CP/QF Crazy: Follow-up On Family of 9 Living in a Garage

How freaking crazy can you be?  No, seriously. 

Lots of people dream of living a completely debt-free life.  In the absence of being independently wealthy, most people decide to manage debt responsibly by restricting debt to secured debt like loans to purchase a new or used car or a house, debt that raises the income of the person like educational debt and limiting the amount of unsecured debt like credit cards.  On a more personal level, people committed to living debt free chose to delay child-bearing until one or both people are in secure careers and often choose to limit their family size.  Homes are quite expensive and large families cost more money. 

On the other hand, a lot of CP/QF large families live in poverty while idolizing families who live in even more extreme circumstances.   A common lament of huge CP/QF families where the mother is reaching the end of her reproductive years is that domestic foster care and adoption has ridiculous requirements like that prospective adoptive families who will be adopting unrelated children can show income over the federal poverty level for their new family size.   For new readers, the federal poverty income guidelines in the US are agreed to be absurdly low by people who work in poverty prevention.  A good rule of thumb is that most families need at least 200% of the poverty guidelines to live a frugal middle class life - so the US poverty guideline of  $20,730 for a family of three should be closer to $42,000.    To size this up to QF families, Kimberly at Raising Olives used to complain that their family of 12 kids and two adults couldn't adopt domestically because the family lived on less than $72,620 per year. 

Back in 2005, Amy at Raising Arrows wrote a blog post about a family she idolized who had nine kids living in a garage for one year so they could build the home of their dreams.   In 2018, I wrote my response to the major reasons I could think of why living in a garage is probably illegal; my more obvious concerns were a lack of exits, too little area of windows,  too little square footage per person, infestation prevention issues and the fact that the taxable value of the land is affected by having a second dwelling onsite.  It turns out that Amy managed to get a hold of that family and write a follow-up in 2017; I'll refrain from guessing as to why it took 12 years to catch up with them. 

Turns out some of my unspoken assumptions were just plain wrong.  Silly me - I assumed that living in the garage would start when the family had all of the money set aside to build the house so that the time living in the outbuilding would be limited to a single building season.  Oh, boy, was I naive!  FIVE YEARS!  The family lived in a garage for 5 freaking years! 

I'm still shocked and horrified - so I guess I'll start with the size of the garage.  The family says that the garage was 24' by 30' and at least partially built to purpose for living in.  The square footage is 720 square feet.   Now, the 1986 guidelines for safe living spaces stated that the minimum square footage could be calculated by 150 + 100(n-1) so a family of nine would need 150 + 100(8) or 950 square feet minimum.

Now, if I was living in a garage, I would be on like 5 forms of birth control - including "we're not having sex until we get a real house or apartment" followed by 4 other forms.  Apparently, I'm crazy because the family happily admits that two children were conceived and born while living in the garage.  That pushes the minimum square footage to 1150 feet - but I'm more horrified at the idea of adding two newborns sequentially to a garage home.   The family mentions that the time they lived in the garage was extended because of unexpected building costs and high medical bills.  I wonder how much of those medical bills were due to two labor and deliveries; childbirth is expensive even when everything goes perfectly.

In terms of exits, the garage did have two external doors that were not garage doors.  Assuming the drawing provided by the family was reasonably accurate, the garage was not compliant in terms of emergency window egresses from the bedrooms.  Personally, I'd be very worried about exiting from the kids' bedroom in case of a fire.  There was one small window, an internal exit towards the main area of the garage and an external exit across the room where the washer, dryer and hot water heater were located.  If anything happened involving the washer, dryer or hot water heater, the kids' fastest exit would be compromised. 

Speaking of the garage doors, the "front" of the garage included a large standard garage door.  This threw me a bit at first; why would a family waste that much wall space on a garage door when they were making plans like building 10 foot ceilings on the garage to make it a workable future temporary home?  Then I remembered - the local tax authority would notice in real time if a family wanted to build a second home on a plot.  Silly me and my beliefs about obeying civil codes and taxation.

Really, the author of post sums it up better than I can.  The 5+ years of living in the garage are great in hindsight.   Looking back at my life, I have a lot of memories that are far more fun in hindsight than they were at the time.  After all, memories allow me to enjoy the fun, exciting or satisfying bits without reliving the pain, frustration or tedium.  For example, I chaperoned a group of teens on a mission trip to Beaver Island when I was around 26.  I had lots of fun on the trip - but I also broke my tailbone early in the trip, one of the other chaperones was having what I can only describe as an untreated manic episode, and I was going on slightly less than 5 hours of sleep a night for over a week.   My memories are of teaching my small group to pain sets and watching sunsets over the lake - not the pain of hiking miles each day with a light pack with a broken tailbone. 

