Someone posted recently on facebook that she did not think fees doulas charged should be based on experience. She said that once she completed her training she felt like all doulas were of equal value. This made me go  hmmm…. I do not think so.  The conversation was started based on new doulas who have paid for training offering their services for free or really reduced rates. All doulas feel this devalues the service. I agree. And the conversation is about how fees are not charged that actually create a living for a doula. But that does not negate the value of experience.

experience-is-the-teacher-of-all-things

If a doctor had only performed your type of surgery a few times, would you feel as comfortable with him as you would someone who does this surgery daily and has been for years?  Perhaps a new surgeon would be impressive- right out of medical school and the newest and latest procedures would be good. But if the more experienced surgeon kept up with his continuing education and went to conferences to learn new techniques, perhaps not.

She went on to say she charged twice as much as many of the doulas in her community but was busy. She said people would pay it because she ran her business like a business vs the way the others ran theirs. I do get this. I have written about the doulas who dabble with a few births a year, do not keep up with continuing education, and even do not have a regular back up yet call around last minute to find a back up while they head out of town after being hired. These are awful and poor business practices.

But in our group we do have different fees based on experience. The doulas set their fees but the recommendation is to set it according to level of experience. Why? Because there is value in having been to many more births. Your experience is just that… how many times have you seen this procedure, this turn of events, used the techniques to help a laboring couple? I do think my experience of over 600 births makes me a great doula. I do think experience is only one piece though in selecting a doula.

We run our group as a business and try to practice good business skills.  We encourage continuing education. When we come back from conferences and workshops and share with the others in the group the information we learned. It is important to continue learning. We spend time together monthly where we sit and share birth situations that we feel others can learn from and those we need to learn from. We have policies in place that help us remain consistent in our services as well.

Because we are a group of doulas who work more like a sisterhood than a group that is merely a referral agency, we support each other. If someone is at a birth and trying to work through a difficult time with them, she knows she can call any of us, especially the most experienced doulas to ask for insight. So, although she may be the lesser experienced one, she has a 1000 births of experience supporting her.  And our doulas begin as apprentices, shadowing and participating as assistants with a more experienced doula before taking births on her own. This hands on mentoring has developed some awesome experienced doulas. So even our lesser experienced doulas have a different level of experience and supported experience behind them.

So, I will say I understand that the poster on facebook believes what she writes. But I do not think she knows what she does not yet know. As she becomes more experienced, I think she may agree, experience is worth paying the extra for!

beach feet

We can talk about self care for anyone but this is specifically for birth workers. I think it is imperative to discuss a few things to insure doulas stay healthy- and in fact these things are for any birth professional.

  • Nurturers- self care is not selfish
  • Choosing clients carefully
  • Reliable back ups in place
  • Bodywork before and after
  • During the labor itself- taking care of self
  • Good body mechanics- how to protect your body
  • Timing of clients
  • Priorities

Nurturers- self care is not selfish

Since we are usually in the mode of helping others, sometimes we fail to stop and let someone take care of us! I raised my fee a few years ago specifically to pay for massage and body work after a birth. I love it when a mom has had a really long or difficult for me- as in a lot of hands on holding, pulling, pushing and hip squeezing and I get offered a tip to do this with specifically.  In order to take care of others, we must take care of ourselves.

Choosing clients carefully

If someone does not seem like a good fit or will need more attention than you can offer, pass on the client to someone else. Having someone who will demand more than you can offer or is not a compatible client  is not of benefit to you or them.

Reliable back ups in place

In our group we have back up built into our agreement- we back each other up. I have used one person who used to be with our company once when a mom was having a precipitous birth and I needed someone closer to meet her until I got there within the hour and in time for the birth, but I knew she would need someone with her when she arrived since things were happening quickly. I always stand amazed when I see doulas have a conflict and they are clammering at finding a back up on facebook or elsewhere. Back ups should be in place at all times. It is difficult to be on call for more than one- or shoot even with one client and not have a great back up system in place. It is also not stressful for the doula but it is unfair to the client who is counting on support for her labor.

