager. Is s/he a morning person? What is her/his personality type? How will you help your manager help you? Learn to manage your boss.
  • Your review. This is the most difficult and stress-inducing things in our industry. 
  • First, set concrete goals for every quarter. For me, my manager and I meet every quarter and discuss my goals. You never know what might change (the market, the economy, technology, ...). If your goals are not aligned with your manager's, you need to align them. Next, find out how your project and your team is viewed by your peers, your manager, and others. Mangage the perception of your accomplishments.
  • Know your review universe. Think of a Venn diagram and draw your review circles inside it. Is it your manager? The guy in the next cubicle that knows your personality? Do folks you worked with in the past have a say in your review? Network very well and understand the pieces that come together to affect your review.
  • Be genuine and be helpful.

Christina: Networking.

  • You have to build your network before you need it. I am not saying that you have to go out and hold a big party every other month -- that is exhausting. But I am saying that the power of knowing a friend of a friend of a friend is powerful. Then you will never be looking for a job -- your next job will be looking for you.
  • Networking is about helping other people. Plan to put more into it than you get out of it. Most of the time you will be helping to connect people across your network. It's little benefit to you, but will be hugely beneficial to someone in your network. Don't be the person that is always asking for a favor -- call to say hello, or thank you, or invite to lunch. Your network should be broad and lacking in holes.
  • Carry a business card, dammit.
Rupa: Negotiate your job offer
  • Figure out what is most important to you. Is it base salary, benefits, vacation time, commuter passes, free food, maternity leave, location, etc.?  Rank these.  Then, gather as much information as you can about things like base salary for the position based on your location and experience.
  • Keep calm. Be confident. And be really polite.


Skits!

Act 1
A software engineering position to Rupa at Foosoft.  Rupa wholeheartedly accepts.

[ Audience boos ]

Act 2
Rupa negotiates: Can you do something about base salary, bonus, vacation, stock options, a pony... Christine says no to everything and they settle on the original offer.

[ Audience cheers ]

(You asked, and you didn't get it -- but you still got the original offer)

Act 3
Rupa negotiates again, with a higher competing offer. The details of the offer are confidential.
[ Time passes ]
Christine comes back with a better offer and more stock but not as high as Rupa wants. Rupa now negotiates some more. Asks for a month of paid vacation.
[ Time passes ]
Christine offers a signing bonus. Rupa wholeheartedly accepts.

[ Audience cheers ]

More information is online at http://bit.ly/ghc12-letter.


Question and Answer

Q from Emily from Portland State: How do you go about handling competing offers coming at vastly different times?

Rupa: Rate the places you interviewed from most interesting to least interesting, and wait until you have an offer from the most interesting place.

Christine: Larger companies are aware that you will not graduate until June, so even with, say, a February offer you will not be expected to start until June.

Q from Jo at LinkedIn: I have a problem where I'm incredibly transparent about my enthusiasm. I have no poker-face. I can't negotiate. I'm just happy to do this job, and they can see it all over my face. How do I negotiate if it's so clear that I want it?

Rupa: What is your next step -- what are you trying to achieve? Change fields slightly? Set your goal and 

Christine: I didn't negotiate my offer from Google because I got an offer from Google. Just ask, even if you're crying tears of happiness.

Chiu-Ki  You don't have to be unhappy with an offer. You're just saying, "Can you do better?" Tell yourself to just do it. Ask. If that doesn't work it's a learning lesson. It's a back and forth.

Jo: This is very helpful for someone that is not a student and has gone through

Q from Jana at Columbia: What are disparities in pay between women and men like in tech, and how do you battle it?

Rupa: Go to those sites that I mentioned and find out the expected salary in your region. When you look up those numbers, put in a male name. That is one way to know what the going salary expectation is. These sites have a lot of information on the numbers and also the benefits.

Christine: Part of the reason that this disparity exists is because women don't negotiate. There is a good book called Women Don't Ask

Q from ??: It is hard for me to think about making a mistake, translated into being overly cautious. I don't want to come across as silly or unaware.

Chiu-Ki  That's the whole reason we had Act 1 and Act 2 for you. Nobody is going to say, "Oh, my gosh, she is so aggressive" for the rest of your career.

Rupa: I'd recommend that it's how you ask. Be polite. Use terminology that is not overly aggressive, but ask.

Christine: Research the heck out of it. Ask your fellow students what kind of offers they're getting and compare. Get them drunk first if you have to.

Chiu-Ki  I practiced technical questions and presenting myself as a professional by going to interviews for jobs that I didn't care for. Then I had competing offers on the table so I had some data about what companies offer. If you don't care about the job, you'll be more comfortable asking questions and making mistakes.

Rupa: You should picture yourself as male. Fight for it like a man would do.

Chiu-Ki: I tried to push the boundary and realized that the boundary was not there.

Rupa: With a recruiter it's okay to be aggressive. They expect it.

Q from Lauren from University of Richmond: Is there a limit in the appropriateness of negotiations depending on the position that you're applying for?

Rupa: If you are, say, in a state that you are being expected to work full time but will be unable to fulfill the obligations, don't lie.

Christine: Are you asking if there's a number that is perceived as obnoxious? I'm an engineer; everything is less terrifying when you have data. It is perfectly reasonable to ask what is the range for this position, when you apply.

Rupa: Go to GlassDoor.com and read reviews on what companies are like to work for. Look up the atmosphere for the group as well.

Q from Liz from ?? College: What would you tell someone that's entering the job market for the first time, that doesn't know what to get into?

Christine: It is hard to give a blanket statement. Work with people that know more than you do. The good thing about a start-up is that you have to do everything. In one place, I had to build my own desk; in some places, there are people that keep your computer running.

