I'm going to throw up UPDATE # 144 - Page 5

[baybee]

Jeannine Parvati Baker (may she rest in peace) was a m.w. who would not attend homebirths for parents who planned to mutilate their sons. I always told my clients that they could make the choice for themselves but they would have to drive over my body on the way to the bris.
Baybee

[mamabadger]

Mamabadger, I have a question for you. What makes your "anti-circ credentials" so good may I ask? What exactly do you do to actively end RIC? Please enlighten me.

I didn't really mean that to be a challenge, but just the usual: didn't circ my sons; teach the harsh facts about RIC in my prenatal classes; publicize the issue where possible. For example, when I have a display or booth for my classes, I usually include a poster and some free literature on genital integrity.

How is it not "his" business? all of those things can impact how labor progresses, depending on how she feels about them. I would expect that any provider worth their pants would want to know all sorts of "unrelated" stuff about the women they work with.

True, but that's different from finding out whether the patient's values agree with the doctor's and deciding on that basis whether to provide medical care. On that basis, a lot of OBGYNs would refuse care to women who planned to BF past 24 months, for example, or to have a home birth. IMO, that would be paternalistic and inappropriate.

Seriously, I don't think it's my business, either, what decisions a couple will make regarding their child's care. Suppose I'm asked to be doula to a couple who say they just haven't decided yet whether to circumcise? Or, as some might well do, reply that it's none of my concern, I'm just being hired to help with the birth, and what happens in their family afterward is none of my business. To me, that's a reasonable reply.

I think spanking is a good parallel. Others have commented that it's not the same, circumcision is far more traumatic and damaging. Probably so, but a good argument can be made that spanking is as bad or worse. It continues over a much longer period of time, it inflicts emotional damage that can last a lifetime. If I have clients who I suspect intend to use corporal punishment - or to call things by their right names, intend to beat their child - I could refuse to attend their birth. Maybe all the local doulas could refuse them. Would making sure they have to deal with their first labour without support from a doula make them better, kinder parents? If anything, a good birth helps parents make more caring decisions about their children. I can hope to have that kind of effect on my clients if I do my job well, but I can't control what they do with their lives after my work for them is completed.

[dnr3301]

Originally Posted by mamabadger

True, but that's different from finding out whether the patient's values agree with the doctor's and deciding on that basis whether to provide medical care. On that basis, a lot of OBGYNs would refuse care to women who planned to BF past 24 months, for example, or to have a home birth.

most OBs refuse care to women planning homebirths. not uncommon at all. Plenty of docs have refused care for people who don't want to vax. Pharmacy workers can refuse to give the freaking birth control pill and you think I'm the odd one?

Originally Posted by mamabadger

Seriously, I don't think it's my business, either, what decisions a couple will make regarding their child's care. Suppose I'm asked to be doula to a couple who say they just haven't decided yet whether to circumcise? Or, as some might well do, reply that it's none of my concern, I'm just being hired to help with the birth, and what happens in their family afterward is none of my business. To me, that's a reasonable reply.

I feel like I'm interviewing them just as they are interviewing me. I have turned down families who wanted to hire me for other reasons, why not because of their circumcision views. If they can't trust me, I have no business in thier birh space.

Originally Posted by mamabadger

I think spanking is a good parallel. Others have commented that it's not the same, circumcision is far more traumatic and damaging. Probably so, but a good argument can be made that spanking is as bad or worse. It continues over a much longer period of time, it inflicts emotional damage that can last a lifetime. If I have clients who I suspect intend to use corporal punishment - or to call things by their right names, intend to beat their child - I could refuse to attend their birth. Maybe all the local doulas could refuse them. Would making sure they have to deal with their first labour without support from a doula make them better, kinder parents?

So you take them on with the hopes of making them better parents? hmmm, I think that's what I've been accused of, hmmmm? Yes, I think gentle parenting starts with gentle birth, but it doesn't have to. I wouldn't take a family who was going to use corporal punishment either, for the record. I doubt they would hire me, given all my talking about gentle parenting. Every single one of the parents I work with knows some things about me, one of them being my other posistion as an API leader. I talk and walk this stuff. More often than not, the parents who ask to work with me hire me BECAUSE of those things, not in spite of them. They hire me because I am a resource for information on how they want to parent anyway.

[saritabeth]

Originally Posted by mamabadger

I didn't really mean that to be a challenge, but just the usual: didn't circ my sons; teach the harsh facts about RIC in my prenatal classes; publicize the issue where possible. For example, when I have a display or booth for my classes, I usually include a poster and some free literature on genital integrity.

True, but that's different from finding out whether the patient's values agree with the doctor's and deciding on that basis whether to provide medical care. On that basis, a lot of OBGYNs would refuse care to women who planned to BF past 24 months, for example, or to have a home birth. IMO, that would be paternalistic and inappropriate.