Be cautious of taking advice from people who enjoyed an experience only in hindsight.

CP/QF Crazy: Family with 9 Kids Lives in Garage.....

Large family blogs - regardless of whether they claim the Quiverfull name - are a quirky blend of great ideas mixed pell-mell with horrible ideas.   Amy, who blogs at Raising Arrows, often has sensible tips for organizing spaces - but this old post slides rapidly into "Yeah, that's illegal under housing codes and CPS have a field day with this one."

Posted two days before Christmas in 2005, Amy rhapsodizes about the minimalist simplicity that a family of 11 has achieved by living in a two-car garage to save money while building their dream home which will "hopefully" get finished next year.   The family has three-tiered bunk beds with a crib at the end for all their kids!  They have food storage and cooking equipment on self-constructed shelves!  Their living room furnishings are a couch, a chair and a chest!  It's great because the garage already has a built-in bathroom plus kitchen equipment and laundry hook-ups!  Couldn't we all learn from the simplicity of this family?

No.  This is a horrible, terrible, no-good, very bad idea.  Let's discuss why for anyone who hasn't run through why we don't all live in garages.

First, Amy works hard at making the garage seem livable by claiming the built-in bathroom plus kitchen set-up and laundry room is an  "apartment" which is always described in quotation marks.   That's a bad idea because rental units like apartments often have much stricter housing codes to follow than a "dwelling" so let's call it a "dwelling" because it's not going to make the easier codes for a dwelling. 

I've pulled up the APHA-CDC recommended minimum housing standards from 1986.   Now,  as long as the bathroom has a shower and sink, the garage manages to have the basic facilities and equipment required for habitation. 
Things fall apart in the "Fire and Safety Section".

•  A dwelling has to have two separate exits to ground level in case of fire - which many garages do not have.   
• Bedrooms located below the 4th floor of a building have to have a window large enough to act as an emergency egress.   We don't see that often on garages here in Michigan.  
• All external doors have to have a deadbolt lock or equivalent which is hard to do on a garage door.

In the "Lighting and Ventilation" section,  a dwelling must have windows in all non-bathroom spaces that are equal to at least 8% of the total square footage and the windows must be openable to allow ventilation.  In my experience, garages tend to either have horrible ventilation because of too few windows or are drafty.   The drafty ones might survive the ventilation section, but I think they will get dinged later on.  

I don't know where Amy lives - but dwellings have to have a dedicated source of heat according to Section 7.  This heating unit must be able to keep the entire living space - including the bathroom - at 68 degrees F for families that don't include the elderly, ill, or infants.  Since the family idolized in the post contains a 10 month old infant, the internal temperature must be at 70 degrees F.   In my experience, that's going to be one of the biggest challenges for this family if they want to live in the garage legally, let alone comfortably.  Garages are not generally insulated very well - or at all.  Any heat generating unit is going to bleed heat outward through all three or four external walls much faster than a standard house would.   If the family lives somewhere really warm where homes are not as heavily insulated as they are in the Great Lakes, they might not freeze to death - but the family is going to be in a world of hurt in the summer!    

The first problem my husband and I thought of when making a long list of why people don't live in garages is that the folding doors that let cars in and out of garages are impossible to rodent-proof or insect-proof to the requirements of dwellings.  I grew up in the city where we had more mice brought in the house by senile cats than entered on their own; my husband grew up in the country where people get a few mice in the house every year regardless of the number of cats they have.  We both remember seeing mice in our respective garages.    Truthfully, my bigger concern would be rats.  They have two kids sleeping at the floor level and an infant in a crib - and no one needs to wake up from a rodent bite in the night.     I can't even imagine trying to keep the garage free from ants.  Every crumb of food would need to be swept up and placed in a sealed trash can, the entire floor mopped and everyone vacuumed to remove any crumbs of food from their clothes after every meal.   

At this point, I'm thinking that the family would be better off sleeping in tents, honestly.  At least then they would have food and sleeping areas separated which would make infestations a little easier to control.

Under the "Space" requirements, the minimum square footage allowed is equal to 150 + 100(n-1) where n is the total number of occupants.  The family has 11 people in it so that's a minimum square footage of 1150 feet.  The minimum size of a two car garage is 20' by 20'  which is 400 square feet or nearly 1/3 of the minimum square footage.    For the family to fit, they would need a slightly larger than average four-car garage.

