providing clients with info. on circumcision - Page 2

[RoseDuperre]

(Not YET a BP here, but will be going into doula training this year.)

Originally Posted by kcparker

I wonder if there are doctors who refuse to perform circumcisions, the way there are some veterinarians who refuse to dock the ears and tails of dogs....

They definitely exist! I don't know how many of them there are, of course, but they're out there. One great story of a doctor who stopped performing them is in the anthology "The Essential HipMama". Come to think of it, it might not be a bad handout to have on hand. It's a quick and easy read and could be a gateway for the parents to seek out more info.

Originally Posted by MegBoz

It was a TERRIBLE DVD.. just TERRIBLE! The narrator had the worst monotone. IT went on & on about the anatomy of the penis - but didn't clarify the RESULT of circ. It even had one doctor on the testimonials say something like, 'Well, ya know, it's not medically necessary, but it's no big deal." or something very non-commital / NOT anti-circ.

What about the movie "Cut"? It might be good to have that in your resource library to lend out. I just saw the abridged version that is now available on their website. I must say - I was a tiny bit disappointed in it, because I was hoping they would go into MUCH more detail about the results of circing (how it affects sleep cycles and breastfeeding, what the negative impact of the cortisol on the baby, and so on), but it sounds better than the one you're describing. And it does show two procedures - one not graphic, one graphic. (And honestly, the unabridged version may have more of the info I was so hoping for.)

Originally Posted by redorchid

I just thought I'd chime in to say that I know of at least two midwives in my area that won't take any client who plans to circumcise.

One of my friends, an apprentice midwife who plans to practice with this policy, put it something like this (I'm paraphrasing here). "It's a human rights issue. I'm not going to go to all the work to make sure the family has a peaceful birth just so the baby can be purposefully violated shortly thereafter."

I think the policy is the best way to send the strongest message about circumcision. It worked for me, I heard about it and thought, "what's the big deal?" I did some research of my own and now I agree.

I quite agree with you here. My LC also will not take any clients who circ. I never asked her to articulate why, but I suspect that her philosophy has to do with the fact that nursing is so much about the body's wisdom - how could she work with someone who has already violated their child's bodily integrity in the most fundamental way?

My question is about the bold, though. How exactly do you screen this out? Is it brought up in the first conversation? It would be rough to have to keep cutting ties with existing clients when the issue is brought up, if it's not immediately.

I'm leaning towards not working with circers either, though I do wonder if I couldn't help to prevent a few from happening through information. Tough call.

[beansricerevolt]

Originally Posted by CanidFL

nak. Sure. I can send a pdf file to those who asked. Please pm me your e-mail.

I know im jumping in here late but can I get a copy too Im having a hard time finding a good handout.

[Sijae]

Originally Posted by beansricerevolt

I know im jumping in here late but can I get a copy too Im having a hard time finding a good handout.

I'd be interested to see it too if it's not too much trouble.

laura

[munkeesmama]

I'm pretty sure my midwife offers a video of an actual circumcision or about circumcision for parents to watch if they're planning on circumcising, or undecided.

[redorchid]

Originally Posted by RoseDuperre

My question is about the bold, though. How exactly do you screen this out? Is it brought up in the first conversation? It would be rough to have to keep cutting ties with existing clients when the issue is brought up, if it's not immediately.

I'm leaning towards not working with circers either, though I do wonder if I couldn't help to prevent a few from happening through information. Tough call.

One of them has it posted clearly on all her networking materials, I don't know her personally, nor have I heard how she does interviews and whatnot. The other mentions it in her screening phone call/email before scheduling an interview.

I think it's better to turn away potential clients early than to invest time and energy into those you won't be working with. Plus, it's always best not to waste a pregnant lady's time.

[Shell_Ell]

I may be in the minority, but I don't offer information unless it's asked for. I have a question on my personal history paperwork (that each client fills out before our first prenatal and I get a chance to read over prior) that asks if the client has research circumcision, and if they would like more information. Usually, if a client has decided to circumcise and says yes to the first question and no to the second, I don't touch the topic. If they ask for information, I bring it up at the prenatal and offer some unbiased info in writing. If they have questions I'm happy to answer.

