Homebirthing and circumcision - Page 5 - Mothering Forums

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Old 04-18-2006, 11:14 AM
 
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Is there one person in here that would work with a family that was planning on circumcising a girl? I don't care that it is illegal, pretend you are in Africa. I can't imagine that anyone would say, ya know...I think that the practice is barbaric, but I wouldn't want to offend anyone, so I will go along. Or however it gets justified with each person.

It doesn't matter what path you take, you get to the same place. I will not attend someone that plans on taking a knife to remove part of their child's body. It is not OK, and it will never be OK with me. And truthfully, I highly doubt someone would want me as their doula badly enough to be completely pissed at my views and sue me. There are a lot of doula's out there, and one who would be perfect for that couple.

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Old 04-18-2006, 11:22 AM
 
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Originally Posted by mom2seven
I find it interesting that everyone zipped right past this point. I believe, if I understand Pam correctly, that she is saying 'there could be legal trouble if you refuse a client b/c they circ for religious reasons'. Anyone want to tackle that one?
There are no laws or constitutional provisions requiring doctors or midwives to accept any and all clients. If I wanted to be a midwife who accepted only white Mormon women, or black Muslim women, I could do that. The provider-client relationship is an at-will one - the provider can refuse to take on a patient for any reason or no reason at all. Now, once the provider-client relationship has been established, the duty of the provider is higher - but the relationship can still be terminated. That is a question of ethics, however, not one of law.

Various organizations take different views on whether it is against medical ethics to refuse to take on a client or to perform a service (i.e. abortion, blood transfusion) on religious grounds, but there is no unified view. Medical ethics violations are not grounds for a lawsuit - they may be grounds for a disciplinary action before an ethics board but not a lawsuit.

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Old 04-18-2006, 12:07 PM
 
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Is there one person in here that would work with a family that was planning on circumcising a girl? I don't care that it is illegal, pretend you are in Africa. I can't imagine that anyone would say, ya know...I think that the practice is barbaric, but I wouldn't want to offend anyone, so I will go along. Or however it gets justified with each person.
I'll bite.

Imagine I'm a skilled, trained midwife in an African nation, let's say, for the sake of the argument, Nigeria, where 60% of girls undergo some form of circumcision and the maternal mortality rate is 1,600 per 100,000, the risk of maternal death is 1 in 18, only 35% of women have a skilled attendant at the time of birth, and 205 babies die per every 1000 births.

Do I really have the luxury of refusing care for any of these women? Can I, in good conscious, say, "I refuse to take care of you if you plan on circumcising your daughter. Good luck, maybe one of you, or, if you're really lucky, both of you will survive the birth."

I am, however, in a position to educate women and families on FGM, and, since most female circumcisions are performed by the village midwife, I am also in the position to refuse to perform one.

So, yes, if I was a midwife in an African nation, I would absolutely without doubt attend the births of women who planned on circ'ing their daughters. And I "justify" this because I cannot leave women's lives up to chance or fate. Refusing care could potentially mean life or death for the mother/baby.

Who knows? Maybe in 20 or 30 years, I can reduce the rates of maternal and infant mortality AND female circumcision in my little village in Nigeria. Which I would not be able to do if I refused to attend the women seeking out my care.
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Old 04-18-2006, 12:30 PM
 
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Originally Posted by sevenkids
I'll bite.

Imagine I'm a skilled, trained midwife in an African nation, let's say, for the sake of the argument, Nigeria, where 60% of girls undergo some form of circumcision and the maternal mortality rate is 1,600 per 100,000, the risk of maternal death is 1 in 18, only 35% of women have a skilled attendant at the time of birth, and 205 babies die per every 1000 births.

Do I really have the luxury of refusing care for any of these women? Can I, in good conscious, say, "I refuse to take care of you if you plan on circumcising your daughter. Good luck, maybe one of you, or, if you're really lucky, both of you will survive the birth."

I am, however, in a position to educate women and families on FGM, and, since most female circumcisions are performed by the village midwife, I am also in the position to refuse to perform one.

So, yes, if I was a midwife in an African nation, I would absolutely without doubt attend the births of women who planned on circ'ing their daughters. And I "justify" this because I cannot leave women's lives up to chance or fate. Refusing care could potentially mean life or death for the mother/baby.

Who knows? Maybe in 20 or 30 years, I can reduce the rates of maternal and infant mortality AND female circumcision in my little village in Nigeria. Which I would not be able to do if I refused to attend the women seeking out my care.
Fair enough. I agree with you that that would be the best course of action.

