The Circumcision Discussion

[jmspeach]

I know this can be a HUGE debate, and I'm not looking to start any arguments. I was just wondering as you are OB nurses. I'm expecting a boy in July and not sure if we should circ. or not. My husband says yes, it's better medically in the long run. My gpa who just turned 70 had to have a circ. due to endless complications lately.

As nurses in this area, is the medication that they use good? And what are some questions to ask my Dr. about it. I already know that my hospital i'll be at uses a med. when they perform it, I"m just wondering what you all think.

Thanks

Jen :)

[MommyLauraRN]

okay, i will bite...tree huggers don't all attack me at once okay, i don't consider myself a tree hugger, but i am an educated nurse who has read several books and a lot of online articles about circumcision for the past five years and a mother of two beautiful natural aka intact boys, so i'll take my turn now thank you...speaking as a male...get the circ. your child will thank you or hate you when he finds out what circ is and what was taken from him...especially when you have access to research that shows that circ is unnecessary,painful, not recommended by the aap, has long term side effects your doctor probably won't tell you about such as adhesions when he grows up in this cruel unfair world. doesn't routine infant circumcision contribute to a cruel unfair world? .this is a hot topic with a lot of schools, folks and so on. there is so much research and stats out there it can be confusing. most reports i have seen are in support of the procedure, citing hiv rates and std transfer rates condoms...hmmmm....it's really scary to think that some circumcised men might actually think that because they're circumcised they don't need condoms...and how come the us has one of the highest circ rates and one of the highest std rates?? as well as cancer. yes, circumcision is required for three things...cancer, frostbite and gangreen...all incredibly rare and only after the fact...not to prevent...i mean really, what is the rate of penile cancer...less than a fraction of a percent...i guess since 1/8 women (including my mother) get breast cancer we should start removing those too on unconsenting baby girls...we can give them implants (you, know, while at the same time they're getting the newborn screen since it's all a bit painful) and they can have big beautiful cancer free boobs to "flaunt" in the locker room...of course we all know studies can be slanted any way the author intends. realistically...my so is l&d clinician..she says that at her facility the rates for circ run about 60% for and 40% not doing procedure. some choices are based on education, research by the family, the forty percent i would bet some by religion or culture, but quite honestly a good portion of these new moms can't even spell their name much less know the father and the rationale of circumcision or not is the last thing on their mind. these moms don't want the nurse to change the channel, casue springer is on, or they need a smoke break. a good majority of the 60%, especially if they live in a state where medicaid still covers it...getting back to your question...

some docs use suprapubic blocks with lidocaine, some use local lido cream, emla cream pre and post procedure, yet others use nothing. to be honest, i can't remember my procedure, so it must not have caused too much trauma to me as some child experts would say. usually if they are speaking out about it, they don't have one, don't have one what? a circ?? a member?? you don't have a foreskin. you don't know what you're missing. please don't advocate for others to have theirs removed too! or could be a hypocritacle view such as the peta president talking about us evil meat eaters, and he is wearing a leather watch bank, belt and leather shoes...but...speak to the doctor and make your wishes/demands be known. start a rapport with him or her. (just make sure no epi finds it's way into the lido mix...things can fall off with vasoconstriction! lol). there is gomco, mogan, plastybell and good old fashion custom carving! this makes me want to throw up. the gomco procedure and mogan are very popular in these parts. they go really fast, with minimal side effects. depending on where you live, your family, friends, social circles...these may very well all have a part in your decision. make it yours and not any one else's including mine. most "boys" want to look like their dad..if this if the only reason, so be it. he might well thank you later. really...interesting...how often do you think about your father's member? how often did you think about it growing up?did you and your father parade around naked? i assume he waxed and kept his on ice so they were entirely identical...or you could have been traumatised!!! and i bet most boys would rather look like their friends than their dads, and at the rate that circ is dropping, circ is the minority in many places! especially the west coast states! however, keep in mind that adults rarely undergo elective circs and once the baby is discharged it is almost impossible for medicaid or insurance, hmos etc. to pay for it.

tough decision but considering all the poor baby has to go through like being shoved into this mean world and getting their heels stuck with needles, injections in the thigh and meds in their eyes, etc. etc. the circ turns out to be another unpleasant experiences, if they are premies, they may even get lavage fed, frequent blood draws ,etc. so look at it as another procedure. if we stop one for the pain it causes, should we stop all??? yes, the unnecessary genital mutilating ones absolutely. the cord when cut, could transmit pain....hehe you never know what some will come up with.there are no nerve endings in the cord, there are however thousands in the foreskin. comparing the two is like grasping at straws

anyway...hope that helps....hang in there and good luck with your new family member!

to the op...please read the case against circumcision as a starting point...you owe it to your baby to be completely informed before you even consider putting him through this procedure.

http://www.mothering.com/articles/new_baby/circumcision/against-circumcision.html

there is nothing that can completely eliminate the pain. and after the procedure, almost all babies get nothing...and they are peeing small amounts of concentrated urine onto a raw wound for several days. then around 70% of babies in the first year or life will get adhesions (since the trend for circs these days is to be looser--adhesions are the member trying to heal itself) and doctors will rip the adhesions and cause even more pain and bleeding. it's a vicious cycle, better off left well enough alone!

