beetle juice?

After reading about the voluntary recall by Abbott Laboratories for the 5 million units of Similac baby formula contaminated with beetle parts and larvae, I was not surprised in the least. Formula recalls are a constant and regular occurrence, with 17 major baby formula recalls since 2000, and countless more in the two decades before that, according to NABA. However, the recall is voluntary, as the FDA determined that the presence of the beetles poses "no immediate health risks," aside from"symptoms of gastrointestinal discomfort and refusal to eat."

Nor I am not surprised in the FDA's stand on this issue. Actually, many of the processed foods that are regularly consumed in the United States contain more than only traces of bacteria and microscopic insects and are considered by the FDA to be safe for human consumption. Bacteria and small insects are regularly present in all forms of baby formula sold in the US, especially as there is no way to produce a perfectly sterilized product, which, according to the FDA, there is an expected allowance, and the number of beetles in the Similac formula recall falls into that allowance.

Then I read this article, Similac Recall Outrages Parents: Are Beetles Bad? from Time Magazine. I have some knee-jerk reactions, not to the formula recall, but to the article itself.

One particular aspect of the article, the statement, "It may be extremely difficult to determine whether beetles are responsible for a baby's symptoms. Inconsolable crying might simply be, well, inconsolable crying, which is sometimes just what babies do," was a jaw-dropper for me. Inconsolable crying is not normal. It is a sign that something is wrong. I know my babies. If they ever cried inconsolably (which was very, very seldom, as their needs were met directly, and in most cases, before it came to crying), then I knew that there was something seriously wrong. Inconsolable crying is a very direct cue for the mother or father to find out what is wrong and fix it promptly.

Another statement that then floored me was the closing of the article:

Not surprisingly, news of the recall rekindled bottle vs. breast animosities, if only online. One woman predicted breastfeeding advocates would wax triumphant. "Very upsetting, and here comes the ‘breast is best!' brigade to add to the anxiety by telling us all we asked for it." Sure enough, another poster wrote, "Yea, breastfeeding is the best. My breastmilk has never ha(d) beetle parts in it." [...] As millions of parents are reeling from the thought that their babies have chowed on bugs, it's a time for support, not gloating.

First of all the Breast is Best 'brigade' (or campaign) exists primarily to promote awareness of the true dangers of formula feeding. Breast IS the best provider of nutrition and immunity for baby, and formula is inferior in that babies who are fed formula as their sole source of nutrition tend to, on average, have lower IQs, suffer from more ailments and infections, and cry more than their breastfed counterparts. When a mother chooses formula, as with anything processed, she takes a risk with the health and nutrition of her baby.

However, for the Breast is Best campaign to be considered successful, facts and information must be available and presented to ALL mothers up front in order for a mother to make an informed decision on how she chooses to feed her infant. Furthermore, informed consent is only valid if the mother who tried (and failed) to breastfeed received TRUE assistance and diagnoses in regards to the problems she faced. How many women do I know who state they "could not" breastfeed for reasons that I, as a birth and postpartum professional, realize are fairly easy fixes had the mother actually had true, trained and knowledgeable assistance? The number is countless. And growing at a steady rate. Many times, it is hard for a mother to know which advice is sound and informed, and which advice is unintentionally misinformed or just plain ignorant.

As a mother who once was faced with the option of breastmilk or formula, I would rather have the facts--the other course is to sugar-coat everything and leave out what is legitimately important information to a major decision of parenting. That this article yet again plays the "guilt" card, comparing any pro-breastfeeding statements to "gloating," irks me. After hearing about this recall, I am thankful that I breastfeed. I am glad I had the foresight, resources and ability to seek out true, factual information regarding the risks of formula when I was pregnant with my first child. And I consider it a true disservice not to pass on my knowledge and the facts to other mothers. Every mother deserves truth and knowledge to lead her to an informed decision. I am glad I did not have to face any of the severe gastrointestional problems many babies are currently recovering from. My heart goes out, yet I continue to remain thankful.

modern midwifery

In the United States, less than 1% of births take place at home. It is difficult for the other 99% of Americans to make the transition from believing that technology is the benchmark for establishing worldwide leadership to the understanding that, in reality, the human body is designed to give birth. Our bodies are generous and amazing in their abilities to give birth naturally.

