GFM

Tuesday, October 6, 2009

Circumcision

First, let me say that I think circumcising your child is a very personal decision.  It should be made by the parents of the child alone.  Nobody else can decide for you what to do to your child. 

Secondly, let me say, that to leave comments about it & then not leave a reply e-mail addy is lame.  Especially when I didn't ask for information or input.

Finally, our son will be circumcised.  I'm not too particular about which method is used, as long as it is done correctly and neatly.  My largest concern is that my baby is given pain medication and local anestesia prior to the surgery and then given pain medication as needed after the surgery. 

The decision to circumcise Luke was not an easy one.  I did a LOT of research.  We are not doing it for any religious reasonings.

There is medical evidence that states that circumcision later in life hurts MORE and takes longer to heal (if it heals correctly) than circumcision as a newborn. 

Both sides of our families have had complications with uncircumcised boys having problems as children/teens and needing to have operations and circumcisions.  Those boys all say that they wish it had been done as a baby, so they'd have no memory of it.  They will remember and be effected by the pain of late-in-life circumcision forever. 

We are going to fight to have Tim go with Luke, to hold his hand and console him during the 10 minute long procedure.  Luke will be numbed before and will have access to pain medication after.  The operating table that is used is heated and Luke will be swaddled during the procedure, not spread eagle on a plastic board like you see in the horror films on Youtube.  Immediately following surgery, Luke will return to me.  He will not be held in the nursery or required to have any length of "recovery" in the nursery. 

If Luke resents us later in life for having him circumcised, well, we'll deal with it then!  I'm sure he'll resent us for other things along the path of life too!  That's part of being a parent.  Most likely, he won't care either way, just like all the guys in my life, don't care.  It's just how it is. 

So, if you're going to comment on this post, I ask that you please leave a reply e-mail, so I can write back to you.  I hate not being able to respond to comments.  Comments that are hateful, ugly, rude, vulgar, or use profanity will be deleted.  Comments w/o an e-mail address may be deleted (at my discretion.)  I love comments, but don't comment on something so personal & not let me write back to you.  Thanks! 

21 comments:

janelle said...

Oh man! I wrote a blog about this a little while ago and apparently it's everyone's responsiblity to tell you that you need to do what they believe! My inlaws called and yelled at my DH over this, I got all kinds of weird comments from strangers. I didn't realize how heated this topic can get. On top of that I mentioned sleep sharing, another taboo subject! I learned my lesson and I wish I would have kept my opinions to myself. It is deeply personal, it's not something that people should give their stupid "advice" on. Good luck with everything! Kudos to you for your bravery, lol!!

Mark Lyndon said...

At least you've been researching this, and one of you is planning to be there while it happens. I still think you should reconsider though.

I agree that it's a very personal decision, but I believe it should be made by the child alone.

Circumcising to prevent a circumcision later on doesn't really make sense. In the UK, only about 1 in 100 males ever actually needs to be circumcised, and it's getting rarer. That means 99 babies have to be circumcised unnecessarily to prevent one circumcision later on. Circumcising later on actually hurts less though, is safer, and the results are cosmetically better. I've never heard of anyone dying following an adult male circumcision in a western setting, or needing a "revision" (a second operation).

You might also want to check out the following:

Canadian Paediatric Society
"Recommendation: Circumcision of newborns should not be routinely performed."

http://www.caringforkids.cps.ca/pregnancy&babies/circumcision.htm
"Circumcision is a 'non-therapeutic' procedure, which means it is not medically necessary."
"After reviewing the scientific evidence for and against circumcision, the CPS does not recommend routine circumcision for newborn boys. Many paediatricians no longer perform circumcisions.


RACP Policy Statement on Circumcision
"After extensive review of the literature the Royal Australasian College of Physicians reaffirms that there is no medical indication for routine neonatal circumcision."
(those last nine words are in bold on their website, and almost all the men responsible for this statement will be circumcised themselves, as the male circumcision rate in Australia in 1950 was about 90%. "Routine" circumcision is now *banned* in public hospitals in Australia in all states except one.)

British Medical Association: The law and ethics of male circumcision - guidance for doctors
"to circumcise for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive would be unethical and inappropriate."

Caroline said...