But what about your African client who walks in the door *here* and wants to hire you for the birth of her dd? She's planning on taking her dd back to her home country for circ at, say, 2 weeks after the birth and lets you know that in the course of conversation. So your taking her as a client is not going to mean the difference between life and death for her, because she has access to good nutrition, good prenatal care, and good maternity care.

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Old 04-18-2006, 12:57 PM
 
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Leaving my ds2 intact was part of the decision to have a homebirth. : I knew dh's preference would be to circ. I also know he hates hospitals, doctor's offices, and watching any medical procedures. I figured if my baby was a boy and born at home there was about no chance that my dh would want to take him into the hospital for outpatient surgery to circ him. Our doctor who I love otherwise made a point to tell us it was available.
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Old 04-18-2006, 02:03 PM
 
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Originally Posted by Quirky
Fair enough. I agree with you that that would be the best course of action.

But what about your African client who walks in the door *here* and wants to hire you for the birth of her dd? She's planning on taking her dd back to her home country for circ at, say, 2 weeks after the birth and lets you know that in the course of conversation. So your taking her as a client is not going to mean the difference between life and death for her, because she has access to good nutrition, good prenatal care, and good maternity care.
but taking her as a client could make the difference as to wether or not she changed her mind. Refusing her care may just make her keep her mouth shut out of fear or shame when she seeks out someone else, and go ahead and do it anyway. I could choose to opt out of dealing with the situation and promptly put her and her baby out of my mind, or I could choose the more difficult path and try my best to help her help herself make the right choices for her baby. Doing the "right" thing is very rarely the easiest thing.
I have attended births with 5 women who were circ'ed as children in their own countries, from cliteroidectomy to excision, (I have not seen an infibulation, thank G-d) and none desired to circ their own girls.
Female circ' is not a religious practice, it's purely cultural. A young woman in America or Canada will have no trouble finding a husband and is not at risk of being ostracized as unclean if she's not circ'ed. Many immigrants want to assimilate, and especially have their children assimilate, into the culture of the country they have chosen. This culture finds female circumcision appalling, and hopefully the parents would choose assimilation and to leave their children intact.

I certainly would do some soul searching, and pray for the right words and to be culturally sensitive when trying to educate and provide information to the woman who planned on circ'ing her daughter. But I'm not going to give up on her or deem her not worthy of my time. She's still my Sister, and I still have to love, honour, and respect her, if not her choices. And if she decides to go ahead and do it anyway? I'm pretty sure my heart will be broken, just as it is when the baby boys are circ'd. Sometimes being "with" women is complex and difficult. There are so many issues that come up when we care for women on such a deep, intimate level that will knock our socks off. I have had to constantly re-assess myself and my beliefs, totally lose the ego (it's not about me, it's NOT about me.....) and do my best to provide non-judgemental, resepectful, quality care that meets the needs of each individual woman I am honoured to serve.


Just wanted to add that this conversation is being very helpful to me with regards to exploring and verbalizing my thoughts and feelings on the subject. It's all a learning process!
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Old 04-18-2006, 02:30 PM
 
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My stepson was born via homebirth. The midwife asked at some point early on if my dh was circing. When he said yes- he believed it was Biblical, she told him that she has many Christian families who believe otherwise and provided him with the name and number of one if he was interested. She also gave him some non religious anti circ material.
He prayed about it and studied it and came to the conclusion that it wasn't Biblical and his son's foreskin was saved.
But he was originally adamant that circ was a religious belief. If she had come off strong- well I won't attend your birth if you circ, he would have never thought about it.

OK- so here is my next question- if as a midwife you found out that a family spanked, would you drop them as clients, what if they choose to public school and you think homeschool is the only option? What if they followed Ezzo or Pearl- whould you deny them midwife care?
I think that what happens after the birth is none of the business of the care providers who help me through the birth.
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Old 04-18-2006, 03:14 PM
 
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Doing the "right" thing is very rarely the easiest thing.
Exactly. We are just on opposite ends.

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OK- so here is my next question- if as a midwife you found out that a family spanked, would you drop them as clients, what if they choose to public school and you think homeschool is the only option? What if they followed Ezzo or Pearl- whould you deny them midwife care?
Probably not, although crying it out and spanking are disgusting and abusive, they are things that can be undone and changed immediately. A parenting style can be changed on not liking what you are doing. Circumcision is for life.