The rates of surgical birth and birth intervention in the US have soared beyond those of other developed countries around the world. The rate of maternal and infant mortality is not only significantly higher in the US than that of other developed nations, but also has not improved in nearly thirty years. Despite a significant improvement in the US maternal mortality ratio since the early 1900s, it still represents a substantial and frustrating burden, particularly given the fact that essentially no progress has been made in most of the US since 1982. Additionally, the Centers for Disease Control and Prevention has stated that most cases of maternal mortality are probably preventable. Among the causal deaths that could be prevented were those that involve both underlying health issues such as poor nutrition and high blood pressure as well as those that are physician-caused, including infection and hemorrhage.

There are many preventable risks of placing birth in a hospital environment. To begin with, bacteria can be introduced, first by the mother arriving in an environment where diseases are being treated, as well as from
infiltrating the natural barriers we have against infection through vaginal exams and, of course, surgical delivery. Additionally, there are higher incidences of hemorrhage from forced delivery of the placenta (when a care provider intentionally pulls on an umbilical cord). Furthermore, injuries and deaths related to the physician’s care range from the off-label use of medicine for the induction of labor as well as the sanctified use of surgical delivery, which is one of the leading causes of maternal mortality and a risk directly associated with cesareans and hospital births.

It is important to remember that pregnancy is a normal, low-risk, significant time in a woman's life. With knowledge of her body, a woman can interpret her body’s signals and maintain her own health. She can educate herself about care options and make good choices based on impartial and complete information because she knows her own body. Modern midwifery care is based on many concepts which are proven to reduce maternal and infant mortality rates and increase a mother’s joy in her birth experience.

Pregnancy effects and is effected by all aspects of a woman’s life: social, economic, professional, familial. A woman who knows about her body and how she gives birth is less likely to need medical interventions. An experienced midwife spends time with her clients. She gets to know them, teaches them and helps them think through their options to make reasoned decisions. She spends time with the client’s partner, observing the dynamics and providing holistic support. She helps identify how best to prepare the chosen space for labor and birth. Under a midwife's care, a typical prenatal visit lasts 30-60 minutes, labor accompaniment is consistent through the active labor and birth, and postnatal care includes several follow-up visits. It is estimated that midwives spend 10-15 times as many hours with a client as doctors spend--at about half the price! Midwives still do 70% of the births in the world and are experts not only at “normal” birth but at keeping infants normal around the birthing process. Midwifery care makes sense for normal pregnancies because midwives are skilled at keeping the pregnancy normal.

Women deserve knowledge to care for themselves before conceiving and during pregnancy and birth. Women gain the best birth knowledge from other women who have chosen natural childbirth with supportive birth care. Women are naturally intuitive and need not accept the negative images of labor that the media portrays. Women, their partners and their advocates can differentiate between normal birth and situations that may require medical guidance. Women want to choose important aspects of their birth experience based on credible information, not fear of litigation. The most favorable physical, mental and emotional birth outcomes for mothers and their babies are best supported by midwifery care.

Women have the right to choose a care provider and with whom and where to give birth. Every woman, and her family, must be recognized as being an individual with her own unique expectations for hers and her baby’s birth. It is a myth that women who seek a homebirth are willfully putting themselves at risk. Women are fully capable of considering their options and choosing how to care for themselves.  It is not rational to say homebirth is never safe; saying so is the product of hysteria. All birth information providers must create a more personable environment for the woman to learn about birth, her body and her birth options.  Protecting choice, not limiting choice, is good, no, GREAT health care.

Artwork: Music by Katie M. Berggren

the politics of infant male circumcison

Infant male circumcision is commonplace in the United States. Since the 1970s, according to the US Circumcision Statistics Report, it is estimated that approximately 60% of infant boys had the circumcision procedure performed on them. However, within recent years, this trend has begun to decline as parents become more knowledgeable about the varied negative effects and untruths of the procedure.

As part of my postpartum doula training, I saw a circumcision procedure being performed on an infant boy. I kid you not--it was the most traumatizing thing I have ever experienced in my life. The helplessness and extreme pain that the child encountered was something I will never forget, though it is not the only reason I am against circumcision.