I apologize for not leaving my email address.

carolinewarren@ymail.com

I didn't realize you wanted that, or I'd have gladly included it.

Caroline said...
This comment has been removed by the author.
Caroline said...
This comment has been removed by the author.
Joel said...

Hello Stephanie,

Although I do not feel comfortable sharing my personal email address with anyone who reads your blog, I will come back and check to see if you have responded, so if you write a reply in the comments section, I will certainly see it, and respond if prompted.

In the past, we in America did not understand the proper care of the foreskin. Doctors used to (and still often do) force the foreskin of an infant back as soon as possible, to try to clean it. But because the foreskin is supposed to remain bonded to the head of the penis for a number of years, this actually cause tearing and scarring and other problems that often result in infections and tight painful foreskin problems that may require circumcision.

However, most of the world does NOT circumcise, and because they have always understood not to retract the foreskin of a young child, they do not have the same problems. Circumcision is unheard of as a non-religious medical procedure in most parts of the world!

You are right that it takes a bit longer for a circumcision wound to heal the older someone gets, but as for the pain argument, that has been disproven. Infants do feel pain. In fact, some research has even shown that infants feel pain even more accutely... (which makes sense, an infant would cry if you flicked them... As an adult, I wouldn't cry if I was flicked).

Now, trust me when I say this, as much as I morally object to circumcision, it is not a critique of your parenting skills. It is very clear in your reply that you have only the BEST intentions for your child. I am very impressed by your reasoning. I really do think its important that if you have it done, you do insist on all the things you mentioned.

However, because of the information I shared, I think that your ultimate reasoning (the medical) is not actually the case. I truly hope it is not the case that you will discount that information, as it seems to be the very basis of why you would inflict something you admit is painful and permanent on your child.

The foreskin IS valuable tissue. If treated correctly, it is just as healthy and functional as any other properly treated body part. I honestly hope you will look into the information I have shared. I know you researched before, but I think if you look again, you'll see that there is a lot of very important information that illustrates my point.

Thank you for being open-minded, and continuing the discussion on something that is very hard to think and talk about.

Smellyann said...

Wow, dude. Brave post! But... where are all these commenters coming from out of the woodwork? Sheesh.

Vikinggirl said...

Stephanie please please please don't do this to your son. If you treat him right (ie wash it carefully on the outside only in early childhood and otherwise leave it alone) there is a 6 in 1000 chance he will have the clinical indications for a circumcision. That's a tiny chance and not worth amputating the most sensitive part of his sexual anatomy to prevent.

You need to be aware that American doctors are highly ignorant of the natural development of the foreskin in childhood and often misadvise forced retraction. They were in Britain too until The British Medical Association started putting pressure on doctors and calling this ignorant surgery 'unethical'. Now it's admitted that in a man's entire lifetime there is only a 1% chance he will need a circ - and even then they wouldn't normally remove the frenulum which is routinely destroyed in America despite being highly sensual.

In places like Denmark and Japan (areas with low STDs and low penile cancer) they leave foreskin to develop naturally and find retraction doesn't occur until 10-15. This is a hygienic thing designed by nature because as long as nature fixes the foreskin to the glans with adhesions there's no need to wash under - any more than you need to remove your fingernail to wash underneath it.

Check out the advice provided by charities NORM-UK and by Intact America on the subject of caring for an intact boy. No one is trying to get at you but you are being seriously misadvised by well meaning family members and possibly also by doctors. It's your duty by your son to find out the truth and to protect him. Remember lobotomy? That was promoted as trivial beneficial surgery like circ once, and they played down the harm. Now we are ashamed to have ever thought it was a good thing, and especially to be done to children with only mild issues.

It's my personal belief that a forced circumcision without medical need is a violation comparable to a rape, and i know many men who feel that way. By the time your son becomes an adult America will be a place where most people realise the flaws in American medical history that lead to the demonisation of this body part. He will know what he's lost and though he may go into denial there's a high chance he'll be very angry with you.

Trust nature and trust your instincts not to interfere with a child's sexual parts. It was only when we began interfering with this body piece that problems with it became common.

It's time to leave well alone and let children grow up whole with all their sexual nerves intact. You wouldn't cut off a daughter's nerve rich labia or clitoral hood because they might possibly be subject to future infection and you should be equally angered by the suggestion you carry out this pre-emptive strike on your son's sexuality.