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Old 04-18-2006, 05:56 PM
 
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Exactly. We are just on opposite ends.
I'm not sure what you mean by "on opposite ends".
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Old 04-18-2006, 06:59 PM
 
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Originally Posted by Quirky
There are no laws or constitutional provisions requiring doctors or midwives to accept any and all clients. If I wanted to be a midwife who accepted only white Mormon women, or black Muslim women, I could do that. The provider-client relationship is an at-will one - the provider can refuse to take on a patient for any reason or no reason at all. Now, once the provider-client relationship has been established, the duty of the provider is higher - but the relationship can still be terminated. That is a question of ethics, however, not one of law.
There are laws against discrimination. I think you are mistaken about a licensed caregiver being able to say 'I will only take black/Mormon/Muslim/fill-in-the blank' women. It is not even so easy to terminate a client while they are pregnant (much easier to do once they are no longer pregnant, but you do have to cite something like 'non-compliance'). Just a little reality check here.
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Old 04-18-2006, 07:40 PM
 
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Originally Posted by mom2seven
There are laws against discrimination. I think you are mistaken about a licensed caregiver being able to say 'I will only take black/Mormon/Muslim/fill-in-the blank' women. It is not even so easy to terminate a client while they are pregnant (much easier to do once they are no longer pregnant, but you do have to cite something like 'non-compliance'). Just a little reality check here.
Yes, there are anti-discrimination laws about many things but not all things, and I do not believe that anti-discrimination laws apply to service providers like doctors and lawyers or purely private entities such as social clubs and private schools. So for example you can have a purely private Jewish preschool that only accepts Jews, and a Christian denied entry will not have grounds for a lawsuit.

As I said, a health care provider can refuse to take on a patient for any reason or for no reason at all, and can fire a patient too - it may be an ethical issue but it is not grounds for a discrimination lawsuit. Think about how many pediatricians fire patients who aren't vaxed on religious grounds - they may be acting unethically but not illegally.

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Old 04-19-2006, 01:32 AM
 
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I guess what I meant by that is the way we handle families who plan on circumcising. I couldn't/can't live with myself and be a productive member of my family by choosing to work with a family that plans on circumcising. It has been an extremely difficult decision to make for me. I am almost always able to give out enough information to help a family change their mind. But in two instances, I wasn't able to. Luckily they hadn't hired me (lucky for both of us) and they were able to find someone else that was more open to the idea of it. And it sounds like you do all you can to educate as well, but aren't opposed to staying with a family even though they are planning on circumcising. So it is difficult for you in a different way. Probably even more so. I can't sleep at night because I am unable to stop it from happening, but I am able to protect myself and my family from it, where you are right there through the whole process postpartum. It takes a lot of courage and strength. I can't do it. It is too horrible for me. (and that makes it sound like I am saying it isn't for you, which I know is not the case, but that you come at it from a different angle.)

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Old 04-19-2006, 11:29 AM
 
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It is difficult, but I have been encouraged by families that changed their minds up to the last minute. I recently had a client who had her third son, second birth with me. Her first was circ'd, and the second, a homebirth, was circ'd, even after I had spent a LOT of time discussing it. She was adament that it had to be done. When she was pregnant with her third boy, we discussed it again, and I said to her, "Well, you know how I feel about it, and you know how the AAP feels about it. We'll give him the vitamin K after the birth so he doesn't bleed." and left it at that.
At her 2 week visit, she undressed him to put him on the scale, and I was thrilled to see his little penis intact. I looked at her, and she said, "You know, I've really given it a lot of thought this time. We decided not to do it. I'm just really sorry I didn't think about it as much with the other two boys." She was amazed at how different this baby behaved from the other 2. He wasn't as fussy, he nursed better, gained weight sooner, was more content. And she was amazed at how much easier it was to take care of his diaper changes. "They always told me it was easier to keep clean if he was circ'd. That was a big ol' lie!"
She's even told her friends and co-workers about the benefits of leaving the baby intact. She went from a die-hard circ'er to an intactavist, not overnight, but over time.

Sometimes it just takes more time for people to consider everything they have ever known all their lives as not true. It really shakes up the whole paradigm of what we know as true suddenly becoming false. There's guilt, there's shame, there's anger, especially coming from a family that circumcises, has always circumcised. You mean, I hurt my baby unnecessarily? You mean, my mother allowed this to happen to me/my brothers?