Rupa: My personal recommendation is, unless you are super entrepreneurial right off the bat, I would recommend a slightly mid-sized company so that you can learn the ropes. Once you learn the ropes, you can switch into a start-up where you have to know the ropes day one.

Chiu-Ki: My take on this? Internships. That's what they're for. Do one at a big company and do one at a start-up; then you have data.

Q from June from Indiana University of Wilmington: ???

Christine: Ask the company how many shares they have standing and what their valuation is. Do not believe them when they say their stock will split many times when they go public.

Q from ??: How do you balance being aggressive with being diplomatic?

Christine: Own your inner bitch.

[ Applause ]

Chiu-Ki: Most of us are leaning toward the non-aggressive side. It will be a long time before you become a bitch. You don't wake up in the morning and go, "Am I bitchy today?" Unless you have been told that, it is not a valid concern.

Q from ??: What is a polite way to reject an offer?

Rupa: I had 45 interviews in 3 months. I would talk to the recruiter and say, "I am very sorry, I have a competing offer that I just cannot refuse. You understand; the market is really hot. I would like you to keep me in mind and I hope we can talk again at a later point."

END

Friday, March 2, 2012

A rant on single-blind peer review

Let's say you write something novel and clever and technical, and you submit it to a conference for consideration. If the paper is accepted, you will go to present the paper, and (depending on the conference) it can be published in some digital or paper proceedings. To determine if your paper (or poster, or whatever) is accepted, it undergoes what is called peer review. The program organizers electronically corral experts (or budding experts) in the field to read the submissions and provide critical feedback. These are your peers because they are in the same general field as you are. Some reviewers have more experience than you do, and others have less.

There are usually three or more reviewers per paper, and the reviews are usually in the following format.

  • There is a score which correlates the degree to which the reviewer thinks the paper should be accepted. For example:
    • -3: Strong reject
    • -2: Reject
    • -1: Weak reject 
    • 0: Neutral
    • 1: Weak accept
    • 2: Accept
    • 3: Strong accept
  • There is a narrative describing the paper's strengths and weaknesses, suggestions for improvement, layout and organization, and critique of the bibliography. Reviewers answer the question of whether the paper makes a significant impact or contribution to whatever field the paper is representing.

Sometimes there is a meta-review, provided by another peer, which synthesizes the other reviews into a short blurb.

Selecting papers for publication goes something like this. The reviewers' scores are tallied for each paper, and the papers are ordered from highest to lowest score. The program organizers decide how many papers to accept, and that number of the top-scoring papers is selected. If the reviewers provided any notes to the program organizers, or made specific suggestions for accepting or rejecting a paper, these submissions are taken on a case-by-case basis.

There are two types of peer review that are used most frequently: single-blind and double-blind.

For single-blind peer review, you submit your paper as it would be published, with your name and affiliation at the top. Reviewers can see this. But when you receive your paper reviews, you do not know who wrote which review because the reviewers' names are not provided. It is single-blind because it is blind to you, the author.

In double-blind peer review, you remove your name and affiliation from the paper, and try to anonymize it as much as possible. For example, if you write somewhere, "Our previous work at University of Waterbucket, our home institution," you would take out the reference to your institution's name. Reviewers are discouraged from trying to infer the authors of the paper, and thus should (in theory) not be biased based on your identity and the identities and affiliations of your co-authors. The reviews are also anonymous. It is double-blind because it is blind to the reviewers, and also to you, the author.

There are two reasons that I dislike single-blind peer review.



Because you are remembered


Pretend for a second that a particular reviewer has a chip on his (or her) shoulder about your research area. Or about specific methods which you might have used. For example, the researcher hates video games and thinks that people that play games are worthless in society, and your paper is about a game to examine social interactions, such as Prom Week (which is a fun and lauded new Facebook game; if you have not tried it yet, do). The review will say something like this.
Rating: -2 (Reject) -- The authors present a video game that lets the player make and break friendships in the week before the high school prom. The authors failed to cite relevant literature regarding the misuse of gaming technology and associated aggressiveness in players. The proposed game promotes poor behavior and sensationalizes high school relationships which are fundamentally flawed. Arguing for not accepting this paper.

Now, you can get a review like this even with an anonymous paper. But what can happen next is that the reviewer remembers your name or affiliation -- consciously or otherwise. And when your name comes up again, either in another conference for which he (or she) is peer-reviewing, or dropped in conversation when networking, or presented as a Nobel Peace Prize recipient, the reviewer will remember you for the paper he (or she) rejected. Your name has been associated with That Thing He (or She) Hates (With a Passion). Even if you write on another topic entirely, you are remembered for the paper that was a flop.


Because of the discourse


The second reason is that when you receive this angry or scathing or unfair review following the single-blind process, there is nothing you can do. When you do not know who he (or she) is, you cannot engage the reviewer in conversation; you cannot further the discourse of your disagreement. And when you do not know where he (or she) lives, you certainly cannot mail the reviewer a box of flaming poop.

Thursday, March 1, 2012

Teaching HCI and Jeopardy

This quarter, like most Winter quarters, I am a teaching assistant for the human-computer interaction (HCI) class on our campus. It is a mixed undergraduate and graduate class, and is cross-listed to two or three departments (this year: two). There is always a group project, and my job as a TA is to advise the groups on their projects. This was a slow week, in terms of project deliverables, so I thought we would spice up the discussion sections with a friendly game of Jeopardy.

