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Also, I Can Kill You With My Brain
The other day I had a rather unpleasant surprise from the El Camino YMCA. It turns out that before one can attend any of their prenatal exercise classes, one must produce a note of consent from one's doctor. They have a handy little "Pre/Post Natal CONSENT FORM" for the doctor to fill out, which I have a copy of here. I complained about this a bit when I got home: chinders suggested I put dead fish on their desks. andres_s_p_b suggested I forge the requested paperwork. After playing along long enough to e-mail my doctor and see if there's a good time this week for me to drop in and get the form actually filled out, I thought about it a bit more and decided exactly how annoyed I was.

I am very, very annoyed.

I have written the following letter, which I intend to send to the Executive Director, both Associate Executive Directors, and the Group Exercise Director. My goals here are twofold:
1. Blister their ears so badly their hair catches fire.
2. Effect immediate policy change.
I consider 2 less likely, so I'll settle for 1 if I have to.

Have a look. See if you can spot any ways it could be improved towards either of those goals. Also, do you think I should have my doctor countersign the letter or at least review the paragraph she's in, or is that just playing into their hands? Furthermore, while I'm planning to e-mail each director a separate personally-addressed copy, should I mail four physical copies as well or just one? If just one, does "Dear Directors:" work as a salutation?

Dear [name]:

About a month ago, I attended one of your yoga classes with a friend of mine who is a YMCA member. My friend recommended that I try the prenatal yoga class, which she found very helpful during her own recent pregnancy. This past Sunday, I attempted to do just that, only to discover that you require a note of consent from a doctor for any pre- or post-natal specific classes. While I understand that it is recommended for any person beginning a new exercise program to consult with a physician, applying this requirement to pregnant women only is patronizing, discriminatory, and unacceptable.

My obstetrician is not a yoga instructor. She is no more qualified to assess the medical appropriateness of this particular physical activity than that of any other physical activity in which I engage: walking my dog, bicycling to work, or visiting a climbing gym twice a week. My doctor has shared with me the particular concerns of pregnancy as it relates to exercise; the signs that indicate a particular activity might need to be modified, reduced, or eliminated; and her opinion that I should “keep doing what [I’m] doing.” I am entirely capable of determining whether my participation in a given physical activity is safe, healthy, or comfortable. As a legal adult, my decisions about what to do with my body—including how or whether to stretch, exercise, or move about—are entirely my own. Requiring the consent of another adult, as though I were a third-grader on a field trip, is infantilizing and degrading.

If you have concerns about the safety of your program or your legal liability, presenting me with an informational pamphlet or a liability waiver such as the one you had me sign before the general yoga class would have been appropriate. Requiring all participants in your group exercise program to affirm that they have discussed the effect of their chosen program of exercise on their personal medical conditions with a physician would be ridiculous overkill, but at least it would be consistent, non-discriminatory overkill. Requiring not only such an affirmation, but the actual consent of a third party, from any subset of the population is treating that subpopulation as less than adult, less than legally competent, and less than equal.

This discriminatory policy should be eliminated immediately. My pregnancy in no way changes my status as a competent, decision-making adult. Over the next few years, if all goes well, I will sign all manner of permission slips and consent forms for the child I am currently carrying. Requiring me to secure a third party’s permission for any personal activity reduces me to the status of a child incapable of evaluating a situation or making a decision. This is simply unacceptable.

I would be glad to attend your programs when I hear that you have changed your policies to consider all legal adults equally competent to make their own decisions. Until then, my active lifestyle and I will support other businesses and organizations.

Most sincerely,

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Not that it necessarily affects the letter, but is this a local YMCA policy, or a whole-organization one?

FWIW, it seems like an appropriately-blistering letter to me.

A quick survey of the results of a Google search on "ymca pre-natal yoga" indicates that this is the only one out of a handful that mentions "physician's consent required to register" on the info page about the class.

That might actually be another thing to mention, if you feel inspired to call a handful of other YMCAs that offer these classes and see if any of them require such a thing -- you could make the "this is also unusual" point.

I wonder if they've formed this policy either for fear of being sued if a stupid woman with a high-risk pregnancy hurts herself, or because of actually being sued?

I would generally be happy to sign a form stating that I've discussed exercising with my doctor, and even give my doctor's name and address. But having the doctor sign the form for something as gentle as a prenatal yoga class seems like total overkill!