The original post was written in 2010 - but the comment section is revealing as well.  Lots of people wanted an interview with the family who did this.  Amy has had some difficulty getting the family to submit pictures or answers to questions asked by the readers.   I can think of two reasons for that.  The one that sprung to mind right away was being investigated by CPS or DHS for neglect - but Amy swears that the family is now living in a lovely, code-compliant home.  There is one other potential issue: if the family has been living in the garage and the garage is truly code-compliant, they are now  living on a property with two dwellings - which often brings an entire new set of zoning and taxation issues. 

My send off for this post involves sleeping arrangements for the parents.  Amy and her family were all over at this adorable, amazing "apartment" for 11 - but she never mentions where the two parents sleep.    Is the sofa a sleeper sofa?  Are the parents sleeping in a car away from their infant?   Do they have an air mattress?  Where do they fit in this whole mess - and were the kids being adequately supervised at night? 

To Jill (Duggar) Dillard From One Mother to Another

Hi, Jill!

I think you've started to realize that you grew up in a cult.  IBLP and ATI taught you that adoption was extremely dangerous spiritually but you have spoken of being willing to adopt.  Those same teachings implied that men with beards and long hair were possessed by the devil but your husband has experimented with a variety of lengths of hair and beards.

You are learning that the world has more options available and that's a good thing.  I want to warn you, though.  Growing up in a high-demand religious movement like IBLP or ATI (or Vision Forum) puts you at higher risk for being pulled into other high demand groups.  My concern is that you are ensnared in the most risky form of natural childbirth (NCB) ideology that conflates an unmedicated home birth with being a good mother.

IBLP/ATI/Vision Forum promise people that following "Biblical" rules will lead to happiness, fulfillment, and a life free from pain or trauma.  Jill, you know that didn't work in your family.  The rules that were supposed to protect you and your siblings instead provided cover for your parents to abdicate their responsibility to seek help when Josh admitted to molesting you and Jessa.  The rules didn't stop Josh from molesting three other girls - and neither did your parents. Your parents were too invested in chasing the limelight of fame for having a lot of cute, well-behaved kids to act like parents.

NCB fits the same pattern.   Facing labor, delivery and raising a child is frightening.  Pregnancy and children take whatever illusions we have about control over our lives and dash them. You saw your mother's last two pregnancies end with Josie being born at 25 weeks and Jubilee's stillbirth which has to make the thought of starting a family more nerve-racking than normal.  Believe me; I get it.  I grew up in a family where my twin and I were born very prematurely and our middle brother died in infancy.   NCB offers a seductive lure; labor and delivery will be safe, painless, and empowering as long as women follow the right rules.  Women need to learn the right mental state by meeting with their midwives during pregnancy.  Labor coaches should be picked by their ability to support your goal of birthing at home.  By laboring without pain medication or medical support, women will realize their personal strength and feel empowered by the memory of a triumphant vaginal birth to a healthy baby.  Thanks to following these rules, the mother and baby will bond instantly, breastfeed perfectly, and everything will be great.

It's a nice dream - but is a dream worth the lives of your sons?

Israel's birth was a comedy of errors.  His water broke before you had contractions and you thought you saw meconium.  You chose to labor at home for the next 48 hours.  I wonder if you realize today how dangerous that choice was.

• Once the amniotic sac has broken, there is a risk of bacteria that normally colonize the vagina migrating into the uterus and causing a potentially life-threatening infection in Israel.  The longer the time the membrane has been ruptured, the higher the risk of infection.  Most doctors would want to be sure that Israel was tolerating labor well and that you weren't showing any signs of an infection before letting labor progress past 24 hours after the membranes broke.  
• On top of the risk of infection, meconium staining in amniotic fluid can be dangerous.  Meconium is the first bowel movement passed by an infant.  The danger with meconium is that a baby who is distressed before birth will instinctively gasp for air.  The gasps draw meconium down into their trachea.  When the baby is born, the meconium can obstruct the baby's breathing or go into the lungs leading to pneumonia or scarring.

After 48 hours, you went to a hospital with a labor and delivery department.  I hope that you told them the truth about how long your water had been broken and the fact you thought you saw meconium.  I hope that the reason they let you labor for another 24 hours was that Israel was doing fine on continuous monitoring and neither of you were showing signs of infection.   

Your shock when the OB/GYNs told you that Israel was breech was memorable.  You spent 70 hours in unproductive labor trying to birth a baby who was in a position that could not be delivered vaginally.   You agreed to a C-section and gave birth to a giant 9 pound 10 oz baby boy who was as healthy as a horse. 