Bodywork before and after

This goes to my first point. Chiropractors, massage therapist, fascia and other body workers are essential. I go to my acupuncturist quarterly to keep myself healthy. My chiropractor and body workers see me much more often. Keeping your body fine tuned helps keep the machine working!

During the labor itself- taking care of self

I developed sialadenitis once from a long labor and forgetting to keep myself hydrated. Antibiotic, a CAT scan and a lot of pain later taught me to make sure I keep drinking during labors. Bringing healthy snacks and nutrition is also important for both you and your client. And simple things like making sure you are stepping out to use the toilet and get an emotional change of scenery for a minute or two is also healthy.

Good body mechanics- how to protect your body

Knowing how to shift your weight- use your legs and body weight instead of your back and shoulders, are just one of may things you should learn to do to protect yourself. When I first became a doula I felt I needed to keep my hands on the mom and most of the time stay upright. But now I realize that being too hands on when the mom is not requesting it, tires not only the doula out but does not allow the mom to have the non interventional freedom in her labor to move and listen to her body. Sitting by close and ready is not only better for her but also for the doula. When you are doing physical support, be smart about how you offer it so as to not injure yourself.

Timing of clients

Every doula gets to decide what works for her family in regards to taking clients. Taking first time moms and VBAC moms may take more time than repeat clients. Taking clients close to each others due dates does not necessarily mean a problem with overlapping. But taking several during the same time does mean you may be doing births back to back without much rest. And a non rested doula does not make the best doula. A really busy doula may help her make her finances work well but may not be in the best interest for her clients who may feel slighted. What is the right number? Who knows- every doula and every situation is different. If you have a lot of moms who want to labor at home without a doula before heading in, or have clients who plan to get induced or get an epidural, those clients may be different than the mom who wants labor support at home and plans for a pain medication free birth. But you will find the number that works for you. In our group, usually 2-4 clients a month is a good number to keep from burning the doula out.

Priorities

Everyone is different in this aspect too. If you have small children, a difficult support system or one that depends on you to be a primary care provider for your children, it may be stressful being away too often or for too long. When you are gone for hours or even days and need to come home to crash- it is difficult if everything is hinging on your return. Missing holidays and special occasions make this work stressful. So, make sure you are setting aside times to be off call to have some time for special events and time with your family. If a holiday is too important to head out in the middle of it to a birth, do not take clients during this time. Take some time off to celebrate life! And be careful joining this work when your babies are small. They are only small for a short while and this work is difficult on families. Keep your priorities clear and strong.

 

Since late 2009 I have had 90 inquiries about our apprentice program. To become an apprentice with Labor of Love it has usually been a difficult process. I don’t mean to make it difficult but I do ask that the women who inquire really count the cost of doula work to begin with. Do they have a great family network who understands the amount of time it takes to be a doula, to be gone all night often, to have disruptive schedules where being on call is the utmost important thing? Do they have great childcare? Do they know that the money is not guaranteed to be steady? If they pass that first hurdle of counting the cost, then they hear my expectations.

iron-sharpens-iron

I demand a lot of the doulas who work with Labor of Love. I have to admit a few times along the way I have accepted women who I did not feel were going to be good fits for sure. It was times when I really needed to add a doula to our group and my decision to take them into the company was soon proven to not be the best for us as a group. This has made me a bit more cautious over time. But when I meet with a potential apprentice now I really drive it in hard that we are different than a referral service, we are a sisterhood of women who care about each other and work together for the best interest of the group and each other. This is really different than most groups.

Even though the women are independent contractors, there is a cohesiveness to our business model. We back each other up and do not act in a competitive way with each other. But that is not all that separates us. In our mentorship/apprenticeship process we demand a lot of the apprentices. We offer a true mentoring program where the apprentice accompanies the mentoring doula to prenatals, to births, to postnatals and is fully involved along the way in her training. We want the apprentice to read books we find significant- not only the ones required for their certification. We want them to sit in on a childbirth class series with parents so they can understand the questions and concerns pregnant families have. We want them to know about breastfeeding by attending our three hour couples’ class. We don’t just take a newly trained, inexperienced doula into our group without feeling very secure about her skill set and knowledge.