My email is laura_esleamac@yahoo.co.uk

DrMomma said...

Hello Steph,

It's great to see a mom taking the initiative to dig into the medical research further prior to her baby's birth!

I am a doctor of human sexuality with specialty training in birth and baby-related health and sexuality. I've had the wonderful opportunity to study and teach (at the university level) on the important prepuce organ (nicknamed 'foreskin in boys; 'hood' in girls) and circumcision for the past 12 years. I currently also conduct research for the National Organization of Circumcision Information and Resource Centers in Washington, D.C. My email for further correspondence if you like is CircResearchInfo@gmail.com

It sounds like you do care a lot about your son not experiencing pain or trauma during surgery - that is great because we see babies daily who suffer from coma, heart attack, seizure, stroke, hemorrhage, respiratory distress, and an assortment of other complications due to having their MOST sensitive 1/3-3/4 of their penis amputated (there are about 70,000 nerve endings in the prepuce organ alone). It is really heartbreaking and I have to filter through reports of death-from-circumcision each week.

Currently, the American Academy of Pediatrics (as you probably know) does not recommend circumcision. Actually, NO medical or health organization in the entire world recommends it. The U.S. is the ONLY country where almost 50% of newborn boys are circumcised. (The country with the next highest rate is Canada and their circumcision rate is currently 9%). To make matters more complicated, the AAP recommends that NO anesthesia be used on newborns because of the high rate of complications that result from anesthesia in tiny bodies - babies do not handle being anesthetized well (even local anesthesia or creams). But on the other hand, the AAP clearly states that NO baby should ever be circumcised without anesthesia...for obvious reasons. Complications can, and do, arise often in both situations (anesthetized or not). The only way they do not arise is among babies kept whole and intact at birth.

Unfortunately, today most hospitals that do circumcise babies do NOT fully inform parents of the procedure or possible consequences. If a baby dies as a result of anesthesia, it is directly placed upon the hospital as 'their fault' because it is counter indicated for newborns. However, if a baby dies as a result of circumcision-complication without anesthesia, it is not as easily pinned upon the hospital, and they are more readily able to get out of law-suits. Therefore, MOST circumcisions are done without anesthesia - even if/when a mother is told that it will be used. (Just one reason parents are rarely allowed to watch).

Even when anesthesia is used -- the dorsal block is the most efficient -- it is typically given in a set of 3 injections into the dorsal parts surrounding the penis. The dorsal surface is numb, but the problem is that it is impossible to numb the perineal nerve and anything beyond that still has full sensation. This is why we STILL see a significant increase in cortisone and other stress hormones, we still witness screaming and/or coma, respiratory problems (as babies gasp for breath), vomiting/gagging due to pain, and we still find babies have complications from genital cutting, even when anesthesia is used. The frenulum is beyond the perineal nerve and must be stretched, torn and severed for the surgery.

I am curious if you have witnessed the various forms of circumcision being done? Or looked at photos? I know that you mentioned the 'horror videos' around YouTube...but I have had to witness many circumcisions for my profession and I can tell you honestly, those "horror videos" are reality and the reason why MOST doctors today WILL NOT perform genital surgery on an infant unless it is ABSOLUTELY medically necessary. Doctors Opposing Circumcision is a great group of medical professionals across the U.S. and around the globe working to share accurate, medically-based, statistically-correct information. www.doctorsopposingcircumcision.org/

(cont. in next comment)

DrMomma said...

(cont.)

Interestingly, a few years ago when the nurses in New Zealand went on strike and started REFUSING to hold screaming, traumatized babies for genital cutting, and mothers were forced to do so, parents finally witnessed circumcision first hand and the rates of genital cutting dropped to almost zero.

I like the idea of keeping your son swaddled -- and the most commonly used Circumstraint is a bit scary to look at. But one way or another (there are now other types of restraints used as well) your son's tiny naked legs will have to be strapped and spread-eagle so that genital cutting can take place without a kick (babies do try hard to escape) and a slip of the knife (which does still occur at times). There really is no 'peaceful' or 'gentle' way to cut the genitals of boys or girls.