Seriously, I don't think it's my business, either, what decisions a couple will make regarding their child's care. Suppose I'm asked to be doula to a couple who say they just haven't decided yet whether to circumcise? Or, as some might well do, reply that it's none of my concern, I'm just being hired to help with the birth, and what happens in their family afterward is none of my business. To me, that's a reasonable reply.

I think spanking is a good parallel. Others have commented that it's not the same, circumcision is far more traumatic and damaging. Probably so, but a good argument can be made that spanking is as bad or worse. It continues over a much longer period of time, it inflicts emotional damage that can last a lifetime. If I have clients who I suspect intend to use corporal punishment - or to call things by their right names, intend to beat their child - I could refuse to attend their birth. Maybe all the local doulas could refuse them. Would making sure they have to deal with their first labour without support from a doula make them better, kinder parents? If anything, a good birth helps parents make more caring decisions about their children. I can hope to have that kind of effect on my clients if I do my job well, but I can't control what they do with their lives after my work for them is completed.

I have been following this thread for a bit. I think it is well within a doulas right to work based on her Ethics. I have a lot of respect for sarah and for the OP that they know themselves and how they want to work. When you inform your potential clients of this there is no problem and no issue of not being 100% supportive...everyone is on the same page.

I do also think that it is valid to be a doula who takes on clients who do make different choices. I think it is a personal line. I have had clients who I was deeply troubled by some of their parenting choices. My hope is that supporting people to have the birth of their choice will empower them to be the best parents they can be. Maybe the education I provide will change their hearts on topics like breastfeeding and keeping sons intact. I can not ultimatly make them make the choice I want, but I can always hope that my personal experience and educational literature can help parents make what is the most logical choice.

I do agree with what mama badger says...I also know it is a matter of philosophy that we will never fully agree upon as doulas.

[dnr3301]

Thank you Saritabeth. I totally agree we need people working this from many different angles. I'm glad there are many kinds of doulas out there, otherwise we'd all be boring and the same.

[saritabeth]

Originally Posted by dnr3301

Thank you Saritabeth. I totally agree we need people working this from many different angles. I'm glad there are many kinds of doulas out there, otherwise we'd all be boring and the same.

Let the doula lovefest begin!

Im really glad you were able to work it out....I hate client conflict like that, its the WORST!

Hopefully they will rethink their choice and leave their sweet boy be!

[coloradoalice]

dnr3301- I am very glad you were able to find a replacement and that things have worked out. I hope that they still reconsider their decision. Maybe even if they do have a boy he will be protected because of the strong stand you took.


mamabadger- Doctors can and do take stances on ethical issues. My own family doctor will not prescribe or refer you to anyone for any sort of pregnancy prevention due to his religious beliefs. He states this at your first visit with him and you can take it or leave it. But he sticks to his own personal beliefs. I believe to be true to your self you must sometimes take a stand. I would never want someone working for me that was harboring negativity about me because of opposing thoughts. It just wouldn't work.

[kldliam]

Dear Mamabadger:

A boycott is an effective way to express disapproval when money is involved. EVERYONE has the right to boycott. You can boycott a person, a store or an organization if you are at moral or ethical odds with their behavior. It is a totally legitimate and useful way to protest injustice of any kind. I feel that doulas and MD's & Nurses (like the great Marilyn Milos) who are fully committed to the Intactivist movement will employ boycott as a measure to help end this insane practice of infant genital cutting.

Kudos to all of them!

[GooeyRN]

I do not have advice, but wanted to say that I am sorry that you are in an uncomfortable position. As a nurse, I hate being put in certain postions, that go against my beliefs and values. It sucks. There are certain area's that I avoid working in to avoid certain things, but other things can not be avoided very easily. I am sorry that you are in an uncomfortable position.

[mamabadger]

Originally Posted by coloradoalice

mamabadger- Doctors can and do take stances on ethical issues. My own family doctor will not prescribe or refer you to anyone for any sort of pregnancy prevention due to his religious beliefs.

I don't think this is quite the same thing, or that the boycott reference really applies, either. A doctor might refuse to prescirbe these things, but that's very different from refusing to treat a patient until he has confirmed that the patient refrains from using contraception.
In this society, even violent criminals are provided medical care. A doctor isn't morally compromised by treating someone who has or will commit atrocities. He's just healing the sick, as he's supposed to.

I take the same approach to doula care. I try to provide good information to my clients, and hope they make the right choices, but they're adults, and ultimately they decide for themselves. Withholding care will only increase the chances of a bad birth experience, which benefits nobody, including the baby.

