Circumventing Circumcision

Because we didn't find out the sex of either of our children before their births, my husband and I had the circumcision discussion when I was pregnant with my daughter.  That was four years ago, and the only resource that I had tapped into was my instinct.  I knew that America was the only developed (?) country in which routine circumcision on boys was still practiced, so I wondered what other countries, and entire continents, knew that we didn't.  Why were Americans so quick to cut off part of a healthy penis?  I spoke to my husband about it, who agreed to do whatever I thought was best.  So, my gut told me that circumcision wasn't necessary, and that was that.

Then we gave birth to a boy.  We opted not to circumcise and met no resistance with our decision.  Then the boy got a urinary tract infection at the age of two days.  He was taken to the emergency room, where they did a spinal tap to make sure he did not have spinal meningitis.  They collected a urine sample which involved me holding him down, his arms put into a pillowcase behind him so he could not move them, and a catheter being placed (yes, a tube inserted into his penis) and waiting for him to pee.  You may not have ever noticed, but when a person is screaming, their abdominal muscles engage, which creates a slight "bearing down" effect on the pelvic floor, making it virtually impossible, and certainly extremely painful, to insert anything up into and beyond the pelvic floor.  We were cleared to go home, shouldn't have been, had to return, and spent a couple of days in the hospital with our son getting intravenous antibiotics.  By day seven of his life, he had had more tests and more medicine than my then-2-year-old daughter - five catheters alone!  He came home, was happy and healthy, until another UTI appeared.  Then a third - all before his 1st birthday. 

My pediatrician was concerned and sent him to a specialist.  We had to repeat the same tests done on day three of his life to ensure that there was no physical reason for the recurring UTI's.  With those complete, and no positive test results, we were faced with the circumcision question.  My pediatrician (completely supportive of my parenting decisions) said that the only medical indication to circumcise was recurring UTI's.  

Popular opinion tells us that circumcision is not a big deal.  That the child cannot feel much pain.  That the boy will be able to stay cleaner without the foreskin in tact.  That the chance of contracting HIV and other sexually transmitted diseases is reduced.  That an uncircumcised boy will look weird in the locker room and feel out of place.  I checked in with my gut, which said that if all these things were true, how is it that so many European and Asian men are walking around in perfect penile health?  I had to formalize my research efforts.  

The subject is very emotionally charged, so getting clear information is a challenge.  In short, I found the following:

1. Circumcision is a big deal.  It is surgery.  It is surgery performed without anaesthesia.  It may not be a big deal to a physician who performs several circumcisions each day, but it is a very big deal to your own son, who only has one penis.

2.  If you think your newborn can't feel pain, try cutting their fingernails too close.

3.  Hygiene is important.  When the boy reaches puberty, the foreskin must be retracted during showers in order to clean thoroughly.  I have two comments: First, a girl's genitals have more folds of skin than an uncircumcised boy.  Second, I'm sure telling my post-pubescent son to touch his penis in the shower will be met with complete embarrassment followed by inner delight.  

4.  I have serious questions about the validity of studies which indicate that uncircumcised men have a higher incidence of HIV.  (See the World Health Organization website for more information)

5.  My husband assured me that boys in locker rooms do everything they can to avoid looking at each other's penises.  That is the last place you want to be caught looking.  

Having armed myself as best as possible, wading through emotionally charged "scientific" articles, I returned with my son to the specialist to discuss what can be done about his recurring UTI's, other than have him on antibiotics constantly (which did relieve UTI symptoms, but left poor son with a blistering diaper rash from stem to stern).  I was armed with the best information I could find and a fierce mama-bear attitude of protection.  I was prepared to put up a fight, and would try my best to not sound hysterical.  How happy I was to learn from this doctor that a new study had been released indicating that if an infant has recurring UTI's and the cause is suspected to be the foreskin, that chance greatly diminishes after the age of 1.  My son was 15 months old.  The specialist recommended following up in one year.  Nothing more.

I returned to my pediatrician for an 18-month checkup and told her the good news.  She was very happy that I would not have to pursue this option, primarily because she knew that I was opposed to it.  She was pleased to learn of that study, and would be looking into the matter more herself.

If you are expecting to give birth to a boy and wonder what you should do about circumcision, please keep the following in mind:

The following reprint from Mothering magazine has two articles in which people speak rationally about the circumcision procedure and the rationale in avoiding circumcision:

Mothering Magazine Reprint on Circumcision

There is not a single medical association in the WORLD that recommends routine circumcision.  NONE!  In fact, this information can be found on the website of the American Academy of Pediatrics.  The headline reads, "Scientific Evidence Insufficient to Warrant Routine Circumcision."  This is dated from 1999.  In fact, this statement goes on to say that parents should be given accurate and unbiased information and left to make the decision they feel is best for the child.  As I have said, that information is hard to come by.

AAP Policy Statement on Neonatal Circumcision

For more anecdotal reference, I have the following story.  A hairdresser (friend of my sister's) is pregnant with a boy.  She has a client who is a mohel (the person in the Jewish faith who performs the religious ceremony of circumcision, known as briss).  The hairdresser was on the fence about the issue, and asked her client about it.  Before she could even complete her question, the mohel answered bluntly, "If it's not your religion, don't do it."

 

Finally, If you have a very strong stomach and can watch a male circumcision being performed, see the following excerpt from "Birth As We Know It," a documentary by a German midwife.  It is not easy to watch, I will warn you.  I was crying and nauseated.  It is restricted on YouTube for content.  I only reference this so you may have all the information I had.  

Birth As We Know It clip

As with all aspects of parenting, one decision does not make you a good or bad parent.  I strongly believe that anyone reading this blog is making the best choices they can make with the information available to them.   So, congratulations.  You are doing a great job.  Keep learning, so you can keep up the good work.