A night or two before, I made a game using the software on Jeopardy Labs incorporating the topics in the first or second slide deck that the instructor provided on the course website. I took the questions -- err, the answers -- directly from the class notes, verbatim. One interesting thing to note is that we do not have regular assessments of rote memorization -- that is, there are no quizzes, no multiple-choice tests, and there is no final exam in the class. Instead, every assignment is project-based. It is an engineering course, and as such, we expect students to incorporate elements of theory and coursework into their engineering (or reverse-engineering) as required by the assignment.

So when I pulled out the first month's content in the Jeopardy game (which you can play online for free) I was unsurprised at the number of wrong answers... though I did wish there were more correct answers. What I found surprising was each of the three discussion section's reaction to the game.

In section A, at 11am,  four of the five groups actively participated in the game. Group sizes ranged from two to five students per group, with the two-person group leaving the game with 0 points (likely indicating that they did not answer any questions).


Group Group Size Score
A.1 4 300
A.2 3 -400
A.3 3 -500
A.4 5 -1900
A.5 2 0


Negative points indicated groups that would volunteer to answer a particular question (or provide the question for a particular answer) but would get it wrong -- thus subtracting rather than adding the points. Group A.1 won the game with 300 points; Group A.4 had the lowest number of points at -1900. Several members of the group, representing the largest group in the section, would attempt answering the most difficult questions -- frequently getting the answers wrong -- but engaging the class in merriment commiserating on their loss (after loss, after loss) of points.

The total points awarded in Section A was the sum of the absolute value of each group's points, or 3100.

In Section A, I did not allow other groups to answer the question after one group provided an incorrect answer. I did, however, provide hints when the answers were not given quickly. For example, I read: "This technique is used to test a system or complicated components of a system that do not exist."


One student was rubbing his head, and another was softly muttering under his breath: "Oh, oh, I remember this, oh!" -- or "I can even visualize the diagram, with the one guy in a different room with the curtain drawn."

I said, "That's right, it's like he is a man behind the curtain."

I waited a little longer.

"Dorothy would use this technique."

"Ding ding! What is Wizard of Oz?"

"That's right!" I exclaimed.


Section A played the game with a great, positive attitude. One student said, "This is fun! We should do this again!" to which I replied, with a wink, that next week, another game awaits.

Section B, at 12:30pm, had three groups. In this section, the largest group (B.2) had the most points at the end of the game, and the smallest group (B.1) had the least points. There were 1700 points distributed in Section B, indicating that groups had the chance to make a comeback -- the point total does not capture if a team has a string of bad luck followed by a string of good luck, or otherwise has a mix of correct and incorrect answers. Each of the three groups actively participated in the game, and, when I threatened another game next week, a student responded that it's high time to study. Right answer!


Group Group Size Score
B.1 2 -500
B.2 5 800
B.3 3 400


Students in both Section A and Section B avoided the Grounded Theory category like the plague. The last category standing, one student in Section B asked, "Can you give us a hint on what Grounded Theory is? Before I select it as a category?"

I thought for a moment, about whether to facepalm or giggle. Instead I just stared blankly at the student until he said, "Uh, never mind -- I'll take Grounded Theory for 100."

In Section B, I provided more hints. "These can be administered to large populations and can include open or closed items," I read from the screen. I waited a few moments. "It starts with a Q." I waited a few more moments. "The second letter is a U."

"Ding ding!" a student called.

"Ding?" I asked.

"What is a questionnaire?" the student answered.

"Correct!" I said, bouncing a little. "Good job!"

Section C was the smallest of the three sections, with just two student groups. There were 3000 points awarded in this section. But what struck me most was the feeling that the game was unfair. I mentioned earlier that we do not have regular quizzes or other assessment techniques to test memorization and rote learning. However, a huge amount of content is presented -- content that somehow needs to be learned, mastered, and applied to the course project and other design activities.

GroupGroup SizeScore
C.152300
C.22700


The student argued that this activity, playing Jeopardy with HCI concepts and terms from lecture, was testing just that -- memorization. Further, he said, designing a system using HCI concepts, and calling out the concepts by name, are two different things. You can look up the names. But you should be able to describe the concepts.

Further, he said, the class size was unfair. Assuming that each student can answer five percent of the questions correctly (I raised my eyebrows -- hoping he said 95% and I misheard), the student argued that there were simply not enough students in the section to make critical knowledge mass necessary to produce correct answers.

I argued that part of the course is learning how to convey your ideas to an audience, and how to persuade others in the HCI field that your methods are consistent and well-grounded. And the only way you can do that is to know the terms, to speak the language. What's more, I said, it only takes one person that knows 100% of the content to produce correct answers. The number of students in the class should not matter. You should each know all of the content.

Right?

If an HCI student cannot tell me, the TA, the difference between performance measurement and retrospective testing, or the difference between latent and manifest content, does that mean he or she does not remember the terms, or does it mean that he or she does not understand them? Can you make an affinity diagram if you cannot remember it from lecture? Can you apply Grounded Theory when you do not select it as a category in Jeopardy because the entire concept draws a blank for you?

I have TAed classes with weekly quizzes, and classes without. My opinion is that (short) weekly quizzes help the instructor and teaching staff in two ways:
  1. Weekly quizzes clue me in on each student's progress and performance.
  2. Weekly quizzes give the students a list of solid topics to study each week.
Maybe HCI should bring back the weekly quiz, so that a little bit of repetition and memorization makes its way to the curriculum. Or maybe we need to reconsider the course project, and see how we can better incorporate the terms and concepts from lecture into the project. That is the danger of creating adequate project requirements: leaving the requirements too open allows students to disregard the formalism; closing them too much stifles creativity.

What do you think?