There is a bit of irony in Israel's birth; trying for a home birth with a midwife increased the chances of him being born by C-section.  Some OB/GYNs are willing to try a procedure called an external version on breech babies.  Near the end of the third trimester, you'd get an ultrasound to check Israel's position.  If he was breech at 36-38 weeks, the doctor could give you an epidural and attempt to roll Israel from the breech position to a vertex position.  The advantage is that Israel would have been around 6 pounds 10 oz to 7 pounds 10 oz and more easy to wiggle into the right position.   Not all OB/GYNs do external versions - but the 13 OB/GYNs in the practice I went to did them if a woman wanted to and was a good candidate.   If an external version couldn't be done, at least you would have had time to plan mentally for a C-section and would have missed 70 hours of labor.

The reason Israel's birth was a comedy instead of a tragedy is because Israel was a strong, healthy baby before birth.  His placenta was working well and giving him enough oxygen between contractions that he could tolerate being cut off from oxygen during the contractions over the course of nearly three days.  Israel benefited from some good luck, too.  He didn't have any issues from meconium inhalation and didn't develop a massive infection during the long labor after his waters broke.

Perhaps you hoped your dream home-birth was merely being deferred until your next child.  But, Jill, even midwives admit that a home birth after C-section (HBAC) has a 383% HIGHER chance of stillbirth than a "normal" homebirth.  The stillbirth risk of a HBAC compared to a low-risk hospital birth is 1185% higher. 

Truthfully, I doubt you realized the risks you were taking - but you saw the outcome when something went very wrong during Samuel's birth.

I wondered a bit when I heard that Samuel had been born.   All that your family had stated was that you were in labor for 40 hours before having a C-section.  I've had several friends and family members who had successful and unsuccessful vaginal births after C-sections (VBACs) - but no one was allowed to labor more than 16 hours prior to vaginal delivery or C-section.   Maybe you found an OB/GYN with a very laid-back approach to VBACs - or maybe you tried a vaginal home birth after C-section (HBAC).

Alarm bells really started ringing, though, when I saw the picture of Derick holding Samuel.  Derick was wearing the standard hair-net and disposable sterile gown that support people get decked out in for a C-section.  Samuel was wearing a diaper, a nasal cannula, an IV in his right arm, three monitor leads, a blood pressure cuff on his right leg and an oxygen saturation lead on his left foot.   Samuel, in other words, was wearing the standard outfit of a NICU baby. 

The pictures released from the hospital look like two parents enjoying a new baby - but NICU parents know the signs.  I recognized the monitoring cords on Samuel trailing around Derick; Jack had the same ones.  Jack also had the little bit of reddened skin on each cheek after the stickers that hold the nasal cannula were removed for a bit.    Samuel and Jack shared a dislike of weaning off oxygen and having their little fingers take a bluish tint when they got tired during a wean. 

The picture of Jana cuddling Samuel was adorable - and brought back memories of schlepping Jack around the house with cords that weighed more than he did.    Honestly, I don't know how you managed a newborn on oxygen with a curious toddler in the house - but you guys managed somehow.

You have been blessed with two little boys who survived rough starts in life.  If you are blessed with another pregnancy, please do not risk your child's life and your own life by attempting a home birth after two C-sections!   Find a local obstetrician and let them decide if you are a candidate for a vaginal birth after two C-sections at a well-equipped hospital.  If the doctor recommends a repeat c-section, be grateful that we live in a time and place where the operation poses few risks to you or your child. 

A vaginal birth is not worth a child's life - or yours.  

Samaritan Ministry Is Going To Kill Someone: Part 1

Years ago - back when I was teaching full time at a high school - I ran into Samaritan Ministries through a reference on one blog or another.   Samaritan is a member to member health insurance cost sharing plan for Christians who want emulate how the early Christians lived.  The basic idea is pretty simple: instead of sending a policy payment to an insurance company every month, members send their monthly payment to a member who has had a large medical bill.  The member uses that money to pay the providers and everyone is happy.

Back then, there was only the plan that is referred to as "Samaritan Classic" now.  Members had a $500 deductible on each medical issue then the rest of the cost of treatment could be reimbursed up to $250,000.  The plan has some exclusions around sexual health in that abortions, problems resultant from an abortion and STD testing were excluded from being funded.  At the time, my only concern was for women or men who had a spouse who had an affair and needed to get STD testing because of that; it felt like punishing the innocent spouse.  My gut assumption was that people who were attracted to Samaritan would not be seeking abortions for any reason.