[orangebird]

I just want to add a quick note that a doctor and a doula have very different roles and different rules and ethics governing their practices. A doctor is providing medical care and a doula is a support person. They both have the right to refuse to treat patients due to ethical beliefs. The only time a doctor is required to perform any service is when it is a life threatening situation. If a woman comes in crowning ( I don't know why but impending birth is considered the same as someone presenting to the ER bleeding IYKWIM) he has to help her no matter what her parenting practices are. But earlier in pregnancy when there is no impending birth he has every right to make a choice about taking her on as a patient. The doula likewise has every right to take or not take a client on for whatever reason. There could be many reasons a doula and client aren't a good match, circ being only one of them. A doula might feel a personal responsibility to help a relative or friend, but there is no such rule in the doula certification that they must accept every client who asks for their help, is there? Docs refuse patients all the time too. I know a woman who had to see a few doctors before she found one who was willing to do her gastric bypass.

[kldliam]

to me it seems almost ludicrous to say that you oppose infant circumcision, but that you will continue to take money from clients who do it. Isn't that EXACTLY what all the circ'ing MD's are doing too? What's the difference? Where are the ethics in that?

[kldliam]

Mama Badger: I take the same approach to doula care. I try to provide good information to my clients, and hope they make the right choices, but they're adults, and ultimately they decide for themselves. Withholding care will only increase the chances of a bad birth experience, which benefits nobody, including the baby.

That's interesting. This is exactly the same mentality that alot of circ'ing MD's take too. They say, 'I oppose this practice, yada yada yada' but if you still want to do it, I'll be glad to take your money anyway.

[saritabeth]

Originally Posted by kldliam

That's interesting. This is exactly the same mentality that alot of circ'ing MD's take too. They say, 'I oppose this practice, yada yada yada' but if you still want to do it, I'll be glad to take your money anyway.

Here is the thing, its an agree to disagree point among doulas. From my perspective, I am a doula because I want to be a support person to the laboring mother to give her the best shot at an empowered self informed birth. I provide information about a lot of different things. I have my beliefs about what I think constitutes a good birth experience, but it is HER birth, her experience. What she wants for her birth isn't always what I would want for myself, or even her...but I can not argue with what her choice is. It is counterproductive. I provide the education and she makes her own choices. It is how I work.

Doulas do not perform Circ. I don't see how it is any more unethical of me to take a client who is planning on circing or who hasn't even told me what her plans for her child are....I am there as her labor support person, not her friend, not her MD, not her mothering mentor. I do not support circumcison one bit...I have educational literature available to any family that wants it that refutes the reasons why people do routine infant circ. When the opportunity arises for me to discuss why I don't support it, I give my opinion. I can not make the decision for them. I don't feel that it is unethical. For other doulas it is. It is a sticking point that doesn't need to be so devicive. I personally think I can do more to persuade from my end by working with a broad range of clients, but that's why I work the way I do. If I thought differently, I would work differently.

It is an entirely different matter for a MD to not support it and still do it. If I was in the position of practicing medical procedures that went against my beliefes I would not be able to do them and would refer out. Since I don't do that, I don't feel it is the same at all as working with a family as their labor support.

I don't think there will be agreement here on this point...Im glad there is a range out there. Women deserve labor support from someone.

[kldliam]

Yes, I guess if I was in business for myself, all that would really matter to me in the end, was that the money was green.

[saritabeth]

Im sorry you are misunderstanding me. That is really a shame. There is no reason to be rude.

[kldliam]

Saritabeth: Im sorry you are misunderstanding me. That is really a shame. There is no reason to be rude.

No... i am sorry. I was not trying to be rude at all. i was simply saying that money is the bottom line when you are in business for yourself. I totally get that.

[saritabeth]

really it is not the bottom line. My above post was a thoughtful response and a different perspective. Im not asking you to agree. There is no reason to think that its all about the bottom line and a profit from what I posted. I take deep offense to that.

[kldliam]

really it is not the bottom line. My above post was a thoughtful response and a different perspective. Im not asking you to agree. There is no reason to think that its all about the bottom line and a profit from what I posted. I take deep offense to that.

Thank you for your thoughful responses. Really. I do not mean to offend. Clearly, you have your principles and you stand by them fully. :

[laneylue]

There are plenty of doctors who have terminated the doctor/patient relationship due to the patient's parents' refusal to have his/her child vaccinated.

Heck, even I have been "fired" as a patient by a doctor before because I refused the treatment he recommended.

Circumcision may be the deal-breaker for one doula, breastfeeding may be the deal-breaker for another, and another doula may take all patients regardless of the patient's choices. Just like some doctors will continue to keep the patients who don't vax while other doctors won't.

Not eveyone has to feel the same about every issue, and this is just one issue where she draws the line. I really fail to see how that is irresponsible of her.