Circumcision Decisions

Today we found out we're having a boy! I'm very excited for my son and daughter to have a little brother soon. However the next thing I thought was "now we have to have a discussion".

When we had our son, I was more involved in preparing for labor and registering for baby gear than I was in researching evidenced-based care for myself or him. I pretty much left the decision of circumcision up to my husband since "I don't have one". I'm now a bit embarrassed and ashamed that I didn't attempt to learn more about the procedure.

Our son was circumcised when he was less than 2 days old, which is the common time frame for the hospital-based version of the procedure. I could not ignore how wrong I felt when they came to take him away. I did know enough to ask the doctor to use anesthesia, which frighteningly is not standard. I did not know the reality of the complications that we fortunately avoided that day. I also did not know the reality of the complications that could arise afterward such as adhesions which we were not successful in avoiding.

When I was pregnant last time (and before I knew it was a girl) I started reading the history and research behind circumcision and was surprised at what I found:

• The US circumcision rate is currently over 50% (and declining) while the rest of the world is around 10%
• The US rate was relatively the same as the world rate in the mid-1800's at under 10%
• The US rate climbed sharply through the late 1800's and early 1900's based on "studies" that said circumcision cured various issues such as bed-wetting, epilepsy, and masturbation
• The American Academy of Pediatrics declared in 1971 that routine infant circumcision had no medical indications, i.e. no medical rationale/benefits - this was reaffirmed in 1999
• The studies done in Africa that concluded "circumcision helped prevent AIDS" did not include factors for the sexual behavior of the men in the study.
• The difference in the amount of infections from the control (uncircumcised) and experiment (circumcised) group of the Africa study was in the 20s. Both groups had new infections, the experiment group just had 20 or so less. Is that true prevention?
• Newborn circumcisions are usually done by obstetricians in the US - not pediatricians. Why is that? Are pediatricians trying to signal an important discrepancy to new parents?
• Anesthesia is not routinely used. Is that humane?
• Penile sensitivity is affected by circumcision - a reduction in sensation by as much as 4 times
• Female circumcision has been held up by a US court as torture and a reason for sanctuary for a foreign immigrant. Is male circumcision that different?
• Religions that promote male circumcision are about offering a blood sacrifice. Christianity does not promote blood sacrifices since Jesus' crucifixion was the final blood sacrifice for all Christians.

I write all of this to emphasize how important this decision is - one that shouldn't be made lightly. I have already told my husband that we have to have a long talk about circumcision soon. The more I research, the more valid my feelings seem for that day almost 4 years ago when my son was cut.