Fast forward to last month when I got pulled into the rabbit hole again when researching something about the Maxwell Family businesses pulled up a blog post on how Samaritan Ministries covered the medical bills for Nathan Maxwell's daughters Susannah (who was born with terminal brain damage from unknown causes) and Abigail. 

As I was looking at their section on  "Maternity and Newborn Care", I saw three sections that scared me from a medical standpoint: ectopic pregnancies, home births and vaginal births after cesarian -sections (VBACs).  This post will cover ectopic pregnancies.

Ectopic Pregnancies:
An ectopic pregnancy is a pregnancy that implants anywhere outside of the uterus.  The most common site for ectopic pregnancies is the fallopian tube - but rarely it occurs on the ovary, the outside of the uterus, the intestines or the cervix.  Fallopian tube ectopic pregnancies will either end when the fetus dies from lack of blood supply or will end when the fallopian tube ruptures causing the fetus to bleed to death when the placenta detaches long before viability is reached.  The danger with a tubal rupture is that it can cause massive internal bleeding for the mother and often requires a more complicated surgery to stop the bleeding and mitigate the damage to the mother's reproductive system.  Women do die in developed nations from ectopic pregnancies but it is rare because doctors  treat ectopic pregnancies by chemical or surgical removal as soon as they are diagnosed.  In developing nations, the fatality rate of diagnosed ectopic pregnancies is around 3% - and is probably higher since women who die away from medical facilities would not be reported.

To be clear, NO pregnancies have survived to viability from a fallopian tube ectopic pregnancy.  A handful of ectopic pregnancies outside of the fallopian tube have surivied to viability - but the most common outcome is fetal death from lack of blood supply.  Delivery of an ectopic pregnancy outside of the fallopian tube is a life-threatening surgery for the mother; the placenta has infiltrated blood vessels of organs that do not have the muscular response to contract when the placenta is removed.  This can lead to catastrophic bleeding that has lead to maternal death - and can do so long before viabilty is reached.

 Samaritan's Policies:

Expenses Shared—Procedures related to a ruptured fallopian tube (including post-operative recovery of the mother, follow-up care, and treatment of any complications), and, where an ectopic pregnancy is diagnosed before a rupture, all pre-operative tests and consultations and expenses related to keeping the mother under medical care while determining what care should be offered for the mother and child.

  Expenses Not Shared—Procedures directly related to the termination of a living, unborn child and/or removal of the living, unborn child from the mother due to an ectopic pregnancy are not shared (e.g. methotrexate, salpingectomy, salpingostomy), unless the removal of the child from its ectopic location was for the primary purpose of saving the life of the child or improving the health of the child.

Issues: Samaritan is mandating that women choose the popular among QF Evangelical route of "Watchful Waiting" where women diagnosed with ectopic pregnancies wait until either the fallopian tube ruptures (or something similar if it is another organ) or the baby dies before removing the pregnancy.

This is a horrible idea based on flawed premises.  The rationale goes that women in the US and Europe have a really low rate of mortality from ectopic pregnancies so it's not dangerous for women to put off treatment of an ectopic pregnancy as long as they are being carefully monitored by their doctors.

The reason that developed nations have low rates of mortality is because doctors interviene in ectopic pregnancies prior to rupture - even if the fetus is still alive.  I'm Catholic and the Catholic Church has recognized this basic principle for as long as doctors have been able to diagnose ectopic pregnancies.  There is no chance of survivial for the fetus and ~25% chance of a potentially lethal rupture for the mother so the Church allows for the fallopian tube to be removed.  Yes, this kills the baby - but the purpose of the surgery is not to kill the baby but to prevent a ruptured tube so it is not immoral.  I find the rationale a bit hackneyed - but women have an option to end the pregnancy.

The QF believers will reply "But we don't really know how long a Fallopian pregnancy can survive because doctors won't let nature take its course!"

Here's a sane reply: Ectopic pregnancies have been killing women for centuries.  Doctors have been doing autopsies on dead women for 150 years.  They've collected plenty of data from dead women with dead babies that shows that ectopic pregnancies in the fallopian tubes will rupture by 16 weeks and that the later the rupture happens the higher chance of maternal mortality or injury. 

OB/GYNs like babies.  They like delivering healthy babies to healthy mamas.  They would love to figure out how to save ectopic pregnancies - but it's not possible until we can build a placenta from scratch and attach it in the right place.

There will be another post on this topic soon. :-)