[RoseDuperre]

Originally Posted by redorchid

One of them has it posted clearly on all her networking materials, I don't know her personally, nor have I heard how she does interviews and whatnot. The other mentions it in her screening phone call/email before scheduling an interview.

I think it's better to turn away potential clients early than to invest time and energy into those you won't be working with. Plus, it's always best not to waste a pregnant lady's time.

Thanks for that. Makes sense. I don't mean to be a huge pest, really, but I'm very interested in how both of your examples phrases this. Can you recall some paraphrase of it, if you don;t mind?

Originally Posted by Shell_Ell

I may be in the minority, but I don't offer information unless it's asked for. I have a question on my personal history paperwork (that each client fills out before our first prenatal and I get a chance to read over prior) that asks if the client has research circumcision, and if they would like more information. Usually, if a client has decided to circumcise and says yes to the first question and no to the second, I don't touch the topic. If they ask for information, I bring it up at the prenatal and offer some unbiased info in writing. If they have questions I'm happy to answer.

This is also a good way to approach it.

[RoseDuperre]

Originally Posted by CanidFL

nak. Sure. I can send a pdf file to those who asked. Please pm me your e-mail.

I'd like one too! PMed.

[Gray's Mommy]

Originally Posted by CanidFL

I present the facts only and I am not overbearing while I do it. I do not give my personal opinion either.

Frankly, I give the information and let the PARENTS decide. It is none of my business as to how they decide.

[Sijae]

Originally Posted by Gray's Mommy

Frankly, I give the information and let the PARENTS decide. It is none of my business as to how they decide.

Just like the definition of "hands off," I think the issue here is that what you consider to be the "information" is variable. The information regarding circ can be as pro or con as you like. From what you've said Gray's Mommy I have no clear picture of how you discuss this issue with your clients.

Of course it's the parents decision but I think it's irresponsible for midwives to give no information or information that doesn't present all the evidence.

I find it odd that midwives (not necesarily the person quoted) are willing to speak out against things like UC birth or refuse to give care to someone who wont participate in their protocols and then turn around and not use their influence to present the circ issue in an accurate light on the excuse that it's the parents decision and not up to the midwife.

Ideally a midwife would give the facts about everything and leave all the decisions up to the parents as is their right. I just think that the facts should be accurate (scientific) and informative.

Laura

[dewi]

How about NOT giving clients information about circumcision unless they specifically ask.

When did it become the doulas job to enter into the fray on this topic, and being the educator about not circumcising. The whole issue is too controversial and pervasive on the Internet for a doula to get involved in handing out brochures on this topic to clients.

I believe it's refreshing to clients, when a doula is the one neutral party. Clients benefit from our active listening (we are all trained in active listening) it helps the client discover her own answer, her own voice as a mother, without the subtle or overt influence from the type of circ literature given to her.

[CanidFL]

Originally Posted by Gray's Mommy

Frankly, I give the information and let the PARENTS decide. It is none of my business as to how they decide.

I'm not really sure what you are getting at. I thought I was pretty clear that I give the facts only and let the parents decide......

Originally Posted by dewi

How about NOT giving clients information about circumcision unless they specifically ask.

When did it become the doulas job to enter into the fray on this topic, and being the educator about not circumcising. The whole issue is too controversial and pervasive on the Internet for a doula to get involved in handing out brochures on this topic to clients.

I believe it's refreshing to clients, when a doula is the one neutral party. Clients benefit from our active listening (we are all trained in active listening) it helps the client discover her own answer, her own voice as a mother, without the subtle or overt influence from the type of circ literature given to her.

I don't really understand this either. It is our job to give the evidence based info to our clients. If a client said to me "I want a planned c-section", I would support her yet still give her the info on c-sections that I have. I don't avoid a subject because it is controversial. I just think it's important to present the info in a non threatening way which I always do. I guess if a client does not want information on anything and wants me to remain neutral then she isn't the client for me because I could never sit there and support someone 100% who did not even know the facts KWIM?