In the early months of taking births there are a lot of inquiries about the prenatal information gathered- is it complete? We are available via phone to chat or text with her when she is in labor with a mom. After the birth we talk a lot about what she learned and concerns she may have about the events of the birth. She is not just on her own.  I feel iron does sharpen iron. And to the one who is given much, much will be expected. And we give a lot to our apprentices. Sometimes my doulas will say I am hard on them. But over time they understand why. They realize they have become an excellent doula who does things excellently.

We take great pride in the calibre of doula who is part of Labor of Love. We want the couple to know they were in good hands at their birth.

Recently on one of the facebook doula business sites the question arose as to which organization the birth professionals were aligned with either by training or by certification. Some birth professionals stated they were not certified because they did not want to be limited by the scopes of practice of any organization. This statement can cause some speculation that may be misunderstood.

Scope-of-practice-250x160

I am certified and a member in good standing with CAPPA. Their scope of practice is spelled out clearly for each of the areas they certify.  It is pretty clear when it says, ” It is not within the labor doula’s scope of practice to offer medical advice or perform any medical or clinical procedure.” It is important also to note- “it is outside the scope of practice for the CAPPA Labor Doula to attend births that are intentionally unassisted.” Meaning that a midwife or doctor needs to be available or planned to be present.

scope of practice

I used to also be dual certified with DONA. I chose to let that certification go due to redundancy of certifications and the support level I was receiving from CAPPA instead. But their scope of practice is very similar. They state, “doulas do not “prescribe” treatment, any suggestions or information provided within the role of the doula must be done with the proviso that the
doula advises her client to check with her primary care provider before using any application. ” And “the advocacy role does not include the doula speaking instead of the client or making decisions for the client. The advocacy role is best described as support, information, and mediation or negotiation.” But where their scope gets really limited is in additional publications like an article by Penny Simkin for instance on aromatherapy. Here it is stated that  there are seven questions that must be considered:

1. Are there claims of specific medicinal or healing benefits from the “remedy” (as opposed to soothing a normal pregnancy or labor discomfort) or claims to correct or cure an abnormality?
2. Are there any possible harmful side-effects?
3. Does the action or advice on this subject require special training, certification, or extra education to ensure safety and proper application?
4. Does the remedy usually require a prescription or supervision of a trained clinician?
5. Is the subject for which you are giving advice usually covered by a doctor, midwife, or maternity nurse?
6. Might your advice conflict with that of your client’s clinical care provider?
7. Might your action or advice worsen the relationship between your client and her caregiver?
If the answers to all the above questions are “No,” then the action or advice is probably acceptable within the doula’s scope of practice. If the answer to one or more question is
“Yes,” then you should not do it.

There are doulas with extra skills that they have learned elsewhere. Perhaps they are also massage therapists, or have trained in acupressure or rebozo techniques. Or perhaps they have taken some additional training in aromatherapy and essential oils. And there are those who have been or are also midwifery assistants with training in neonatal resuscitation or fetal monitoring. When they use these additional skills, they may be stepping outside of their scope of practice or they could just be wearing a different hat in your labor support than what you hired them for.  But one of the things you need to ask is do they plan to wear that hat in your labor? Do you desire for them to do so? Do you need them to do so? For instance if you are having a home birth, will the midwife have an apprentice or assistant that provides some of those more midwifery skills? If you are having a hospital birth, would any of those “outside of a doula’s scope” skills really be used?

I was casually chatting with a new midwife recently. She said that some doulas seem to think there is a fine line between being a doula and being a monitrice. A monitrice according to the free dictionary states that a monitrice is “a labor coach, usually a registered nurse, who is specially trained in the Lamaze method of childbirth. The coach provides emotional support and leads the mother through labor and delivery, using the specific techniques for breathing, concentration, and massage taught by the Lamaze method in classes for the psychophysical preparation for childbirth.” but this is not correct at all! And this may be why there needs to be a bigger line between the jobs of a doula and a monitrice. You should not trust all you read on the internet for sure! Here is a better explanation: “A monitrice’s primary role is that of labor support. Just like a doula, a monitrice offers continuous, hands-on support during labor. Unlike a doula, whose scope of practice generally prevents her from providing any clinical services (by their certifying organizations), a monitrice will perform limited clinical assessments such as monitoring the baby’s heart rate during labor, mom’s vital signs, and assessing cervical dilation.” Often a monitrice is a midwife who offers herself to women as labor support.