Saturday, February 25, 2012

Reblogged: How to have a baby in graduate school


Having babies in grad school: what do you need to make it work? This article was published in ACM-W Winter 2011 newsletter, written by three women grad students (two with children, one without). The article highlights why graduate school is an excellent time to have a child, and outlines strategies for success. I reblog it here with permission from the editor, and include tags which link it to the associated Birds of a Feather session at Grace Hopper Celebration for Women in Computing 2011.


A. Holloway, C. Sadowski and L. Vega. Babies in Graduate SchoolMaking It Happen. ACM-W CIS Newsletter: Celebrating, Informing, & Supporting Women in Computing, 2011. 3.


Babies in Graduate School: Making it Happen
by Alexandra Holloway, Caitlin Sadowski, and Laurian Vega
{fire,supertri}@soe.ucsc.edu, laurian@vt.edu

Abstract
There is never a perfect time to have a baby, but the present is always a good time. For women in graduate school, pregnancy and child-rearing present unique opportunities and challenges. In this article, we discuss ongoing perceptions about mothers in academia, including common prejudices and preconceptions. Although certain trends are helping mothers pursue a tenure-track position or re-enter the work force after starting a family, key challenges still exist for starting a family in graduate school. These challenges include maintaining both good interpersonal relations between partners and good professional relations within our graduate departments. We propose a checklist of the key ingredients for success in childbirth in graduate school—the things we found most important in our own and others’ experiences for starting a family early in academia.

Background
Motherhood is a crosscutting concern for women spanning economic, religious, and cultural groups. A known problem is the “motherhood penalty:” mothers are rated as less competent and committed to paid work than non-mothers, are given less slack about being late, and may be offered a lower starting salary [1]. In fact, within particular demographics the pay gap between mothers and non-mothers is larger than the pay gap between women and men [2].

These challenges are particularly disparaging due to their inequity; children provide a benefit for men and a penalty for women. Fathers are rated as more committed than non-fathers, are given more slack about being late, and may be offered a higher starting salary [1]. In academia, men with young babies are 38% more likely than women with young babies to achieve tenure [7]. Perhaps a partial reason for this difference is the social expectations about who will care for children. For example, a survey of more than 440 faculty in the University of California system found that women with children spend almost twice as many hours per week acting as caregivers than men [7].

Taken together, all of these statistics present a daunting picture for a women thinking about, or starting to venture into, motherhood. Recognizing the problem and educating co-workers is the first step to combating these biases against mothers. Furthermore, research has demonstrated that a mother’s ability to do science does not disappear after having a child. For example, a 2004 survey of German postdocs found that there was not a difference in scientific productivity between scientist mothers and female scientist non-mothers [5]. A similar study looking at working mothers across disciplines in the Netherlands also did not find a productivity difference between mothers and non-mothers [10]. Additionally, working mothers have been shown to have better physical and mental health, higher self-esteem, and financial stability [11].

Much of the difficulty with academia and motherhood is due to the fact that it is difficult to re-enter the pipeline once a woman drops out of the academic workforce [6, 7]. If time is taken off because of a difficult pregnancy or even just to spend time with a young infant, it can be challenging to return to academia. Some programs, such as British Daphne Jackson Fellowships, exist to help female scientists return to the pipeline after taking a leave of absence [5]. Unfortunately, programs to support mothers are not mandatory—not even paid maternity leave. Given the problems apparent at all stages in the academic pipeline, graduate school may be a particularly good time to have children before entering the tenure race.

Recently, awareness has increased of the challenges of combining motherhood with a career in academia as a whole and science in particular [3, 8]. Universities and organizations are taking some steps to improve the position of women who want to combine motherhood with a career in science. Part-time and “stop-the-clock” tenure-track options, which provide additional time before tenure reviews, are becoming more popular [5]. Progress is being made to change the landscape of women in academia.

We present this article for two purposes. The first is to start engaging in the discussions about motherhood in computer science. The second is to raise awareness on aspects of motherhood as a graduate student. With many female graduate students lacking female academic role models (not to mention role models who have children or who are pregnant), computer science as a field is particularly prone to the biases discussed above. To help raise awareness, in this article we describe personal experiences with motherhood in computer science graduate school. We start by discussing problems for women in graduate school, and then provide advice and personal experience on how we combated these problems. We then consider how computer science as a field can respond to—and support—parents in graduate school.

Time Is Ticking
Women in computer science are a rare breed.  Mothers in computer science, at any stage of academia, are an even rarer occurrence. One large problem for any woman in academia having a child is the lack of communal knowledge about and support for this life-changing phase. Computer Science departments may be particularly prone to this problem, particularly at the graduate school level. For example, when one author when told her department chair that she was pregnant and needed to change teaching assignments, the response was not one of congratulations, nor condemnation—but more one of confusion: “What? Students can get pregnant?”

Graduate school involves unique time pressures.  Three considerations in graduate student family life are personal relationships, financial challenges, and the ticking biological clock. We do not have any magic bullets, but we do have key considerations we wish that someone had passed on to us when our babies were “loading.”

Time == Love
Few graduate students strictly adhere to a nine-to-five schedule.  Instead, we work in the evenings, nights, and weekends, playing a careful balancing game between work and personal life. This can lead to multitasking and unclear divisions between work and home life: while our code is compiling we may be heating up a bottle, running a load of laundry down to the washer, or quickly uploading baby pictures. Time is precious, and given how little of it is available, finding time to spend with a romantic partner can be vital. Given that leisure time spent with a significant other is already limited, how can we find the additional time to devote to a baby? Will having a child put too much stress on our adult relationship?