I suspect what's going on here is a result of this particular YMCA's location. That is, they're right next to a hospital, and I believe they see a lot of rehab/physical therapy type clients because of that. So they're probably used to working more closely with specific doctors' recommendations than most gyms, and I expect that's had an effect on what they see as reasonable.

Good letter. And definitely don't have your doctor sign it. If you want to her her opinion on the letter by all means do so but don't have her sign it. If she is moved to send her own letter about how silly the policy is she should feel free to do so though :)

I think that's perfect - and, as noted, does absolutely not need your doctor's signature. She should write on her own account, to say how stupid and offensive this is.

"applying this requirement to pregnant women only is patronizing, discriminatory, and unacceptable."

I want a word like "only to pregnant women" which doesn't really work since it's a pre-natal.

What frustrates me about this policy is that if it /were/ applied fairly across the board - by which I mean for people who /may/ be at risk during the activity, then they would be requiring notes from diabetics or people with pacemakers, with low bone density, or hip replacements.

There should be some way of pointing out that they're treating pregnant women as a group differently from other groups that would share the same level of risk.

Also, if it is a requirement just for that one gym, and you really want to bring attention, maybe requesting a meeting with the activity director or some such. Either one-on-one or with a small group. Scheduling a meeting to address some "concerns about some potentially discriminatory language in your policies" tends to open doors sometimes.

Also it's interesting to me that the difference between pregnant women and the other random groups I plucked out of mid-air is that they can identify y'all by your appearance.

Also I'm wondering if the requirement may come from the fact that it's specifically a pre-natal class. If you were wanting to take a "normal" class - would you still have to have the signed form?

I'm also wondering, if you were already a member and "slipped in" to a prenatal class, without telling the front desk (you do not have to sign up for them specifically, if I recall, the other "pre/post natal" classes they offer are water aerobics and that isn't specifically pregnant women, it's a general class. (I'm not saying this is OK, I'm just wondering how far they go in stalking pregnant women for a letter.)

I know it's wrong of me, but I'm really amused by the idea of fitness/pregnancy stalkers standing guard outside gyms with polygraphs and pregnancy tests demanding to know pregnancy statuses.

Sometimes I wish that the bad things people do would be more obviously bad to the rest of the world.

"You want to do an aerobics class? Pee on this stick first!"

I think it's interesting how different people tend to react to the presentation of rules they don't like. Andres goes straight to lying to get around them; I'll either go along with it or try to get it changed. (For example, when we signed up for memberships at the climbing gym, they had prices posted for 1, 2, 3, and 4-person memberships. We were like "Great! We'll have a 3-person!" and were then informed that the 3 and 4 really meant 2 parents and 1 or 2 kids. I thought we should track down a manager and see if they'd put the three of us on the same membership with the same incremental price difference between 2 and 3 as between the standard 1 and 2, since that would be fair and accurately reflect the situation from everyone's perspectives; Andres thought we should pretend another friend also lived with us so we could split 2 2-person memberships. So cobalt_00 mailed some official university stationary to herself at our house....)

There are definitely a number of different tactics I could take if my goal was prenatal yoga, or even prenatal-yoga-without-jumping-through-this-particular-hoop. But my goal is no longer prenatal yoga.

I'm not even saying it, necessarily, to try to cheat around the system or anything... i'm mostly curious now. When I, hopefully, am pregnant soon and start going to prenatal yoga do they stop me at the door? If I go to the water aerobics class are they gonna question me because i'm the only one under 60 and therefore may be pregnant? I mean, if I'm feeling up to it I'll continue in the regular yoga classes where I don't expect to be questioned. But the difference between now and when I joined 2.5 years ago (and you're situation) is I specifically joined for the prenatal classes. Now I'm already a member I don't have to sign up and ask questions at the front desk.

ALSO, I was, i recall now, annoyed at needing a dr. note, but I'm MORE ANNOYED and bothered now. I wonder how much my level of putting up with it was due to the fact that i "needed" some prenatal yoga because I had a painful pregnancy and how much is the current political "war against women" climate. I think all the attempts to block abortion, birth control, freedom in general, for women is making things like this more troublesome than I felt it was then...

Yeah, I think the political climate has definitely influenced my level of annoyance / chosen response here. It's not like this specific policy is a big huge thing -- but that means that it's small enough that I can describe the problem clearly and actually take (possibly) constructive action. Which is not something I get to do to the larger political climate until it is voting time.