You mentioned your interest in Attachment Parenting and nothing could be more wonderful (for both parents and babies) than AP ways of baby-raising - which really are the 'natural, normal' ways that babies have been cared for throughout all of human history. Dr. Sears is of course the guru pediatrician of the AP world and his statement on circumcision is pretty simple, but to the point: www.askdrsears.com/html/1/t012000.asp

Even when the 1 in 3 complications of prepuce amputation do not occur after surgery (33% must have repeat surgery, have their penis severed, loose too much blood and need transfusion, etc), we still find that babies are impacted in grave ways. Breastfeeding is most often complicated. Failure to thrive, and attachment issues develop, as well as dramatically increased colic and fussiness as a result of circumcision. We rarely find these issues to be true among the babies of AP parents who are kept intact at birth. I suspect that is why keeping babies whole from birth is the foundation of attachment parenting - it impacts all else.

[New research shows surgical pain in infancy impacts adult experience of pain and stress hormones as well: drmomma.blogspot.com/2009/10/infant-pain-impacts-adult-sensitivity.html and even our 'old' research was often ended early due to the trauma of circumcision: drmomma.blogspot.com/2009/10/circumcision-study-ends-early-due-to.html]

(Cont. in next comment)

DrMomma said...

(cont.)

Your concern for your son's future wellbeing was mentioned -- that you wouldn't want him to face prepuce amputation at a later time in life due to problems. It is terribly unfortunately that so many babies in generations past who WERE protected at birth and kept intact still faced 'problems' because of (often well-meaning) parents/doctors/care-takers who were told to forcibly retract, stretch, or 'clean' the foreskin. 95% of the problems we see among intact babies, older boys, and adult men occur because someone OTHER than the boy 'messed with' the prepuce prior to it detaching and retracting on its own.

When babies are born, the prepuce organ is SECURELY attached to the glans (head) of the clitoris or penis much like a fingernail to the finger. If we pulled back our fingernail...tried to 'clean' under it, etc., we would irritate it, cause damage, and possible infection. One doctor tells his new parents that the only item they need to care for their intact baby boys is a ruler - to slap the hand of anyone who tries to mess with it. So often in times past (and still today in some unknowledgable areas) parents of young boys or adult men are told they MUST be circumcised for a variety of reasons that occur even more frequently in women - yet we never amputate the prepuce in girls/women. There is very, very RARELY a true need for circumcision - either in girls or boys, men or women, babies or adults.

You may be interested in more on this topic as you said it had occurred among men on both sides of your family:

Protect Your Intact Son: Expert Medical Advice: drmomma.blogspot.com/2009/08/protect-your-uncircumcised-son-expert.html

Medical Testing: Do Not Retract: drmomma.blogspot.com/2009/09/uti-testing-on-boys-do-not-retract.html

Only Clean What is Seen: Reversing the Epidemic of Forcible Retraction: drmomma.blogspot.com/2009/09/only-clean-what-is-seen-reversing.html

Ask the Experts: Forced Retraction & Problems: drmomma.blogspot.com/2009/09/ask-experts-forced-foreskin-retraction.html

[Side note: Have you looked into the history of female circumcision in the United States? It has a VERY similar history to male circumcision in the U.S. There is a photo on this page as well of the prepuce organ of a baby girl and baby boy -- they are homologous and analogous organs with the same important functions. When we 'mess with' the prepuce of baby girls, we have the same problems arise as when we 'mess with' the prepuce of baby boys. drmomma.blogspot.com/2009/09/history-of-female-circumcision-in.html]

The pediatricians I work with give this great advice to their clients: INTACT = DON'T RETRACT! ONLY CLEAN WHAT IS SEEN. The prepuce is a self-cleaning organ in babies and children and NEVER needs to be tampered with in any way. It is also the only body organ (other than a lactating woman's breasts) that produces its own antibodies, antivirals, and anitbacterials. It is part of the immune system, believe it or not - which is why we also see intact babies (boys and girls) having a healthier babyhood/childhood than their circumcised peers.

(cont. in next comment)

DrMomma said...

(cont.)