Grad_school != money
Graduate student research assistants are compensated by university fees and a living wage stipend, which is less than minimum wage when factoring in the long hours spent working.  In a family composed of two graduate students and no outside support, money can be stretched thin.  According to the National Association of Child Care Resources and Referral Agencies, child care for infants or toddlers costs between $4,388 and $14,647 per year [12]. To put this within the range of the authors’ graduate stipend, child care alone costs  half of our pay, without even accounting for the additional costs of having a child. We ask ourselves: How can we find the money to have a baby?

Time –= 1
For many graduate students, the refrain is the same: “I will wait until my Ph. D. to have children.”  Then: “I will wait until I have a faculty position.”  Then: “I will wait until tenure.”  For men as well as for women, advanced age can contribute to decreased fertility [13,14], a more complicated pregnancy and birth [15], and other possible complications.  Further, it can take some time—in some cases, as long as a year or more—to become pregnant; then, once pregnant, the normal side effects of pregnancy, such as nausea and fatigue, can negatively affect job performance. How long should we wait to have a baby?  How can can we make time to have a child?

Why Grad School?
With these very compelling constraints, why is graduate school a good time to have a baby?  First, a graduate student’s schedule is malleable.  Especially after coursework is complete, a research schedule is generally flexible, allowing the student to work around the baby’s schedule (and the parents to work around each others’ schedules).  Not all universities support tenure programs like stop-the-clock, nor do all employers support extended time off after giving birth. However, it is possible to take a semester off after having a child.

Second, graduate students have youth—hence, energy and creativity—on their side.  A young person can adapt to circumstantial challenges and can overcome obstacles more easily.  Moreover, grad students are surrounded by equally young peers who can help with occasional, free babysitting to let a new mom (or dad) study or sleep. If the grad student’s parents are available, they are also likely to be younger, making it easier for them to travel and lend a hand.

Third, a grad student’s support network is more flexible. Whether due to pregnancy complications or postpartum mayhem, changing teaching assignments formally within the department, or trading schedules with a peer informally, can be easy as a graduate student.

Finally, we answer a question with a question: Why wait?

Strategies for Success
Having a new baby can be a rewarding yet challenging time for any family. In the first months, the parents are up throughout the night, frequently as often as every two hours—and that is if everything is all right.  Meanwhile, meals need to be made, the house needs to be cleaned, and, perhaps most importantly, graduate work needs to move forward.  These are the ingredients we have found to be key in making childbearing in graduate school a reality.

A Supportive Advisor
An advisor that supports his or her student’s decision, both in word and in deed, to have a baby is a keeper.  The support can be as mild as suggesting ways in which to make sure classes are completed prior to the birth of the child; providing a flexible schedule to allow the student to work in the time between infant feedings; relaxing the deadlines, understanding that the student’s probable decrease in productivity is temporary (although one atypical new mom reported clocking in 80 hours the week after giving birth to twin girls).  One progressive advisor suggested to her student that she Skype in to all of her classes after giving birth, and allowed all work to be completed from home.

If your advisor seems cool to the fact, ask outright about his or her feelings about your impending motherhood.  The battle over work responsibilities will not stop at the baby’s birth but will continue until either you graduate or you move to a different advisor.  If your advisor assumes you will continue producing at the pre-pregnancy level without missing a beat, one of you may end up disappointed.  Think proactively.

Adequate Me-Time
With all the work that is waiting, it is easy to lose focus of what is also important: You. Not to make having a child seem insurmountable, but there are times when your child is first born when time feels like the enemy. There is just not enough of it to sleep, work, and eat. This lack of time can lead to the malaise that overworking and under-sleeping induces. There are two things that can help you re-charge and re-focus. The first is spending time telling people objectively how cute your kid is, and breathing in the new-baby smell of your kid’s hair. The second is taking time for yourself. Find time to read a book, go on a walk, play video games, go to the gym, or do whatever it is you need to do to recharge.

Although it may be difficult, realize that there are times where you might have to put your career first. There are times when your kid is sick, and he really wants to be held, but you have to get that paper edited by midnight. For one of the authors, her baby boy had just had surgery for ear-tubes earlier that day, but because there was an important networking event that night, she had to leave her child with her partner. There will be conflicts between your career and your family. Knowing that sometimes it is okay to put your career first can help with this dichotomy.

An Amazing Partner
A pinch of prevention is worth a pound of cure. If a partner is involved, having an honest conversation with him or her, in advance, about what is expected postpartum can smooth the new-parent transition. Who is going to do the laundry? change midnight diapers? go grocery shopping? If no partner is involved, the bright side is that there will be no conflict about who will do all of these things. There is not any way that you can prepare for everything before the baby comes, but setting expectations will help. For one of the authors, having a partner who understood that she might be a mom, but her career was important, made a large difference. This meant talking about how soon she might want to return to work, what child care options were available, visiting the child care centers together, and setting some ground rules. Those rules included who pays certain bills, who gets to work which nights late, who stays home when the child is sick, and who does the grocery shopping.  If a partner is not responsive to talking about these issues, parenthood, in general, can become very difficult.

A second benefit of an amazing partner is having someone who values your experience. The shock of being walked in on while expressing milk with a breast pump in a mostly male department is, to put it mildly, upsetting. Or, when people start asking you if you are planning on staying in graduate school now that you are pregnant (because pregnant women should be barefoot and cooking), you need someone at home who will let you express your feelings and then help you react. Or, when you get told for what feels like the hundredth time that, “You must have a very supportive partner,” and you realize that a man in the same position would not get told the same thing, a discussion with your partner about the (hopefully unconsciously) biased workplace is key for your own sanity.

