In your third trimester, you’ll want to fill out hospital forms in advance to save yourself from having to do it while you’re in labor. One of these forms is likely to be a release to perform a circumcision if you’re having a baby boy. You may have already decided yes or no, but if you haven’t, here are the pros and cons:
Reasons for circumcision:
Religious. If you’re Jewish, then a brit milah is considered a commandment from God, though note there is no requirement for how much skin must be removed to fulfill it.
Cosmetic. Some parents prefer the look of a circumcised penis. The most common reason parents give for circumcision is that they want the son to “look like daddy.”
Getting it over with. While a newborn will recover from the surgery in a few days or weeks, an adult circumcision is very debilitating, requiring weeks of bed rest.
Reasons against circumcision:
Medical advice. Every major medical organization, including the American Academy of Pediatrics and the American Medical Association, does not recommend routine circumcision. While circumcision may slightly reduce the risk of certain diseases like penile cancer, the benefit does not offset the risks of the surgery. For every case of penile cancer prevented, an estimated 41 babies die from surgical complications. Research has also found conflicting evidence for the claim that circumcision reduces the rate of HIV. Says the AMA,
“Virtually all current policy statements from specialty societies and medical organizations do not recommend routine neonatal circumcision … The low incidence of urinary tract infections and penile cancer mitigates the potential medical benefits compared with the risks of circumcision.”(2)
Ethics. It’s not easy to justify performing cosmetic surgery on a child who is not able to consent.
The surgery is irreversible. Your son will not be able to reverse your decision should he decide later that he wishes he wasn’t circumcised.
Pain. While there are ways to reduce the pain a baby experiences during and after the procedure, no method, not even a dorsal penile nerve block, eliminates the pain completely. Even today, the majority of circumcisions are performed without anesthesia.
Declining popularity. While in the 80s about 80-90 percent of newborn boys were circumcised, that rate dropped to 56% in 2006 and dropped again to 32.5% in 2009(1).
Complications. While the immediate post-operative complication rate of newborn circumcisions is low — about 1 in 476 (3)– some complications can be serious, including excess bleeding which can lead to death, infection, partial penile amputations, scar tissue adhesions, complications from anesthesia and incomplete or uneven removal that requires additional surgery.
Financial. Not all insurance plans or state Medicaid programs cover the cost of surgery.
Sexual. Circumcision removes the most sensitive parts of the male organ and the penis’ protective covering, reducing penile sensation by a lot (which is exactly why it became popular in Victorian-era America in the first place). It also reduces lubrication and sensation for a man’s partner.
Ease of care. A circumcised baby’s incision site will need to be treated with petroleum jelly and wrapped with gauze and checked for infection daily for the first week. The end of his penis will be red, and after awhile, a yellowish crust may form around the incision site. This is normal, but call your doctor if you notice:
Purple or deep red discoloration of the penis
- Bleeding
- Pus, spreading redness or fever
- No wet diapers for more than three hours
- Inconsolable crying.
On the other hand, uncircumcised baby penises don’t require any special care or cleaning. Don’t try to retract the foreskin or clean under it or let doctors or nurses do so; forcible retraction can cause injury. The foreskin will naturally become fully retractable, usually before your son hits puberty between the ages of 11 and 16. Once the prepuce is retractable, you’ll just need to tell your son to use a washcloth to wash under the foreskin with plain, unsoapy water.
But back to the present: if you still can’t decide to have the surgery performed on your newborn, you can also postpone the decision until you’re in the hospital, or schedule the surgery yourself at some point after that.
From Great Expectations: Pregnancy & Childbirth
(1) El Bcheraoui, C., 2010, “Rates of selected neonatal male circumcision-associated severe adverse events in the United States, 2007-2009, ” XVIII International AIDS conference, Vienna, Austria
(2) Pediatrics 1999;103:686-93
(3) Pediatrics Vol. 105 No. 1 Supplement January 2000, pp. 246-249