I came across this article, Would you Circumcise your Daughter? which presents an interesting perspective of highlighting the cruelty of female circumcision and then comparatively switches focus to the the circumcisions we have performed on infant boys for decades. When a circumcision is performed on an infant, it is just plain genital mutilation, and it indeed disregards the human rights of our children. As the author says, "We've trampled on the human rights of our baby boys, and we've done it holding our heads high and justifying ourselves." Whether for boys or girls, it is about time we rethink the circumcision procedure.

I firmly believe that you really do catch more flies with honey than with vinegar, so to say, but the author took a completely unique approach by bringing the subject of female circumcision into the picture before making the connection to the largely accepted practice of male circumcision. Many new parents are not even aware that they have the option to deny the procedure as it is so accepted in the US--and by taking an accusatory standpoint, the author really does run the risk of losing her audience's respect and causing needless guilt in certain members of her audience. However, you must also consider who the article was directed at--by the looks of the blog, it is likely feminists who are seeking passionate arguments that will rile them up and get them thinking about a new idea.

The author fortunately provided plenty of resources out there that site good, peer-reviewed information on the subject of circumcision, and as of now, it is parents' right to make the decision whether to leave their child intact or not. I firmly believe, however, that, as parents, we must make appropriate decisions to keep our children healthy and whole. It all comes down to informed consent. Our country's medical ethics state that it is absolutely unethical and illegal to perform an unnecessary procedure on an individual who does not have informed consent. Infants, as individuals, cannot give informed consent, and therefore should not be circumcised. If our own standards of ethics were unbiasedly applied to the common practice of infant circumcision, it would certainly be an illegal procedure. Our children's healthy bodies should be preserved as best as possible for them to make decisions of alteration when they are old enough to do so.

Additionally, not a single national medical association in the world recommends infant circumcision as it offers no significant health or medical advantage over the intact state for the vast majority of males. In fact, many European nations look down on the US for performing such a barbaric procedure. Circumcision is literally a painful mutilation of a healthy, functioning body part, and when performed on an infant, it is done so without the consent of the person whose body is being modified, risking complications (in an alarming 2-10%, a statistic believed to be under-reported), and botched circumcisions (>1%) which often result in the need for reparative surgery, and even, in some drastic circumstances, gender reassignment.

Some may argue that parents must make medical decisions on behalf of their children in order to keep them healthy until they are old enough to take care of themselves on their own. As such, circumcision is often compared to vaccination, another common childhood medical incident--the argument often being the administration of vaccine is often painful, and, if given the option, children would most likely choose not to receive them. My arguments against vaccination aside, inoculation is a completely different issue and not at all comparable with circumcision for several reasons.

Firstly, by administering a vaccine to a child, scientifically engendered toxins are actually added to the body. Circumcision, on the other hand, surgically removes an otherwise healthy and functional body part. As the author questions in the article, should you remove all the child's teeth as they come in just because someday he may end up with a mouth full of cavities? Probably not.

Secondly, vaccination does not deprive individuals of functional body parts. On the other hand, infant circumcision always deprives the male of the protective and sexually enhancing gliding mechanism of the foreskin, as well a substantial portion of genital tissue, hundreds of nerves and thousands of nerve endings contained in the foreskin. Consequently, infant circumcision reduces a male's full range of natural penile functioning.

Thirdly, inoculation can prevent common diseases over which individuals may have little control; on the other hand, circumcision does not prevent any disease--at best, circumcision is only alleged to "reduce risk" of certain rare diseases, all of which are behavior-related, and most of which take place after a man is mature enough to make the decision for himself.

Moreover, while it can be argued that a parent must make decisions based on what they believe is best for the health and well being of their child, it must be considered that, unlike vaccination, the motivation for circumcision is based primarily on religious and social customs, and alarming little research was done on the medical aspects of the procedure before it became wide-spread in the US.

I will not argue the pros and cons of vaccination here. I do, however, feel it is completely necessary to understand how drastically different circumcision is from vaccination, and how completely incomparable the two procedures are.
It should also be acknowledged that infant male circumcision is a medically unnecessary procedure with Biblical roots (Leviticus) based on the Kosher laws of cleanliness--essentially to prevent boys from masturbating by removing the pleasure the foreskin naturally adds. As such, it is a ritual that is not unlike the many other customs of childhood bodily modification from around the world.