Trustworthy Child Care
You can’t start code-slinging again when you literally have your baby in a sling. Find someone that you can trust your child with, even if it is for only a few hours.  Trust is the key part in that sentence: check with friends, listservs, and websites  for good home care, child care centers, and nanny shares.  Talk to pregnant women; talk to both men and women swinging their toddlers in the park.  They face the same decisions, and have probably investigated some of the same, or different, options.  One point of advice, though: mom-networks are often sources of second-hand information (e.g., Sally says that Sue says...). Verify anything you hear.

There are many options for trustworthy child care, even though it might not feel like it: day care, live-in nanny, live-out nanny, nanny-share, au pair, and stay-at-home partner are just a few of the options.  Just because you visited a child care center when pregnant and you know that it is the right place for your child, that does not mean that in six months you will still feel the same way, when you leave your kid there for the first time. Similarly, just because you like your child care solution does not mean that your child will. Anything can happen: your nanny might move (or graduate); your child care center might close down; you might realize school is too far from the center. It is important to stay adaptive and recognize that you can find alternate creative solutions.

A Support Network
Tap into your family network: your parents, your partner’s parents, and even cousins, aunts, and uncles.  One of the authors was able to attend classes for a quarter by asking her partner to take her infant every Tuesday, and mother to come every Thursday for ten weeks.  Ask friends.  Be creative, accept help when it is offered, ask for help before it is needed, and be thankful.

Having a baby changes your outlook on life.  Suddenly, your priorities shift entirely, and it can be a bit of a culture shock to realize that you have a hard time relating to the friends who have not yet had children.  If they are interested and supportive of your life’s changes, bring them up to speed and include them as much as they like.  But also, find other new and expectant moms that can share your experiences.  Even if you are the only female graduate student you know, we promise that you are not the only mom in town. Find others who are having kids. Your ob/gyn may know of a working-mom support group, and you could ask your graduate school about any university-wide efforts.

A Positive and Grounded Outlook
As a final note in the checklist, be positive and celebrate your accomplishments as they come.  Enjoy these limited years with Thesis Baby as much as possible and keep the big picture in mind.  In the grand scheme of things, your child’s infancy and toddler years, and your dissertation years, are short.  For many working women, compartmentalizing motherhood and academia is an ongoing battle: when working on your research, you feel like a bad mother because you are neglecting your child, yet when with your child, you feel like a bad student because you are neglecting your work.  Our advice is to remember the big picture, and try not to let the guilt take over.  Being a grad student is mental exercise and is as important as having a child.  Both of these aspects of your life make you a complete, unique, and fascinating woman.

Making It Happen
One mother-professor, known to store expressed breastmilk in her laboratory refrigerator, quoted Gandhi: “Be the change you wish to see in the world.”  The only way to change perceptions of, and biases associated with, mother-students, mother-faculty, and mother-professionals is to gently, firmly, and consistently prove these perceptions wrong.  Show the world that it can be done: mothers defend their dissertations; mothers produce quality work; mothers are incredible, productive professors and industry professionals.

Conclusion
Having a child is a life-altering event, no matter when the child comes.  However, being a student should not impact a mother’s decision to have a child. Computer science and engineering, to succeed as disciplines, are positioned to examine how to support students with lifestyle circumstances such as having a child in graduate school.  Our generation of student-mothers paves the way for student-mothers that come after us.  In this article we presented reasons having a child in graduate school are favorable yet difficult, and have presented some of the tools and strategies that have helped make our experiences with being student-parents easier.  Finally, we end this article with a request from the authors to women faculty: be the kind of role model you would want to have.

References
[1] S. Correll, S. Benard, and I. Paik. Getting a Job: Is There a Motherhood Penalty? American Journal of Sociology, 112(5):1297–1338, 2007.

[2] A. Crittenden. The price of motherhood: Why the most important job in the world is still the least valued. Metropolitan Books, 2001.

[3] E. Evans and C. Grant, editors. Mama, PhD: Women Write About Motherhood and Academic Life. Rutgers University Press, 2008.

[4] G. Gehring. Mixing motherhood and science. Physics World, 15(3):18–19, 2002.

[5] V. Gewin. Baby blues. Nature, 433:780–781, 2005.

[6] M. Mason and M. Goulden. Do Babies Matter (Part II)? Closing the Baby Gap. Academe, November–December, 2004.

[7] M.Mason and M. Goulden. Marriage and baby blues: Redefining gender equity in the academy. The Annals of the American Academy of Political and Social Science, 596(1):86, 2004.

[8] E. Monosson, editor. Motherhood, The Elephant in the Laboratory: Women Scientists Speak Out. Cornell University Press, 2008.

[9] S. V. Rosser and M. Z. Taylor. Expanding Women’s Participation in US Science. Global Education, 30(3), 2008.

[10] C. Wetzels. Does motherhood really make women less productive? The case of the Netherlands. Bilbao ESPE Conference, 2002.

[11] L. Bennetts. The Feminine Mistake. Voice, 2007.

[12] Parents and The High Cost of Child Care: 2010 Update. National Association of Child Care Resource & Referral Agencies, 2010.  Retrieved from http://www.naccrra.org/docs/Cost_Report_073010-final.pdf

[13] S Kidd, B. Eskenazi, and A. Wyrobek. Effects of male age on semen quality and fertility: a review of the literature. Fertility and Sterility, 72(2), 237–248, February 2001.

[14] D. B. Bunson, B. Colombo, and D. D. Baird. Changes with age in the level and duration of fertility in the menstrual cycle. Human Reproduction, 17(5), 1399–1403, 2002.