I couldn't live with myself if I didn't keep trying, up to the very end. And when you open yourself up to caring so deeply, you open yourself up to a lot of heartache.
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Old 04-19-2006, 11:48 AM - Thread Starter
 
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Sevenkids, that is such an encouraging story. It almost brought tears to my eyes.

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Old 04-19-2006, 12:22 PM
 
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Originally Posted by Quirky
Yes, there are anti-discrimination laws about many things but not all things, and I do not believe that anti-discrimination laws apply to service providers like doctors and lawyers or purely private entities such as social clubs and private schools. So for example you can have a purely private Jewish preschool that only accepts Jews, and a Christian denied entry will not have grounds for a lawsuit.

As I said, a health care provider can refuse to take on a patient for any reason or for no reason at all, and can fire a patient too - it may be an ethical issue but it is not grounds for a discrimination lawsuit. Think about how many pediatricians fire patients who aren't vaxed on religious grounds - they may be acting unethically but not illegally.
Right, which is why we have pharmacists refusing to fill prescriptions for emergency contraception and birth control pills, hospitals refusing to allow physicians to perform therapeutic abortions, etc. etc. But, these laws only apply to some states in regard to abortions and family planning services, and some states only allow for religious or private institutions to refuse care based on religion, and a few states allow any institution public or private to refuse care. However, if a healthcare provider provides healthcare services to others, they cannot refuse care to a specific racial/ethnic/religious/gender/sexual orientation group. A Catholic hospital, while it can refuse to perform sterilizations based on religious beliefs, cannot refuse to care for Jewish or Muslim or Baptist patients, as long as the services sought are provided to ALL their patients.
Private educational institutions, that accept no federal funding, can accept or deny whomever they want, but healthcare providers can not discriminate or refuse care based on the religion, race, sexual orientation, gender, ethnicity, etc. of the pateint seeking care. They can refuse to perform services that are against their own religion (abortion, family planning), but they cannot refuse to provide care they offer to their other patients. This is basic Civil Rights law.

With pediatricians refusing to care for non-vaxed children, vaxing is the "standard of care", recommended by the AAP and CDC. A ped can fire a non-vaxing family citing non-compliance to his recommendations, but not because of the religion of the patient. However, a pediatrician whose religious beliefs do not allow him to offer vaccines, may refuse to vaccinate all children.
I cannot fire a client whose religious beliefs will not allow her to eat meat, but I can fire a client who refuses to follow a healthy vegan diet and lives on potato chips and iced tea.
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Old 04-19-2006, 12:55 PM
 
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So for example you can have a purely private Jewish preschool that only accepts Jews, and a Christian denied entry will not have grounds for a lawsuit.
Nope- I have my MA in child development- and studied the law reguarding this. You can have a Jewish (or Catholic or Christian or insert whatever religius group you want in) preschool that only teaches Jewish tradition and does Jewish rituals, but you cannot deny entry to a student if they are not Jewish. Same goes for employment at said school. Most people would not choose to have their child taught contrary to their beliefs, but there have been law suits in neighborhoods where the Jewish preschool was the best by far and they like anyone else cannot discriminate on the basis of religion.
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Old 04-19-2006, 01:00 PM
 
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Yep, it is the same here.

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Old 04-19-2006, 01:16 PM
 
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My brother, who is a discrimination lawyer (he did years with the ACLU) e-mailed me this

Quote:
The law deliberately draws the line in an unclear manner. Each case must be taken on its own merit so as to consider a number of factors, or to use a "balancing test" whereby the fundamental rights of the physician are weighed against the fundamental rights of the patient against the overall availability of the procedure to the individual and so on and so on . . . .

A doc might be disinclined to accept as a patient one who will not immunize because for what ever reason, that patient may be higher maintenance, or on a personal level, the doc might just not like "the type" of patient who rejects immunization. If a private practice, the doc can legally discriminate to a considerable degree. And, that requires the examination of the definition of discrimination. For instance, is the individual in a protected class? Religion = protected class. Does refusal to treat a jewish baby who has a bris constitute discrim? Not if the doc can articulate a legitimate non-discriminatory reason for rejecting such patient. What is a legit non-discrim reason? Well, that's subjective, isn't it. The doc can be a secret member of the aryan nation and because he hates jews he refuses to treat. But, all he really has to say is I'm too busy for that patient; risk of injury from that procedure causes me to shy away from those patients; the parents had unrealistic expectations- too demanding; too litigious; too argumentative- whatever. What you are going to find is that in today's christian conservative dominated legislature and government, a doc can do whatever he wants, so long as it's in line w/ christianity. If it is not in line with christianity, the legis will find a reason to illegalize it- See Terry Schiavo
.