For instance, there is the practice of foot-binding common in China in the 10th through 20th centuries, a fashion trend that caused painful disabilities in millions of young girls and women over that time period. There is the skull shaping and artificial cranial modification common in ancient Andean and Egyptian societies and still practiced in some cultures around the world today, a gradual procedure that is performed on children, whether to designate spiritual maturation or simply to be aesthetically pleasing. Also, there is the practice of neck stretching on girls from neck rings in certain African and Asian cultures; the elongated neck is a symbol of beauty in these cultures. When neck stretching is performed gradually, starting at ages three or four and continuing through puberty, it is not a painful modification (though rapid neck stretching, occurring when a girl reaches puberty as a right of passage, is extremely painful) and it does weaken the neck muscles and inhibits the ability to hold up the head once the rings are removed.

Despite their social popularity throughout history, we now find many of these traditional modifications to be barbaric and disabling. We, as parents in the US today, would not perform these procedures on our children because they would cause them pain and visually mutilate their bodies. However, it is considered perfectly acceptable to surgically remove the genital foreskin of our vulnerable baby boys in a painful procedure.

So why, when so much of the world does not circumcise their baby boys, does society and the medical community in the US still believe circumcision to be necessary? It always comes down to this one thing: Money. As Thomas Wiswell, MD, said back in 1987, "I have some good friends who are obstetricians outside the military, and they look at a foreskin and almost see a $125 price tag on it. Each one is that much money. Heck, if you do 10 a week, that's over $1,000 a week, and they don't take that much time." Over the two decades since Dr. Wiswell admitted this honest observation, the cost of the procedure has tripled, and in some areas, quadrupled, and is still on the rise.

Not only do they charge a pretty penny for a circumcision procedure, the foreskin itself is sold by the hospital for profit for medical research; one single Neonatal Foreskin Epidermal Keratinocytes goes for a profound $250 at the Coriell Institute for Medical Research. If you consider that 55% of boys are circumcised these days, that is a stark statement of how much medical professionals and hospitals are making on a 15 minute procedure.

My father was born and raised in Germany, and, as infant circumcision is nearly nonexistent in continental Europe, he has an intact foreskin. I once asked him, when we were discussing the politics of circumcision in the US, if he had the option, would he have his foreskin removed. Not surprisingly, he said no. He also does not regret that he was not circumcised as an infant. If you asked me if I wanted my labia removed, I would sure as hell say no. If an infant boy had the mental competency to make an informed decision on whether he should remain intact or not, what do you think his answer would be?

I believe it all boils down to one thing: Informed Consent. As parents, we should respect our children's bodies. Medical reasoning for infant male circumcision has not shown me any research to make me feel that the procedure is necessary or even warranted. Quite the contrary, actually. Informed consent is a beautiful thing, but is so often disregarded by the medical community, especially in obstetrics and pediatrics.

Unfortunately, much of our society does not even know they have a choice--a choice that should be a basic human right. Educate yourself. Research unbiased information. Spread the word.

Choose informed consent.


 References:

Would you Circumcise your Daughter? Woman Uncensored, 12/28/09
US Circumcision Statistics Report, The Circumcision Reference Library
Estimated US Incidences of Neonatal Circumcision Complications,  NoHarm.org
There's Money in Circumcision, Circumstitions Intactivism

help establish a gentle birth clinic in Hati

I came across this article, Giving Life in a Land Overflowing with Pain by Damien Cave, which was published in the January 29th issue of The New York Times. It really highlights a lot of the problems Haitian mothers are facing after the disastrous earthquake.

This morning, I received the following message from Katherine Bramhall, who is in the process of establishing a maternal/child gentle birth clinic with colleague Rachael Lim in Jacmel, Haiti, which is just north of Port-au-Prince. They are in dire need of cash donations before the middle of March to purchase supplies for the clinic, which can be sent to Allies For Trauma Relief, 25 Colby Street, Barre, VT 05641. Donations are are tax deductible.

Beloved Friends,

I arrived home last Thursday afternoon after nearly a month at Bumi Sehat's Bali clinic. In the time I was away, Robin and I made the decision Bumi Sehat would go to Haiti to set up a permanent clinic in Jacmel, north of Port-au-Prince, in response to the massive earthquake which devastated the country.

This decision to establish a permanent maternal/child gentle birth clinic was encouraged along by our partners Direct Relief International, our donors and a small amazing team of midwives and medics, determined to go make a difference.