I just sent out the e-mail to those that requested it. I hope it helps in your circ discussions with clients

[callieollie]

I'm not a BP but I found this thread interesting and thought I'd respond. When I was pregnant with my first baby, I hadn't thought about circumcision at all. My midwife is the one who brought it up during one of our visits (just one of the checklist items to go over during one of our appointments). If she hadn't brought it up, someone would have asked about it after my son was born and I would have had him circumcised. What happened though was that when the midwife asked me whether I was planning to circumcise, I told her that we were planning to. She followed that up with some comment along the lines of "how did you come to that decision?" I remember feeling kind of dumb because I honestly hadn't given it any thought and she made me realize that I should have at least thought about something that was going to be a major procedure on my child. She ended up giving me a handout that described the procedure and had some pictures as well. I looked through the handout and was so upset by the pictures that I decided to do some research. I really was doing research to find reasons TO circumcise and yet the more research I did, the more convinced I became to not circumcise. I ended up not circumcising my son and am so happy with my decision.

But my point is that I am so grateful to my midwife for providing me with the education to make my own decision. If she hadn't, I wouldn't have given it any thought and would have just done it because "that's just what people do when they have a boy." I'm so grateful that asked me about my plans so that she got me to think about my decision.

[RoseDuperre]

Thank you for sharing that. It's really helpful to hear it from a client's perspective.

[wombjuice]

Originally Posted by callieollie

I'm not a BP but I found this thread interesting and thought I'd respond. When I was pregnant with my first baby, I hadn't thought about circumcision at all. My midwife is the one who brought it up during one of our visits (just one of the checklist items to go over during one of our appointments). If she hadn't brought it up, someone would have asked about it after my son was born and I would have had him circumcised. What happened though was that when the midwife asked me whether I was planning to circumcise, I told her that we were planning to. She followed that up with some comment along the lines of "how did you come to that decision?" I remember feeling kind of dumb because I honestly hadn't given it any thought and she made me realize that I should have at least thought about something that was going to be a major procedure on my child. She ended up giving me a handout that described the procedure and had some pictures as well. I looked through the handout and was so upset by the pictures that I decided to do some research. I really was doing research to find reasons TO circumcise and yet the more research I did, the more convinced I became to not circumcise. I ended up not circumcising my son and am so happy with my decision.

But my point is that I am so grateful to my midwife for providing me with the education to make my own decision. If she hadn't, I wouldn't have given it any thought and would have just done it because "that's just what people do when they have a boy." I'm so grateful that asked me about my plans so that she got me to think about my decision.

Thank you so much for sharing that!

[calice]

What we do

I am a midwife, I work in a practice with two other midwives and together we deliver about 70-110 or more babies per year.

We have a waiting area where NOCIRC pamphlets are available for patients.
When we know or if we know a couple is having a boy we do discuss it at the time when they find out (around 20-22 weeks or so), again at 36 weeks and at the delivery.

We discuss it with all our clients even when they tell us that due to their religion they are compelled to have their boy cut. And yes we have had both Jewish and Muslim couples who did NOT circumcise and were very happy to have had a chance to discuss the issue.

We say that the AMA and the AAP do not recommend circumcision because it is not medically necessary. Our materials have been approved by a board of medical experts and they are both timely and accurate.

Many parents prefer to research on their own. We give them a list of internet resources that parents can look up on their home computers. We also have the NOCIRC dvd available.

Sometimes parents will ask us, what do you think? Should we or shouldn't we? and our response is that it is medically unnecessary and that the majority of our patients do not circumcise, but that it is up to them.

We have had parents who have said they wanted to circumcise their baby anyway. Our answer after having offered the material is, you need to discuss this with a qualified pediatric surgeon. We do not perform surgery.

[shoru]

jewish thoughts on circ

hi, new here, just wanted to tell those of you who are sooo strongly against circumsision,to please check out how the religious procedure is done before jumping to conclusions. (i do not know anything about how the Muslims do it)
for the record, i do not think it should be done "just because", but religious reasons is an acceptable reason in my eyes.