For more information on the many important functions and purposes of the prepuce organ, you may be interested in Dr. Fleiss and Dr. Hodges book, "What Your Doctor May Not Tell You About Circumcision." www.amazon.com/Doctor-About-Circumcision-Performed-Unnecessary-Surgery/dp/0446678805/ref=sr_1_1?ie=UTF8&s=books&qid=1254949624&sr=8-1

Dr. Fleiss is a pediatrician in L.A. and has studied the prepuce organ and circumcision for the past 30+ years. Dr. Hodges conducts research and teaches at Yale, and he too, has spend his lifetime career studying this topic. They really are 'experts' on the subject and warn parents that MOST doctors have not received any adequate training when it comes to the prepuce, care of an intact penis, and circumcision. An excerpt from their book on the many important purposes of the prepuce can be found here (but the whole book is a very thorough, excellent resource for someone who wants to be fully versed in the literature): drmomma.blogspot.com/2009/09/functions-of-foreskin-purposes-of.html

It is no wonder that more adult men are suing (and winning) the hospitals that took so much from them as a non-consenting infant: drmomma.blogspot.com/2009/10/class-action-lawsuit-circumcised-men.html

If I can be of any help at all, please let me know. We have medical research packs that we give out at the D.C. hospitals and I'd be happy to send one. This is an area that parents deserve to be FULLY informed on prior to their beloved baby's 'birth day'. I meet with mothers and fathers each week who tell me they WISH they had had more information...they regret deeply decisions and consequences made. Derek Markham is one father who watched his first born son's circumcision and he writes about it frequently: drmomma.blogspot.com/2009/09/circumcision-will-you-make-cut.html

After all, healthy, functioning body organs in babies are there for a purpose (or several) and very, very rarely is it a good idea to remove them from a newborn.

Further online resources:
www.circinfosite.com/
www.nocirc.org/
www.asnatureintended.info/
www.cirp.org/
www.circumstitions.com/Restric/Circ.html
www.mothersagainstcirc.org/
www.noharmm.org/raising.htm
www.mothering.com/

sig47emt said...

Lord, people act like it is the end of the world and you should be ashamed for doing it. Whatever.

Like you said, it is up to a parent to make the decision, and no one else to judge. My son is circumsised because we chose to do it, and did so with confidence. He is a healthy, happy, well-balanced, well-adjusted 3 year old boy who hasn't a care in this world. His penis has nothing to do with it, nor do I think his circumsized penis will cause him to miss out or be lacking anything in life.

I wish as many people who are worried about a little bit of skin on their child's penis devoted the same passion towards their children's education and moral/social concerns, or other more important things for that matter.

Seriously - how did any child ever survive the 1950s!? They spanked, circumsized, drove without carseats, and *gasp* made their children play ALONE. Small wonder any of us are even here, since according to estimations, our parents born in that decade should be traumatized beyond repair!

I also think it is funny that so many people are aghast and try to compare removing a bit of skin (which a baby never remembers nor are they "traumatized for life" by) to rape - but then some of the same people have no problem with saying it is a woman's choice to mutilate her baby's body to death by abortion.

If you decide to circumsize, do it knowing that you make the best decisions for your own baby, and be confident in that. Circumcision is not as huge of a deal as people make it out to be. If you choose to NOT circumsize, that is just as fine as if you do.

I hate when people try to make other people feel bad for their parenting decisions.

Is circumcision necessary? Not really. Does it make you wrong, or a bad parent? Most certainly not.

Heidi said...

Holy cow Stephanie, you are getting a lot of negative comments here! I just want you to know I stand behind your decision to circumcise. . . Jerry and I had Jacob circumcised as an infant. He was numbed up before he left my room and when he returned a very short while later he was just fine... no fussing or anything! And no he's a perfect, happy, and heathly 2 year old. Chin up girl! I think you are making the right decision!

DrMomma said...

Heidi - I sure hope my comments did not come across as 'negative' - it is just a shame to make a decision that is not based in research, facts, and fully informed, accurate information - especially when it involves the life of another human being.

The work I do is a passion, but it is solely for the purpose of accurate and complete education - not to hurt or bash anyone.

Most people want to do what is best for their little one - and one action is not going to make you a 'good' or 'bad' parent, but genital amputation w/out medical need certainly is NOT attachment parenting in the works, and it DOES impact other aspects of babyhood, whether we wish to admit it or not.