In the 2 weeks since Robin and Kelly left on Team One, the earth has moved again...not in violence and destruction, but gently and steadily...ever so slowly... towards peace and health...one tiny grain of sand at a time. Our permanent clinic is quickly becoming a reality.

It has seemed impossible at times, confusing, chaotic, always overwhelming...as the conditions on the ground in Haiti are bound to be right now. Patient care is the best that can be affected for right now and so much less than what any health care provider would ever want to consider ok enough.

Sometime in the next 3 weeks I will be leaving for Haiti to join Team Two in Jacmel, north of Port-au-Prince, site of Bumi Sehat's new permanent Haiti clinic.

Between now and the end of February I need to raise $5000 to aid the immediate relief effort in our Bumi Sehat Haiti clinic.

Much is needed and in a short time.

This Sunday I am hosting a gathering at The Loft at Gentle Landing Midwifery at 2:30 (only small, nursing babies please...no children). Please see the attached poster about the event. I hope you will join me and bring all of your friends.

I invite you from the bottom of my heart to pass this email along to all you know. Then please consider coming on Sunday for moral support, updates, stories of hope...and ways you may be able to help the maternal/child effort toward safe and gentle birth in Haiti. Haiti represents a disaster of Tsunami proportions in our Western Hemisphere. The pain is so close to us. The love and hope of healing for Haiti is ours to remember.

I am attaching the freshest field report sent yesterday from Robin about the first few days on the ground. In 2 days we will have delivery of our 44 foot solid dome structure, the new home of our permanent clinic.

Yesterday we were granted a license to operate from the Haitian government. A license to care for pregnant and birthing women whose entire lives have been shattered.

18 months ago, the A Million Mothers campaign email made it across the world two times, raising $20,000 for Bumi Sehat and gentle, affordable Birth Care for women in Bali and Aceh, Indonesia. One mother at a time. One dollar at a time. www.amillionmothers.org

A Million Mothers created a miracle 18 months ago one dollar at a time. Please help a million mothers in Haiti believe in a future for their children. Please pass this email along to all you know. Please post it on social networking sites, yahoo groups...all the places we all go for support and community...

Let's shoot for the stars...A Million Mothers helping mothers and children in Haiti $10 at a time.

My blessings and deep love,
With gratitude and hope,

Katherine

________________________________________________________

If you cannot come on Sunday, or for those receiving this who live too far away, please consider donating to my non-profit organization: Allies For Trauma Relief toward the Haiti effort.

We are not on the web, but are a 501 (c) 3 and contributions can be sent to:

AFTR
25 Colby Street
Barre, VT 05641

Donations will be used to buy supplies for the new clinic and I will be posting updates and photos regularly between now and the middle of March.

If this email was forwarded to you, please email me to have your name put on the email list if you are interested in the updates.

Tax deductible receipts will be issued for all donations over $100.


Please note: All donations made to Haiti between January 12 and March 1 can be claimed for a 2009 deduction, according to a new IRS ruling.

_______________________________________________________


Katherine Bramhall
802.279.3158
katherine@gentlelanding.com
www.gentlelanding.com

the politics of breastfeeding in public

Breastfeeding is normal, biologically and physiologically speaking, while bottle feeding, on the other hand, is not. However, in our society, breastfeeding is not necessarily considered the cultural norm. As such, breastfeeding in public is a very political topic, with surprisingly heated arguments coming from both sides. I am always surprised about this, surprised at how sexualized breasts have become, and how uncomfortable some people can be when they see a baby breastfeeding in public. Having nursed two children for a total of nearly six and a half years and counting in nearly any and every location imaginable, it makes my head spin to think about how backwards we are here in the United States. The fact that people are uncomfortable seeing a child at the breast stems from cultural perceptions and previous practices.

Before I continue, I want to point out that, despite some people feeling uncomfortable seeing an infant at the breast, most states have jurisdiction protecting breastfeeding in public. In the state of Ohio, it is illegal to ask a nursing mother to stop nursing, move to a different location, or to even cover up (1). To do so may result in a civil lawsuit and charges of harassment.

For several generations now in the US, breastfeeding was not seen much outside of the home. As a result of this absence, breasts are perceived only as sexual tools, and breastfeeding is seen as a private act. Perhaps one way to look at this situation is to consider that, at one time, it was acceptable to exclude women and racial minorities from certain places and jobs. Now, though, as a society, we have decided this exclusion is wrong, unfair, and unconstitutional. But it often remains that, despite the societal shift, seeing others in these positions is still not what they consider to be 'normal' and can make these people very uncomfortable. The more often women chose to breastfeed outside the home, the more quickly it will again be considered an accepted and 'normal' practice by society.