I think that is a huge divide in services. As a doula I do not perform any clinical assessment. I have knowledge of some clinical tools since I have been a doula for two decades and attended 600 births, but I do not want to mislead anyone in thinking that hiring me or one of my doulas who may have additional training, that we plan to use that training in your labor support. In fact, it could be quite misleading to share the knowledge or skills I have if I do not plan nor agree to offer those skills when you hire me as your doula. In our company we feel there is a huge divide between a doula and a monitrice.

We are all either trained or certified with a national or international organization. I have only shared the two most known organizations. Please look at our doulas skills and realize we stay within our scope of practice.  If we are using tools outside of the tools taught in a doula’s initial training, you can be sure we have had additional training to do so. But also know that we do not step outside of our role as a labor doula in doing so.

Sometimes women say that when they make a decision to change the original plan for their birth, they “throw in the towel.” I hate this phrase as I feel making an informed decision is never a failed decision. Throwing in the towel is usually seen as a failure.

throw in the towel

But when I am at a birth and others influence the mom’s decision to change her plans, during the most vulnerable time in her labor, that is not fair. When women have been in labor a long time, they need to be infused with only encouraging words and support. If she decides to get medication or choose to have a surgical birth she needs to be supported in that decision too. But badgering her or causing her to lose hope, or offer disparaging words to cause a mom to follow their decision is wrong.

There are two questions you need to ask before making any decision: How is my baby doing? How am I doing?

If there is a medical reason to move in a different direction, then follow that advice for your sake and your baby’s. But if your care providers or support team are “throwing in the towel” because they are tired or have lost faith, remember you do not need to follow that advice.

Shame on care providers who have their own baggage or agendas that cause they to coerce women into getting medication or into a surgical suite to give birth. We have all been at births that somewhere in the labor we too wondered if this was going to progress in a favorable way to be in alignment with the woman’s birth desires. But given time and patience, given the proper support and love, the woman proceeded to amaze us all. Don’t manipulate or discourage women in their most vulnerable time! Women stay strong and keep those around you that only offer positive support.

Within the birth the community there is a big surge in conversations about the business of being a birth professional. Often there are a lot of doulas out there who act more like this is a hobby. For a long time birth professionals have more or less given away their services and there are those who feel they can help stop that by some guidance. (Of course they charge a fee to learn these tools.) There is nothing wrong with any of this. There are a lot of birth professionals who give and give and never get anything in return and quickly burn out. That does need to change.

phone calls

Just as attorneys, business consultants, life coaches and counselors charge by the hour; there is talk that we should too. Some doulas charge a flat fee for up to 12 hours of labor support and then charge hourly thereafter. Hmmm, I think this would cause some women to not call their doulas for guidance in early and mid labor for fear the clock would start charging them.  We charge a flat rate.

There are some doulas who only offer prenatals as an option to their services, within a package of services with everything ala carte. We offer one or two prenatals- different doulas offer different options within our company. But we all feel a prenatal is essential to helping us know you,  you to know us and  how we can help you and how you want us to help you. It will always be a part of our “package.”  There are several things we do as doulas without adding things as extras that are additional charges. Prenatals, phone calls, unlimited labor support, meeting you at your home before going to the birth location if it is not your home, photographs, breastfeeding assistance, birth stories, postnatals… it is all within our scope of services.