[15] E. Zasloff, E. Schytt, and U. Waldenström. First time mothers’ pregnancy and birth experiences varying by age. Acta Obstetricia et Gynecologica Scandinavica, 86(11), 1328–1336, 2007.

Monday, February 13, 2012

Choosing a birth facility in five easy steps

How do you choose where to give birth? This post attempts to answer the question of how to choose where to give birth -- where to look for data, and what questions to ask yourself.

In the region of the US where I practice, for low-risk pregnancies, there are basically two options: birth at home with a midwife, and birth in a hospital with whoever happens to be on call (sometimes this is your own doctor or midwife).

Birth at home

Choosing a safe homebirth requires forethought. I am not an advocate for unassisted birth, with no medical professional on hand to help. I think that choosing a homebirth is a big deal and requires sufficient preparation. Selecting a homebirth midwife is a lot like selecting a doula, except there is more responsibility involved in a midwife. (And, you should have a doula as well.) Here are some things to ask your midwife when you consider birth at home.

  • How long do you spend in prenatal visits with me? Midwives are known to spend longer in each prenatal visit with their clients than obstetricians or doctors.
  • How do I prepare and educate myself for birth? Some midwives teach their own homebirth childbirth preparation classes.
  • When I am in labor, when will you come to my house? How long will you spend with me in labor? Midwives vary widely on when they will arrive. Some will arrive in active labor and will provide doula-like support throughout the birth. Most will arrive at the end of active labor, in time for pushing, to help you have the baby.
  • How many assistants do you have, and will they be coming to help with the labor? Some midwives send their assistant(s) first for support, and will come later. Others come with their assistants. There should be at least two trained midwives with you: one for you, and one for the baby.
  • What kind of equipment do you provide? Some midwives will bring a birth (yoga) ball and/or birth stool, and may rent a tub for you to labor in.
  • What kind of emergency equipment do you have in your midwifery kit, and under what circumstances do you use it? This should be standard, but should include oxygen, Pitocin, sutures, etc. The oxygen can be administered to the mother or the baby; Pitocin helps with postpartum bleeding; and sutures are used to sew up any lacerations (tears) in the mother.
  • What are the factors that will cause a transfer to the hospital in labor? This is fairly standard as well. Expect answers such as labor before 36 weeks gestation (preterm baby),  induced labor (ask when induction will occur), meconium in the amniotic fluid at any point in labor, baby's heart rate decelerating (measured with intermittent monitoring), bag of waters being open for over a certain amount of time (24 hours, 36 hours), and maternal fever, to name a few. Some midwives will not deliver breech babies and multiples (twins, triplets).
  • How long will you stay with me postpartum, and how often will you check on me and the baby? Expect that the midwife will stay at least a couple hours postpartum, until you are settled with the baby, and will check on you frequently in the following days.
Of course, you can also ask about transfer rates (the percentage of mothers that transfer to the hospital), c-section rates, emergency intervention rates, and so on, but that may not give you a good idea of what the midwife brings to the birth. These numbers could tell you her willingness to relinquish control, or to "allow" interventions to happen to the mother, but there is a chance that all it tells you is whether she has had a run of good luck or a run of bad luck.

Research what other mothers said about their home birth. Check out The Birth Survey project, which is a self-reporting tool in which mothers can enter their own experiences and information in the months after their birth. Keep in mind that these data may be skewed because of selection bias: this is not a randomized study, and mothers choose whether or not to participate.

Finally, skip to Step 5: You are not locked in. Though it may be trickier to switch home birth providers later in pregnancy, it can be done.


Birth in a hospital

Choosing a hospital can be a hairy task. No two hospitals are alike. I hope this guide will help you narrow down your choices.

Step 1: Choose a non-profit hospital.
Nathaneal Johnson of California Watch (2010) reported that for-profit hospitals have a higher c-section rate than non-profit hospitals. And that increase in c-section rates is nontrivial: mothers giving birth at a for-profit hospital have a 17% higher chance of delivering surgically. For-profit hospitals are more likely to perform costly procedures, less likely to serve under-served populations, and less likely to have breastfeeding success.

Step 2: Figure out what's important.
Priorities the importance of the following things: cost of birth, mode of delivery (vaginal vs c-section), c-section rate, breastfeeding success, diversity of population served, infant outcomes, whether you will have a room mate, what language(s) are spoken, where your doctor/midwife practices, how many residents (trainees) there are, how close the facility is to where you will spend most of your labor, and any other factors you consider important to you.

Step 3: Do the research.
There are several ways to look at birth facts. Check out Health Grades and search for the hospitals in your area. In California, you can use California Watch to look at statistics. For example, say I wanted to compare San Francisco General Hospital (SFGH) and UCSF Medical Center (UCSF) -- both non-profit teaching hospitals in the center of San Francisco, California.

Figure 1 shows the California Watch page for SFGH. Interesting things to note here: the decreasing trend of the low-risk c-section rate across three years, and the most recent reported average is 11.10% in 2007, much lower than the US average of 33%. This is very reassuring if mode of delivery is important to you and/or you wish to avoid a c-section. The Hospital Info section below tells you that SFGH is a non-profit teaching hospital that caters to under-served families, with over 60% of the patients coming from a low-income household. If breastfeeding is important, the 88.90% exclusive breastfeeding rate is a very good sign, and there is a positive correlation between beginning breastfeeding in the hospital before discharge and continuing to breastfeed for at least a few months postpartum. Finally, the (risk-adjusted) VBAC (vaginal birth after c-section) rate is a promising 30.23%.
Figure 1: Decreasing c-section rate for
San Francisco General Hospital (California Watch)
Click to enlarge

Figure 2 shows the California Watch page for UCSF. You will notice that it is very similar to SFGH: relatively low c-section rate of 14.20% in 2007 (compared to the US average of 33%), even when you look at the base c-section rate: 19.47% of all mothers, even high-risk mothers, deliver surgically. About 30% of the patients are low-income, judging by the insurance carrier. The breastfeeding success rate is 74.77%, which is still very good -- three quarters of all babies born at UCSF are exclusively breastfed when they check out. The risk-adjusted VBAC rate is 24.23%, which is fairly good.
Figure 2: Information on the University of California - San Francisco
Medical Center (California Watch)
Click to enlarge
Another thing these charts do not tell you include whether or not vaginal breech birth is attempted at each hospital (it is).