Many women walk around in clothing that reveals far more skin and cleavage than a what is revealed by a breastfeeding mother. Breasts are everywhere. Provocative images of cleavage and breasts are plastered billboards, television shows, movie previews, fashion ads, beaches, bookstores, cereal boxes, animated children's shows, and the six o'clock news. These images are all considered acceptable. Most people do not feel uncomfortable when they see breasts. Some people are, however, uncomfortable when they see a baby nursing. Perhaps this discomfort is because the breasts are being used in a non-sexual way. Our society LOVES breasts, it seems--everywhere, at least, except in a baby's mouth--which is ironic, as the purpose and function of breasts is to nourish our young.

To say a woman should be 'discreet' and cover herself when she breastfeeds, well, I say if you have ever nursed a babe, then you know how illogical that mentality is. When nursing a young baby, positioning is often a challenge, and raising, lowering, and removing layers of clothing helps a mother observe her nursing infant and provide the most attentive care possible. And when nursing a baby older than eight to ten weeks, any covering will doubtless be pulled down, up or away by the impatient hands of the curious baby. Most importantly, it is not only unsafe to cover a baby's head with a blanket or towel, it can endanger the life of the baby. Many, many medical associations around the world have official statements advising against using any cover over a baby's head as it greatly increases the chances of heat stroke, suffocation and Sudden Infant Death Syndrome.

One thing that angers me more than just about anything else is when someone compares breastfeeding with deification. That is a disgusting statement. The only thing breastfeeding can be compared to is other methods of feeding a baby. Breastfeeding is not public sex or masturbation or passing gas or voiding in public. It is not a peep show or a political statement or a way to flip the proverbial bird to anyone who happens to see it. All it is is a way to feed a baby. If a baby bottle-feeding in that particular circumstance is not an issue--and there are very few places where it would be--then breastfeeding should not be an issue either. Because at the end of the day, that is really all it is about--feeding a baby.

When observing a mother and child breastfeeding in public, we must consider whose rights are most important in this situation. Is it the person who walks by and insists upon looking, gives in to being offended, and then voices that offense? No. Is it the nursing mother who has chosen to nourish her child in the healthiest, most natural way possible? Again, I would be inclined to say no. Even though a woman has the legal right to breastfeed whenever, wherever, we must not think about it as a woman's right to breastfeed. We must rather think of it as a baby's right to eat.

If someone is uncomfortable seeing a woman breastfeed, then by all means, they should not look. Perhaps they should even throw a blanket over their own heads. But an individual's personal kinks and sexual proclivities should not dictate how women feed their children. It is chauvinistic and patriarchal.


There are several public service announcements from around the world that highlight the importance and acceptance of breastfeeding.

From Canada, Sudbury District Health Unit--Breastfeeding Commercial:



From UNICEF, Importance of Breastfeeding Public Service Announcement:



From Puerto Rico, Dar la Teta es Dar la Vida (To Give the Breast is to Give Life), one of the most beautiful and heartfelt videos I have ever seen:



From Australia, Australian Breastfeeding Association advertisement:



Another from Australia, Australian Breastfeeding Association advertisement:



From Spain:



From Bulgaria:



From the United States:



Another from the United States:





Notes:

(1) A Current Summary of Breastfeeding Legislation in the US: Ohio, http://www.llli.org/Law/Bills31b.html

Comic: Parenting by Jim Borgman

reiterating the risks of male circumcision in infants

Sometimes it helps to remember that parenting is not black and white. What works for one family may not work for another. Aside from abuse, I firmly believe every family has the right to make their own choices, in birth choice, vaccination, discipline, and even circumcision.

As a postpartum doula, one of the code of ethics that I follow is to NOT bring my personal opinion and choices into my relationship and care with clients. I am to give them information on both sides of a parenting issue and let THEM make their own educated decisions. It goes like this with circumcision, vaccinations, infant feeding, diapering, etc. I already know what I believe as I have the right to informed consent, as do my clients. And my clients need to be given the same respect in their parenting decisions. If they are given unbiased information, facts, and resources on BOTH sides of an issue, they will be able to make their own decision. A lot of times, it will be what I consider to be the RIGHT decision, sometimes, though, their decision is vastly different than mine.