I think that rolling your eyes and jumping through the silly hoops is a totally reasonable response -- it's the way to get what you want, if what you want is the class, and it's not really much work. I didn't even realize what was really bothering me about it until I'd sat with it for a day or so, so I could easily have just gotten the silly note and moved on. But having identified the actual issue, now I am having a Principled Moment.

Trying to fix broken, stupid bureaucracies is a lot of work and seldom successful. Circumventing them by ignoring rules or outright lying is very easy and usually works.

Also it's interesting to me that the difference between pregnant women and the other random groups I plucked out of mid-air is that they can identify y'all by your appearance.

They're making the distinction on whether you're signing up for the pre- or post-natal classes, not on what you look like.

I suppose in three months or so when I am completely unarguably obvious I could go try to sign up for something else and see what happens. In the interests of completeness.

Those specific comparisons to other groups with high injury risk could be handy if they try to argue back at me; thank you.

The thing that's making me just crazy about this is that they're requiring a consent form for a prenatal yoga class, which is supervised by an instructor who has dealt with this stuff before and is experienced, whereas you could go buy a DVD and do it all on your own and have no supervision whatsoever. And I am not feeling that the latter part is the crazy part.

Good letter. Hang in there.

For that matter, it sounds as though she could take the ordinary yoga class without that discriminatory permission slip. It might be worth asking whether prenatal yoga is riskier than all their other exercise classes and, if so, why the form doesn't say "we ask a doctor's permission because of the high risk factor of this class. If your doctor considers prenatal yoga inappropriate for you, we suggest the ordinary yoga class, weight-lifting, or a dance class."

The thing is, I'd much rather take the prenatal class than the regular class, because the prenatal class would be safer. (And also, by report, tuned to include things like stretches that are useful childbirth preparation.) If I were already an experienced yoga student it wouldn't matter so much because I'd already know I was doing things correctly and could adjust for changing balance and modify things for safety on my own -- but I'm not, so I'd very much prefer to have someone who does know what they're doing there to keep an eye on me and tell me things like "Whoops, no, don't lean straight from there, you could strain your back; twist this way instead."

I sort of worry whether pointing out quite so explicitly that I could ignore their rule by doing something even slightly riskier at their facility might lead them to look harder for pregnant people rather than people taking pregnancy-related classes, which would be remarkably counter-productive.

Exactly. Exactly, exactly, exactly.

With redbird's amendment about why pre-natal yoga is singled out: this is a great letter, and don't get the signature, but if your doc could write her own letter, that would be wonderful.

I'm thinking that the policy is also discriminatory against women with less money and time and/or with jobs where they have to clock in and out, because such women are less likely to be able to afford to make an extra doctor's appointment to get the form signed. That works out to inadvertently discriminating against poor women and women of color. Making it more difficult for poor people and people of color to participate is against the Y's stated principles.

1. most doctor's in most pregnancies wouldn't require a visit for this, just a phone call (assuming the woman has already been under their care).

2. Also, this YMCA is located in Mountain View and I've noticed and commented before that this is not a poor person's YMCA. We have a 1997 civic. Nothing special, but often, by far, the poorest car in the lot. Audi, BMW, etc. This is yuppie YMCA. Which was very confusing to me for quite some time.

If one were aware of the policy in advance (which I could have been if I'd checked the website first) one could just pick up a note at a regularly-scheduled appointment. I mean, your point is also valid, but it could be addressed in ways that totally miss the root of the problem. It's not that it's a big obnoxious roadblock, it's (1) that it's applied only to pregnant women and (2) the particular infantilizing nature of the requirement that has got up my nose. I don't want them to make it easier to get third-party consent; that wouldn't address my concerns at all.

Having not read the comments yet: your second paragraph kind of goes against what you're trying to do. "My doctor says I'm doing the right thing!" to justify not having to get doctor permission feels weird. Perhaps rephrase to remove "keep doing what I'm doing" but keep the rest. Or something. I like plymouth's comment and agree.

Do you know why they're requiring this form? That might be very useful knowledge to tweak the letter (if applicable once you know why).

I am unsure about multiple copies - if you're already emailing, why the paper letter? (But I'd lean towards separate, individually addressed if you are going to send a paper letter. Consistency.)

if you're already emailing, why the paper letter?

People take paper letters more seriously sometimes.

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