There are those who feel birth consultations should be something birth professionals should charge for. I was recently criticized for “giving away” phone conversations regarding birth options.  If I have time, I will always talk to women about their options for birth. I would gladly discuss with her the offerings in our area and the choices in front of her. Sometimes she goes on to hire one of the Labor of Love doulas or take one of our classes. Sometimes she hears truths she does not like and chooses a different doula. Perhaps one who will not tell her the truth she knows but instead the truth the woman wants to hear. I am sometimes seen as pushy or too brazen with the truth. Perhaps if she was paying me she would see it as be more valuable information. But I am hopeful she may head into her birth with more knowledge and understanding her options more clearly. And that is my motive for taking the time to chat with her without any obligation of outcomes or fees. And for those who call us to get information without hiring us, we still offer information.

We do charge a fair fee for our services. But we do not charge for longer births nor do we discount fast ones. We offer a different level of access to chatting with us as your doula the moment you hire one of us. You continue to have access for questions along the way and even after the birth to help you get off to a great start. It is what we do. It is what we love. We feel we do a great job of offering excellent services.

If you want a relationship with a birth guide, hire one of our doulas. Your support will go far beyond a phone conversation. If you want evidenced based information, consider joining our classes. Our educators love sharing information with you and your partner.  If you just want to chat for a while about what is out there to consider, give me a call- no charge- if I am available, I will share my knowledge and give you my time.

It does not mean we do not consider being a birth professional a business- a profession- but it is much deeper- it is our calling. Many of us need to have the income to be able to do this work, but we consider this work our calling and will continue to share information with women who ask for guidance regardless of payment.  It is the philosophy of our company and our business model to share, in hopes of helping you have a more gentle birth. We care about birth, women, families and babies. I run a business. We are birth professionals. But it goes far beyond that with our company. We will be blessed by doing so we are sure.

What does this mean to you? Fortitude means ” courage in pain or adversity.” Synonyms are courage, bravery, endurance and resilience. So in order to have fortitude of spirit it means you do not lose hope in the midst of the pain or struggle.

valkyrie-high

For me as a doula one of my jobs is to help women find their fortitude. It does not mean she is unable to make decisions that are right for her- although perhaps not what she planned or desired, but to persevere regardless. It means facing her fears before labor ever begins. It means listening to her intuitive spirit early on in her life but especially in the pregnancy.

For me personally it means moving forward with strength that I am unsure where the origin of that strength can be found at the time. I can affirm that my God is with me giving me strength and that encourages me. I can remind myself of those things I have come through in my life- death of mom, dad and sister, cancer surgery with complications, etc… but it means having to put myself back out there again and again, trusting.

And that is the key to me…trust. I trust birth. That is why I believe a woman can birth without a lot of interventions and pain medications. I also trust that medications usually are safe if they are needed. You do need to note I said usually. I do think more women could birth normally and naturally if they had been raised with the idea of birth being normal and natural and to trust their bodies. I am deeply sadden that we propagate more fear in women when they are pregnant than any other time.

I trust I do not stand alone. I have a force within me that is stronger than the forces outside of me. I also have some wonderful support from those around me who love me and trust me. I do think more women would birth normally and naturally if they had proper support. When their family and friends scoff at the idea of natural birth, it is hard to move forward with that trust. That is why women benefit from having a doula along side of them.

I do believe we need to encourage women daily from the time they are little girls to have fortitude of spirit. It is something we  encourage in boys but not in girls. We need to teach women to not be afraid of birth from a very young age. It will change birth for them. And birth can change a woman forever.

What are you doing to instill courage and fortitude in yourself and others?

Recently at a Meet and Mingle I had a pregnant woman ask me this question, “Are you just the boss, or do you take clients too?” At the Mingle I run the event as the owner of the company. It puts me in a “mover and shaker” type role.  So yes I guess she can consider me “the boss.”  And  at the same time, I have been a doula for more than two decades. Over that time I have doula’d for almost 600 couples for the births of their babies. At one time I was taking three clients a month every month for around 36-40 births a year.  In the future I will only be taking two births a month or about 25 births a year. You may think that means I am slowing down. Well, nope! I have chosen to move in a little bit of a different direction. Here are a couple of reasons.

boss

The first is my family. My grandkids live only 50 minutes away but I do not see them as often as I would love to. They are getting involved in music and sports and I want to go to those concerts and events. I want to have them over to spend the night and know I will be there in the morning to fix them breakfast and enjoy the time with them. My son and his wife live in San Francisco. We recently vacationed there and it made me realize going to see him needs to be something I do more often!