Even scarier than I thought!
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Old 04-21-2006, 12:50 AM
 
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It sounds like from your brother's explanantion that someone could be disingenusous and say 'I won't take [Muslim circ'ing] client x b/c they are "difficult"', but once they say 'I won't take [Muslim circ'ing] client x b/c they circ [in line with their religious belief]]' you have a problem of discrimination.

And yes, my kids are in a Jewish, religious school that states on page one of their handbook that in admission they do not discriminate on basis of race, religion, etc, etc.
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Old 04-21-2006, 01:50 AM
 
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All the religious schools around here (Houston TX) have the same policy on their front page of admissions information as well on their websites. As a matter of fact, there are some Jewish schools around here that have more Christian students than Jewish students. And some Catholic high schools that have as many Jewish and Muslim students as Catholic ones.

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Old 04-22-2006, 11:06 PM
 
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Originally Posted by UmmBnB
I have several homebirthing friends who circ'ed for religious reasons. They typically have used a local mohel who will do a non-ritualistic circ in the home.
Huh? The only religion I know of that requires circ also requires the ritual for it to mean anything. The other religions tend to discourage it, if anything.
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Old 04-22-2006, 11:16 PM
 
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Yeah, if they honestly think they are doing it for religious reasons, they don't know their religion very well.

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Old 04-22-2006, 11:31 PM
 
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Do you know how many nonvaxers use a religious exemption whose nominal religion officially is neutral on vaccinations, or even pro-vax? I completely don't support circ'ing for any reason, but all they need for it to be "for religious reasons" is to feel called to do it by/for their G-d(s).

Which is different than, say, Protestants who think that it's biblically mandated that they have to circ. Please (please!) re-educate them on the falseness of that. But things don't have to be written down in holy books in order to "qualify" as "for religious reasons."

Which makes the intactivist's job of gentle persuasion much harder, to be sure (how do you argue against a religious calling?), but I think it's a really important fact to remember.
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Old 04-22-2006, 11:41 PM
 
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Huh? The only religion I know of that requires circ also requires the ritual for it to mean anything. The other religions tend to discourage it, if anything.
Nope, Islam encourages/requires circ, depending on who you ask. Correct me if I'm mistaken. No ritual is required. From what I can understand, there are at least a couple schools of thought on the issue-- I know at least a couple of Muslim mamas here don't believe that they have a religious requirement to circ, though others disagree.

It's kind of complicated.
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Old 04-24-2006, 04:04 PM
 
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Old 04-24-2006, 04:48 PM
 
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i am trying to read this but i reaaly wish i had not circed my son....
my mw is against. i gad ds in a hospital.....
if dd had been a boy we decided not to.(duh) my friend had a terrible time with it.... she did not.(thank God)
she talked about it every day.
anyhow- my mw had 2 of her sons circed( they are in their 30".
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Old 06-04-2006, 07:50 PM
 
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Old 06-05-2006, 08:25 PM
 
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maybe one of the Jewish mothers (or Muslim) on the thread could explain to me how this (refusing to Doula/Midwife a woman who plans on circ'ing) could be a religious issue when there are people within the religion on both sides.

Not trying to cause problems, honestly curious.

V.
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Old 06-06-2006, 03:19 AM
 
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A doula who is taking private clients can most likely do what she wants, but a healthcare provider who refuses a client b/c of a held religious belief is walking a line that I personally wouldn't want to have to defend in court. The fact that there are Jews and Muslims who do not circ does not change the fact that those who do it see it as a religious imperitive.
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Old 06-06-2006, 03:32 AM
 
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The fact that there are Jews who eat pork does not mean that pork is no longer a forbidden food under the laws of Kashruth. Individual action does not change the law.

Likewise, the fact that there are Jews who do not circumcise their sons does not mean that it is not Jewish Law to do so. Individual action does not change the Law.

Where I can't see someone sueing a doula for her refusal...I can see her losing a lot of business if she were to be honest about why she was refusing.

I don't think I would want to defend myself in the court of my peers, in a court of law, or even just in the general public for refusing care to someone for a religious practice that would not even happen in my presence.

I wonder how midwives/doulas who refuse care for these women would advertise: No Jews, No Muslims...unless you've assimilated into the dominate culture?

mv
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