Health Grades gives both of these hospitals one star for maternity (worst grade possible), but it is unclear why. So let's take a look.  Figure 3 shows that San Francisco General Hospital (SFGH) and UCSF Medical Center (UCSF) each has one star. SFGH reports 64% of the cases that UCSF received in 2011 -- implying that SFGH is a smaller hospital. But here is where it gets interesting.

At SFGH, 2544 women delivered vaginally (79.62% of all women that delivered at SFGH in 2011), 12.23% (N=311) had complications related to the vaginal delivery.  But the national average for complications is 8.21% so we would expect only 209 women to have had complications. So more women have complications at SFGH due to vaginal delivery than the US average.

We know that SFGH had a 11.10% c-section rate (in 2007) from Figure 1 and we will assume the same c-section rate in 2011. In Figure 3, we see that there is a 20.28% c-section complication rate. That is, of the 651 women that delivered by c-section at SFGH, 20.28% of them (N=132) had complications related to the surgery (e.g., infection, excessive bleeding, etc.).  But, the national average is 4.34% so we would have expected only 29 women to have had complications. So, the c-section complication rate at SFGH is more than four times the US average.

At UCSF, 3745 women delivered vaginally (74.81%). Of these, 15.09% had complications (N=565). The national average for complications related to vaginal delivery is 8.21%, so we would have expected only 308 women to have complications. The vaginal delivery complication rate at UCSF is almost twice the US average.

Now, UCSF's c-section complication rate is a little worse than SFGH's, at 13.16%. That is, of the 1261 women that had c-sections, 13.16% of them (N=166) had complications. Since the national average is 4.34%, we would have expected 55 women to have had complications. The c-section complication rate at UCSF is three times the US average.

Health Grades does not explain the "Newborn Survival" column so we have to take it at face value, and, if possible, compare the newborn survival (text) across the hospitals we wish to examine.

Figure 3: One-star ratings in maternity care for San Francisco General Hospital
and UCSF Medical Center (Health Grades)
Click to enlarge

If we wish to investigate whether there is a difference between any of the following, we can run a quick Chi-square on the data from Figure 3.

  • SFGH and the national average, in terms of vaginal and c-section complications
  • UCSF and the national average, in terms of vaginal and c-section complications
  • SFGH and the UCSF, in terms of vaginal and c-section complications

We find that indeed, there is a difference in all of these categories. Although calculating Chi-square does not give us the direction of the relationship, we can see that SFGH and UCSF both fare poorer than the national average, and that c-section births at UCSF are more than twice as likely as expected to have associated complications. Yikes! Figure 4 contains all of these calculations.
Figure 4: All correlations for SFGH, UCSF, and the national average.


Research what other mothers said about their birth experience at the facility you choose. Check out The Birth Survey project, which is a self-reporting tool in which mothers can enter their own experiences and information in the months after their birth. Keep in mind that these data may be skewed because of selection bias. For example, SFGH has 60% under-served population; are mothers from this group more or less likely to fill out an online survey than higher-income mothers, in the interests of science?

Ask your friends about their experiences in the facilities. One gal I know praised her birth facility for its harp music and tea time in tones that I understood to be insincere. Then she divulged that she had a room mate, and she hated the experience of someone else's baby crying in the night next to her own bed. No amount of tea could make that memory go away.

Step 4: Visit.
Knowing, on paper, that these hospitals are so similar, how can you choose the right one for you? Visit. Maybe it is a prenatal appointment with a midwife or obstetrician. Maybe it is a procedure, like lab work or the 20-week ultrasound. Maybe it is a maternity center tour. Get a feel for the dynamics of the hospital, for the nursing staff, and for the check-in and check-out procedure. Imagine arriving in labor at rush hour. Is it crazy, with papers flying and nurses pulling their hair out? Or is it a smooth and calm atmosphere? If it is a teaching hospital, ask when the new residents start their training. If their first week corresponds to your due date, and that makes you nervous, that could be a strike in the "no" column. If you are taking a tour, look around the birth room and ask what kinds of things the nurses usually try to help a mother labor. Look for answers that promote relaxation (e.g., birth ball, music player), movement (e.g., waterproof wireless fetal monitors), and hydrotherapy (e.g., bath tub, shower). Ask about routine procedures and if any of them can be skipped (e.g., pubic shaving, IV, Pitocin for labor augmentation).

Step 5: You are not locked in.
Even if you have made your choice of birth facility, or obstetrician, or midwife, or doctor -- whatever -- you are not married to that choice. You can always, always switch. Remember that you are paying good money for the services that will be rendered to you. You are hiring a medical professional. If you are unhappy with your choice, and you are unable to reconcile it (by talking about it, e.g.), you can switch. I have asked doulas, midwives, and nurses in the past: When is it too late to switch providers? The answer: After the baby has come.

Good luck, and happy birthing!
Related Posts Plugin for WordPress, Blogger...