The second is my BOLD direction. Charlotte Scott and I will be heading to NYC in October 2014 to train with Karen Brody to become trainers of the BOLD Method for Birth. This will entail some traveling to other states to conduct trainings.  We also hope to do some short weekend trips to neighboring areas. Initially we only see us going on four or five trainings a year. We are both excited about the new opportunity to infuse the BOLD Method in others and thus change birth preparation worldwide.

What does this mean? It means if you want me to be your doula, you need to contact me early on! And it means I will continue to teach the classes and workshops I currently teach. And if you are a birth professional that wants to be infused with some new ideas to pass on, give us a call, Charlotte and I will be ready come 2015!

So as you guessed, I turned to that mom to be and said, why yes I do take clients and I also run the company! And I also have a plethora of wonderful doulas who are also taking clients each month if I am not available!

~Teresa

We have a previous client who had a precipitous – very fast- birth with her first child. Her doula arrived just after the baby was born and helped her come down from the adrenaline rush and settle in with the new baby. The doula provided weeks of on call and even more weeks of being available for contact and assisting her along the way. She is pregnant again and is fearful that this birth may be fast again. But she is concerned about whether to hire a doula if it does.  The fact that she called her doula again this time, tells me that she saw value in having the doula the first time. She asked the doula if she would offer a refund if she had the baby in the car on the way this time.

Those of us in the birth business know that each birth is a stand alone and may not be anything like the last one.  I reminded the doula that there is value in her work prior to the birth and this mom knew it. That is why she wanted her again. But I also offered a different thought approach. What if the doula charged the way other professionals did- by the hour.  I used to work a job where we billed by the quarter hour- so I wonder  if this client were charged for each phone call, text and email, what would that actually cost a client? I wondered if she wanted that prior support and then if she had a longer labor, would she still want an hourly rate? (I realize there are doulas in this town who charge for the interviews, limit the labor support to a certain amount of hours and charge  for teleconsults. We do not do this. Our fee is the same whether it is a fast labor or a long labor.)

Recently I had a client who during her labor kept comparing her first labor with her current one. But there were lots of different variables at play that she kept having to be reminded  of. This pregnancy was almost a month longer, thus the baby would most likely be larger. Her water broke the first time and was intact up until nearly the end of this labor. But I feel like this mom struggled with the comparisons all through her labor and birth. I was with her twice as long this time – her labor was three times longer than her first. Each labor is a stand alone labor. You never know.

apples to oranges

We recently were contacted by a mom who had a gentle birth with her first baby without a doula. She then found out late in this pregnancy that she had placenta previa. This means she will have to have a planned cesarean. The news was devastating. She has contacted us to see if we can provide guidance regarding her planning a gentle birth albeit a cesarean. She and I had an hour long conversation regarding her options. I did not charge her for this time as I saw it as helping her change her birth experience and time I can offer her. She is meeting with one of our doulas who is available during that time to consider having a meeting with a doula  prior to the date of her surgery and have adoula prior to her going to the OR. She is not going where a doula is usually allowed. But she wants the doula to stay to help her afterwards if the baby is able to be with her afterwards. She feels there is value in helping her prepare and be ready for her surgery. There is value in having a doula along the journey.

I had my fastest labor with my first daughter. I had my longest labor with my second child, my son. My third child fell in between the two in length. I have doula’d for moms who had such a fast labor the first time with having a baby as soon as she walked in the hospital door. She was convinced by her doctor to be induced so that would not happen again. Her induction was long and difficult. She said later it would have been easier to have a baby in the car! I had a similar situation with a mom who was due during the Olympics here in Atlanta years ago. The doctors convinced her to have an induction so she would not be stuck in traffic. Her labor was made more difficult than her prior labors and births due to a fear of inconvenience.

