ICAN of Huntsville crucifies a physician ally


It started with a sign.

Please let us know if you hire a doula during your pregnancy as Dr. Aguayo has decided not to collaborate with doulas or other lay support people… Please feel free to discuss any questions or concerns at your appointment.

It has escalated to a full fledged attack on a doctor orchestrated by Huntsville Alabama ICAN (International Cesarean Awareness Network). At this point, ICAN’s followers are jamming the phone lines and patients cannot get through to speak with the doctor or staff.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]ICAN Huntsville doesn’t understand that it might not have been Dr. Aguayo’s choice or they don’t care.[/pullquote]

When I first saw discussion of the sign on Facebook, I assumed (incorrectly) that the doctor was an older, man who got fed up with doulas acting outside their scope of practice by giving medical advice to patients.

But that’s not the case as a variety of testimonials on Facebook make clear:

Dr. Aguayo is wonderful and very pro patient choice. With both of my pregnancies she has been very kind to listen to my concerns and open to my choices, never once saying no to any of my requests. I chose to use a doula with my first birth and she was very encouraging and supportive of that. She even made recommendations when I brought the subject up. All I can say is something big must have happened to come to this point for her. Love her so much and I’m so glad she’s the one delivering my children!!

And from the page of Huntsville ICAN itself:

I love Dr Aguayo she is one of the kindest most patient providers Ive ever met…She has always been very welcoming to Doulas and has always encouraged natural child birth and wasn’t very invasive at all…I can’t imagine what would have happened to make her take this stand…There has to be more to this story…One of my best friends delivered with her just 2 months ago with a doula and it was a wonderful experience…‍♀️I think something had to have happened to make her take this stance.

It does not take a rocket scientist to figure out that Dr. Aguayo, apparently a staunch supporter of both natural childbirth and doulas, was probably forced into taking this action.

How might that have happened? It could have been precipitated by a dreadful outcome — a brain injured or dead baby — whose care was compromised by a doula operating outside her scope of practice. It may not have even involved Dr. Aguayo herself.

Nonetheless, Dr. Aguayo’s malpractice insurer might have told her that her insurance would be invalid if doulas were involved in patient care.

Dr. Aguayo’s hospital might have told her that doulas were not longer welcome in the wake of bad outcomes.

Dr. Aguayo herself might have come to the conclusion that certain doulas in her area were actively harming patients or interfering with the doctor patient relationship.

One thing seems certain, however; Dr. Aguayo is not personally opposed to doulas.

That didn’t stop ICAN of Huntsville from naming and shaming her. It resulted in a story on AL.com, Alabama OBGYN refuses to work with birth doulas, causing online uproar.

A local birth advocacy group, ICAN of Huntsville, posted the photo Tuesday morning. By Thursday afternoon it had been shared more than 1,500 times and had more than a thousand comments.

But for ICAN and many of the commenters, the online uproar over Aguayo’s policy isn’t just about the ability to use doulas with one doctor. It’s a natural outgrowth of changing cultural expectations for how childbirth is supposed to go. Doulas are often seen as patient advocates and witnesses in a setting that favors the needs of hospitals and doctors of those of laboring women.

“Birth culture is changing among consumers,” said Brianna Barker of ICAN of Huntsville. “We are realizing we do have the ability to take hold of our rights.”

They were especially angry that an ally had let them down:

The post also gained steam on Facebook because it was about Aguayo, said Barker.

“Anybody else in town would have been less shocking,” she said. Aguayo is well-known in the Huntsville area for her welcoming attitude toward birth plans, natural birth, and her willingness to work with doulas.

“That’s why I chose her,” said Lowder. “I have very natural views on childbirth and wanted to have a doctor that supported that. And she did.”

Without bothering to consider that Dr. Aguayo might have been forced to stop working with doulas, they crucified her.

The online anger was swift. Negative reviews popped up on Google. Barker said she and Justen Alexander, also of ICAN, spent hours deleting inappropriate comments on the post and banning commenters who stepped out of bounds, including those who shared links to Aguayo’s personal information.

At All Women’s OBGYN, the phone lines have been so backed up that patients have had a hard time getting through, Janah Baker, the office manager, told AL.com.

“It’s been disheartening and frustrating,” said Baker.

Huntsville ICAN and its followers were so drunk on self-righteous rage that they never stopped to analyze the situation or consider the impact of their actions. They’ve been backpedaling ever since.

If you feel strongly about this policy, writing a letter may be the best way to share your concerns without disrupting the patient care. Do not post links to Dr. Aguayo’s personal profile – these comments will be deleted. Please do not leave reviews on her page unless you have been her patient. This is about her policy, not about her as a person. Please do not call her office unless you are a patient.

But they still don’t get it.

ICAN does not support maternity care providers dictating who a patient can privately contract for services. The abuse of power dynamic is outlined in ACOG’s Committee Opinion of refusal of medical recommendations.

They either don’t understand that it might not have been Dr. Aguayo’s choice or they don’t care; they crucified her anyway.

With friends like Huntsville ICAN, who needs enemies.