DrMomma said...

sig47emt - I believe you are missing the point... it is NOT "a little bit of skin on the penis" - it is a complex, multifaceted prepuce organ present in both men and women (boys and girls) on ALL mammals. It serves many purposes - protection, lubrication, immunological, gliding, sexual, health. It includes a smooth muscle (the ONLY part of the penis/clitoris with a muscle), the ridged band, 2 sphincters, 70,000 nerves, multiple mucus membranes and glands that emit antibiotics, antivirals, and antibacterials. The prepuce contains the frenulum, the internal and external prepetory sheaths, and is meant to protect the glans (head) of the clitoris/penis the same way your eye lids protect the eye balls. The glans is meant to be an internal organ. You may wish to learn all the many purposes of the prepuce organ and how it impacts human development, health and sexuality before commenting on what it is/is not. http://drmomma.blogspot.com/2009/09/functions-of-foreskin-purposes-of.html

Joel said...

Sig47emt & Heidi,

I hope to reiterate that the intentions of my reply were certainly not to make anyone feel like a bad parent. I even said my comment was "...not a critique of your parenting skills. It is very clear in your reply that you have only the BEST intentions for your child."

I realize that a lot of parents have their children circumcised, and I believe them when they say it seems as though the child did not endure much pain. However, having read the research that I have, I do feel as though it is undeniable that the child must go through a large amount of pain during the healing process - whether they make this fact explicitly clear or not.

More importantly that the pain to me, is the lost functionality. The foreskin is a wonderful body part, and it saddens me to hear it constantly disrespected, and treated as though it is worthless. I know this to not be the case.

Even this would be fine if it were a choice an individual made for themselves, but I just cannot accept the premise that it is such a neutral and acceptable decision for a parent to make - we're talking about healthy genital tissue!

I am not suggesting that everyone speak out against circumcision the way I have, but simply to not take that part away from a child. I don't think that request is really all that extreme or fanatical, given what we know about its purpose.

Mark Lyndon said...

I thought my email address was available on my profile, but it's ml66uk2@yahoo.com

That "little bit of skin" is the most sensitive part of the penis - it's not just there to protect the glans. Even on a circumcised man, the glans isn't the most sensitive part (it's normally the scar line, or the frenulum if that wasn't removed).

It's not really the pain of the operation that makes people against it, but the fact that part of a child's genitals are being cut off. I think everyone should be able to decide for themselves if they want part of their genitals removing. It's their body.

If we'd gotten used to cutting off little girls' labia, it would actually be doing less damage than male circumcision. They're "little bits of skin" too, the girls wouldn't remember it, and most would be healthy, happy, well-balanced, and well-adjusted, rather than traumatized by it. That wouldn't make it right though.

Michele said...

I had my son circ'd and will never do it again to any future sons.

Good luck to your husband watching this happen to his son. It may just change his mind...

DrMomma said...

By the way... I noticed that while you said this decision is not being made for religious reasons, your faith seems very important to you and your family. I (personally) walked the same road with my husband. There is a LOT more in the NT for Christians on the subject than we openly discuss in church. Here is our story: http://drmomma.blogspot.com/2009/06/information-on-circumcision-for.html and we both really liked this article highlighting Biblical passages and the background of the early Christian church on this topic: http://drmomma.blogspot.com/2009/10/circumcision-christianity.html

enithhernandez said...

Hi mama! There are a lot of great advice here but I just wanted to let you know that I didn't circ my dearly perfectly securely attached little boy and he is very healthy and happy :) I am too an AP parent and circumcision is not a gentle practice :(

If you decide to leave your son intact here is a video of how to care for an intact penis of a boy. Very simple! Wipe like a finger! :-) can't get better than that!!!

http://www.youtube.com/watch?v=HIOP5EA8jd0

Imagine mama, the foreskin is naturally attached from birth to the head of the penis, this is just like the hymen in little girls. It will slowly dissolve until after puberty, then with masturbation and intercourse. So basically, circumcision is like forcing them to loose their virginity with a knife. How awful is that? :( Pls mama protect your newborn, let HIM decide later in life what he wants to do with his own penis.

Blessings ((((hugs))))

Swagbucks