I am not sure what that previous client will do this time around. I do know that often much of the work of a doula is prior to labor beginning. I also know being hired last minute without a time to establish that early relationship is sometimes difficult as well.  I understand that there are a lot of doulas who charge for consultations if someone is not a paid doula client. I am often on the phone with women and couples who want to understand their options.  I currently do not charge for phone calls where I feel like I am helping to guide them in a gentle birth but I am also being a birth change agent. Often if I am available, these conversations will lead to them hiring me. More often I am no longer available to them and they may hire one of the doulas in our company. Occasionally they will hire a doula elsewhere or not at all.

Recently a client became upset with me because I revealed I am an intactivist. I feel strongly that couples need to make an informed decision regarding this far from benign decision. This article may make me unpopular, but if  one hundred babies died in the United States by another procedure, I would be writing about it. Did you know that stat? It is interesting- folks will get the Vitamin K shot since hemorrhagic disease- something that can occur “The incidence of classic vitamin K deficiency bleeding ranges from 0.25-1.7 cases per 100 births,”  because what if their baby was one of those babies. But did you realize that circumcision is risky too? What if your son is one of the 100 who died?

circumcision_decision-maker (1)

 

I have hesitated to post on facebook or elsewhere too strongly on this issue since I was afraid it may cost me business. And it did this week.  But I felt it was time. Time for me to share my personal feelings in print.

I have written articles before on this subject:

I have shared research my students have done- Newborn Procedures

But I have to say I am alarmed at parents that do not do the research on this procedure and base it mainly on how the dad looks or feels. I hear women say, it is a father’s decision. Dads want their sons to look like them, right? But when is a boy going to look like his dad? Puberty and perhaps even a bit longer- so who is sitting around comparing penises when they are 17 years old?

And what happened to the doctors’ oath of do no harm? Cutting off a healthy piece of a baby’s body is certainly doing harm. And yes in 2012 the American Academy of Pediatrics made a determination that the benefits outweighed the risk- but guess what it was based on studies in AFRICA- a third world continent who have health risks that we can avoid by safe sex and healthcare advantages. HIV and STDs can be curtailed by the use of condoms. And penile cancer rates are really low. Lung cancer is higher- so should we remove one of our son’s lungs? Of course not! But insurance covers it most of the time. But the doctors are making on average more than $300 to do the procedure. Are you concerned about a cosmetic procedure increasing your healthcare cost?

And with more information and consideration, the rates are declining each year. “In the United States, those rates have declined today to about 55%, from a high of almost 80% during the 1970s and ’80s. In Europe, only 10% of boys are circumcised.” And the rates vary based on the level of education and income too.  Here are the stats per state. “Circumcision rates are 24% higher in states where Medicaid covers the procedure, according to a brief produced by the Health & Human Services Department’s Healthcare Cost & Utilization Project.” So if you want your son to look like everyone else- there is a strong chance he will look like at least half of his classmates anyway. And I hear the comments in the locker room now not being an issue- especially since it is more concerning in a homophobic way- “Why are you looking at my penis ” retort.

I support parent’s choices in labor, birth and parenting- but removing healthy tissue that this study confirms the importance of the foreskin for penile sensitivity, overall sexual satisfaction, and penile functioning, should that be his decision, not the parents? 

By circumcising an newborn you can also interfere with the bonding and breastfeeding. The adverse impact is documented. So if breastfeeding is an important issue for you, you may rethink circumcision
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So yes, I am an intactivist. I support an adult male deciding to have his foreskin removed, but I understand some parents will gather information and still decide to do it. I will choose to look the other way. There, I have said my peace. This is my opinion and not a company stance. If you do not like my opinion on this matter, I get it. We can still work together on your birth preparation and you labor, because they do not do this procedure while I am around anyway! Just as you are entitled to your opinion, I get to have mine. But I did want to make sure you are fully informed on this subject. It is a much bigger decision than does my son look like his father.

And I am not alone in my opinion- here is an agency that has hopes of giving you the no circ side of the decision. They even offer some videos for you to be able to know what is done during this surgical procedure.  Click on the picture above and it has a decision making ap to help you in your decision.