With circumcision, I personally believe the procedure it to be abuse and genital mutilation, taking the rights of personal choice away from the boy who the procedure is performed on. But it is still a common procedure, with over half of all male infants receiving the procedure in the US. Ethically, as a birth/postpartum professional, I cannot and would not look down on a family who makes that choice for their sons, whether it be for religious, congruous, or mainstream reasons. It is their path to walk.

This week, I have seen a slew of statements from various sources about the CDC possibly pushing through routine circumcision of all infant boys born in the United States. The CDC lists their official stand here: Male Circumcision and Risk for HIV Transmission and Other Health Conditions: Implications for the United States

In regards to these recent news headlines about recommending male circumcision for HIV prevention, I have some concerns about the plausibility of using circumcision as a prophylactic measure.

Neonatal circumcision is surgery and carries many risks, which include bleeding, disfigurement, and death. An Atlanta boy and his mother were recently awarded 2.3 million dollars as payment for a botched circumcision, in which part of the boy's glans was accidentally amputated. A Canadian boy, Ryleigh McWillis, died from hemorrhaging to death following his August of 2002 circumcision, leading the Canadian government to further discourage parents from having the procedure performed. It seems a bit far fetched, to say the least, to expose a boy to these real risks on the theoretical idea that he may possibly be part of a population with who takes part in risky behavior 20 years down the road.

Not only does neonatal circumcision carry serious risks, it also violates a man's right to choose. If a grown man, after being presented with all the facts, decides on a circumcision, that is his right. However, subjecting infants to a non-medically necessary procedure to which they cannot give consent violates those infant's right to choose how their genitalia look and function or if they want to use a more conservative approach, such as abstinence or condoms, to decrease their risk of contracting the HIV virus.

It is also important to remember that, in the United States, it is currently illegal to make a token cut on the genitalia of a female minor, even if no tissue is removed. According to the constitution of the United States, all persons should be entitled to equal legal protection, regardless of sex.

Typically, proponents of circumcision cite only the short term risks of circumcision, while they unfairly cite both the short and long term risks associated with having an intact foreskin. Evaluations of circumcision as a preventative measure need to take into consideration the long term complications that can arise from circumcision, such as erectile dysfunction, keratinization, painful erections due to excessive skin removal, meatal stenosis, skin bridges, sensitivity loss, etc. I urge the CDC to consider those factors before putting a recommendation into place which would result in even more boys being exposed to those long term risks.

Additionally, the Randomized Control Trials sited in the CDC research and circumcision recommendations (which can be viewed at the link above) show only a reduction in risk for female to male transmission, not male to female transmission, or male to male transmission. In addition, this reduction was only over a two year period, meaning that the protection was only for that time frame; it is unclear if the protection will continue beyond two years or not.

It is crucial to keep in mind that the studies sited by the CDC is limited only to one culture, that of Africa. African culture is very different than the culture of the United States. Rape, dry sex, and other practices common in African culture are not practiced in American culture. To make a recommendation to circumcise millions of newborn males for a hypothetical benefit 15-20+ years down the road, based on studies conducted in another drastically different culture is questionably unsound and should be subject to further evaluation.

Finally, no national or international medical association recommends routine circumcision. Also, major worldwide HIV/AIDS organizations, including the World Health Organization, French Nation Council on AIDS, Australian AFAO, and many more, do not support the use of circumcision as a prophylaxis in countries where HIV is low prevalence and relates to specific high risks groups. The United States falls in to this category.

I am happy to report a new statement from the CDC was released on Thursday: Status of CDC Male Circumcision Recommendations. I am interpreting this statement as the CDC taking all the advocates condemning the practice of infant male circumcision seriously.

We are making progress by informing people that they do have a choice, informing them of the statistics and risks of both sides of circumcision. Letter writing to your government representatives and to the CDC is already making a difference. We cannot change every policy overnight, but we can keep fighting of our rights and the rights of our children.