[LauraCochran]

I'm an apprentice midwife who will begin practicing on my own in the next year or so. In the practice that I work in, we give out a number of handouts with a fact-based anti-circ tone. We also talk about it a few times prenatally.
It is very, very difficult for me to support people who choose to circumcise. I DO express my own opinion about circumcision (especially if the parents know they're having a boy) because I feel that my opinions are well researched, fact based, and (admittedly) because I'm passionate about it (although I certainly don't tell people what to do).
I have had many more Jewish clients who have chosen not to circumcise than those who choose to do it. Most hold a naming ceremony without the bris and sometimes substitute a different tradition. All of the Muslim clients I have worked with have chosen to circumcise.
I like to remind my clients that there is, in fact, a federal statute in the United States (along with many state statutes) that protects women and girls from genital mutilation. The fact that there is not similar legislation protecting boys is based on social tradition and crap "science". There's a good reason scientists don't perform studies on the potential benefits of female genital mutilation, why do we keep looking for a reason that it would be beneficial on males? Framing it in this perspective tends to be a real eye opener for even the parents who have already made up their minds.
But at the end of the day, I truly believe that people should be allowed to make their own informed decisions even if I wholly disagree with the outcome. I know that I would want that much respect and so I feel that I must give that to my clients.

[mamato3cherubs]

I agree that as a doula, and someday midwife, my job is to educate. I was not educated when I had my boys, I did not think anything of it and only knew one man who was not circed and his teen years were hell. He did not have a normal childhood to begin with from the age of 13 and circumstances put him in a bad spot.

I have since learned and could cry every time I see my 7yo climb out of the bath, knowing what I did to him. All I got was "This is not necessary, and these are the immediate possible complications of the procedure." I was not so concerned about that.

What I needed to learn was the life long results and possible complications to go with it. I was not given that and honestly did not even think to ask. I am not a stupid person and felt well educated when it came to many things, I did delayed, selective vax (still do but at a MUCH more restrictive level), natural childbirth and breastfed without any thought otherwise.

I expect to take the time with clients to help them understand. I do not know, once a midwife, exactly how I will handle clients that refuse to pay attention to the issue, but hope that the line of work and the clients I work with will make it much easier as I won't encounter it as much as one would with hospital birth.

As for religion, I am not strongly religious myself, but do have my own beliefs. There are some things that are naturally wrong, those become human rights issues, this is one of them, humans were born with a foreskin for a reason, therefore I am not concerned about offending someone by handing out information. If that offends them, they need to find a different provider.

[wombatclay]

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Just a friendly reminder that the Birth Professional forum is not the appropriate place to discuss circumcision (pro or con, religious or secular, etc). It is, however, the correct place to discuss how, specifically, the topic is handled within a care provider's own practice.

The Birth Professional Forum is intended to provide:

A gathering place for those involved with maternal care/birth work to share professional experiences, evidence-based protocols, educational concerns and birth-related research analysis and more. The Birth Professionals Forum was designed to be a resource for birth professionals and those interested in the birth-related professions to discuss issues that are pertinent to their livelihoods and various career paths.

If you are interested in discussing circumcision, please visit The Case Against Circumcision Forum and review the guidelines for that forum, specifically:

Mothering questions routine medical circumcision and advocates for informed consent. TCAC hosts discussion of the reasons to avoid circumcision, the history of the procedure, medical issues and studies, complications, the needs and rights of the child, care of the intact child's penis and other educational topics. We are not interested in hosting discussion on merits of routine infant medical circumcision. Advocacy threads requesting members take action should be submitted to the Activism forum for approval.

and

The discussion of or reference to religion is outside of the scope of this forum. Any posts which bring any aspect of religion into the discussion are not appropriate and will be removed. Respectful discussion of a religious nature regarding circumcision, alternatives, etc. may be hosted in the Spirituality forum. The Spirituality forum is a debate-free zone. Members maintain a list of helpful websites in a Web Resources thread for further information about religious issues.

Please PM a moderator with any questions or concerns you may have!

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