Keep up the letter writing to help prevent painful, permanent and involuntary body alteration of children!

ethical consumerism

Within the last year, I have consciously undergone a major consumer overhall. I guess it started when David bartered for just about all of the gifts he gave me for my birthday last year. Bartered. He hates the ideology of money, so he is constantly looking for barters and trades. Recently, he traded for a new set of tires for his work van, for a laptop, for my birthday gift this year, for massages and home repairs and a new banjo. It is amazing to me that he is so talented. At about this time, though, I read, Blessed Unrest: How the Largest Movement in the World Came into Being and Why No One Saw It Coming by Paul Hawken. The following is a brief video Paul Hawken speaking about his book and the WiserEarth movement: I initially thought about boycotting money, but I could not figure that into the Big Picture, with filling up the car, and a few other relatively necessary odds and ends. So I decided to leap head-first into ethical consumerism. I made a point to buy products and services that are sold and provided by companies who are publically making an effort to promote the greater good (as opposed to fattening their wallets). My personal guidelines for following ethical consumerism? I look for organic, cruelty free, locally produced, fairtraded, reused and recycled products. So, how do I do this? Well, first of all, I am vegetarian. I chose this path originally about five or six years ago, not only for nutritional reasons, but also for a variety of ethical reasons. Eating meat has a major effect on the earth, but more importantly to me, it has a major effect on the quantity of food that is available for human consumption. I do not remember where I originally read these statistics, but they changed my complete outlook on life, so here they are anyway: it takes approximately 4.5 pounds of grain to make one pound of chicken meat, 7.3 pounds of grain to produce one pound of pork. The world's cattle alone consume the amount of food equal to the caloric needs of 8.7 billion people, which is more than the entire human population. Around 1.4 billion people could be fed with the grain and soybeans fed to cattle in the United States alone. Wouldn't it be far more benificial to use these grains for human consumption, to fight the hunger and famine that is plaguing billions of people around the world, rather than to feed farmed animals for rich, fat Americans? You do not have to give up meat entirely to make a difference--just eat smaller quantities. Not only am I vegetarian, I also seek out locally-grown, in-season fresh fruits and vegetables. Locally grown, organic foods have less impact on the environment (chemicals are not sprayed on them, no hormones; they are not shipped far, so we save gasoline and energy; and freshly picked is more likely to mean "vine-ripened," and will be more nutritious). Check out Local Harvest for organics, farmers' markets, and co-ops near you. Products that I buy MUST be cruelty free. The dairy and eggs I buy must be from free-range, naturally fed animals. No animal testing. I do not purchase commerical cleaners or personal hygine products, which also cuts down on animal cruelty as well as pollution. Fairtrade items are a little harder to come buy, though more and more companies are surfacing who offer such products. What is fairtrade? Wikipedia defines fairtrade certification as "a product certification system designed to allow people to identify products that meet agreed environmental, labour and developmental standards." Fairtrade products include items that are made without child labor or forced labor, without unsanitary or dangerous working conditions, and for which workers are paid decent wages. Reusing items is important. I try to buy second-hand when possible. I shop thrift shops and garage sales. When I no longer need an item, I either pass it on, resell it, or trade it for something I need, want, or can use. Also, then the item does not end up in a land-fill, rotting away--and someone else can use and enjoy it. We have a collection of cloth bags I keep in my car for produce and groceries. We use cloth diapers, pads, and napkins rather than their disposable (and costly) counterparts. In the kitchen, we reuse glass jars for food storage and glass bottles for taking beverages along with--and we use dish cloths and rags in place of disposable paper towel. I also use family cloth over toilet paper--and toss it in the cloth diaper pail until laundry day. I also recycle whatever I can. I also pay close attention to items that have a lot of packaging that cannot be recycled, and choose to buy items with little or no packaging instead. As an ethical consumer, I have also taken it in turn to boycott companies that I believe are unethical. What especially comes to mind is the companies who disregard the International Code of Marketing of Breast-Milk Substitutes, corporations that provide unsafe or unethical working conditions, and companies who impose their will on indigenous cultures. Some of the industries to watch out for/companies on my boycott list include: the gasoline, timber, mining, paper, dams and waterways, and coca eradication industries, Disney, Nestle, Coca-Cola, World Bank, Chevron, and the USDEA are all various culprits. There are so many levels of ethical consumerism, and I am learning more and more every day. I hope to increase my support of the little people out there, who ever they are, decrease my dependence on corporate America, and improve and preserve Mother Nature. Every little thing I do will make a difference in the long run.