[rnmomtobe2010]

My son is 5 and he has NOT been circumcised. I know it is not the best decision. I could not bear the thought of him having to go through that. No way! No how!

[Rock, LPN, RN]

My son is 5 and he has NOT been circumcised. I know it is not the best decision. I could not bear the thought of him having to go through that. No way! No how!

You made the right choice. Leave it alone!!!

http://www.cirp.org/

[joeb1, ASN, BSN, RN]

just a thought, how do the opposers feel about toddlers etc. getting their ears pierced. they obviously have the choice made for them/or at least did not know that it hurts. not to copare circs with ear piercing, im not doing that. i am for them and equally support those who opt out. i do see a better level of analgesia with the lido block. all our pediatricians do them. i seem to be the assist most of the time on these as i usually try to get assigned to he nursery. from my experience, at my hospital, it probably 80 percent

or higher.

[rnin02]

just a thought, how do the opposers feel about toddlers etc. getting their ears pierced. they obviously have the choice made for them/or at least did not know that it hurts.

isn't it funny...but i wish my parents had gotten my ears pierced when i was a toddler, and they would have had to take care of them for me at first! i was older when i finally talked them into it, but got freaked out about taking care of it...so i just got infection after infection. finally my mom made me take them out...or maybe i gave up? and whenever I have tried again I just get all freaked out about taking care of the piercings. Its sad, but I just can't do it, but I love, love, love earrings. Maybe someday I will try again (yeah right). But, if I had them done when I was really little, and grew up with normal healthy piercings, maybe it would all be okay. Guess its not important enough to worry about, and definitely off topic, sorry!

[Atl_John]

I'm a male. I'm circ'd. I'm happy I'm circ'd. Any boys I have/adopt will be circ'd. I was circ'd in Germany (not common there) and they used full anesthesia in Germany, actually they use full anesthesia back when I was born for labor and delivery if the mother wanted it. I am very glad that anesthesia was used on me, and MANY studies have shown that males that are circ'd without anesthesia have a much lower pain threshold than males who were circ'd with adequate anesthesia. Not using anesthesia of some sort (EMLA, etc) is to me malpractice....you wouldn't dare circ an adult without anesthesia, so why should we allow it for a neonate, they can feel pain just like we do. If you do it, REQUIRE your doc to use anesthesia and more important make sure he waits long enough to make sure it has had time to work.

Below are just a few articles I found quickly off of the Medline database there were too many too look through them all. I think the line that is quoted in the last of the three articles refrenced is most important for all of us here.

Anand KJ. Johnston CC. Oberlander TF. Taddio A. Lehr VT. Walco GA. Analgesia and local anesthesia during invasive procedures in the neonate. [Review] [298 refs] [Journal Article. Research Support, N.I.H., Extramural. Research Support, U.S. Gov't, Non-P.H.S.. Research Support, U.S. Gov't, P.H.S.. Review] Clinical Therapeutics. 27(6):844-76, 2005 Jun.

Razmus IS. Dalton ME. Wilson D. Pain management for newborn circumcision. [Clinical Trial. Comparative Study. Controlled Clinical Trial. Journal Article] Pediatric Nursing. 30(5):414-7, 427, 2004 Sep-Oct.

UI: 15587537

Malnory M. Johnson TS. Kirby RS. Newborn behavioral and physiological responses to circumcision.[see comment]. [Clinical Trial. Controlled Clinical Trial. Journal Article] MCN, American Journal of Maternal Child Nursing. 28(5):313-7; quiz 318-9, 2003 Sep-Oct.

UI: 14501633

"this study suggests that preoperative analgesia before circumcision could be helpful in managing the pain of circumcision. Nurses have a responsibility to advocate for policy and practices changes that provide interventions for pain relief for all newborns."

[dawngloves, BSN, RN]

just a thought, how do the opposers feel about toddlers etc. getting their ears pierced. they obviously have the choice made for them/or at least did not know that it hurts.

I think babies with pierced ears look stupid, too.

[fergus51]

This one always comes up doesn't it? Personally, I wouldn't circ if I had a boy and I don't participate in them as a nurse. Can't do it. I don't care if other people want to do it though. Most of my American friends would circ their kids. Most of my non-American friends find that odd.

[fergus51]

, if an adult was in that circumstraint, people would realize how tortuous it is and would never let it happen, at least not that way. !

That's one of my main complaints about it. Very few docs I work with give anything but a pacifier dipped in sweetease. I can't imagine you'd give a grown man a lollypop and then cut off a piece of his most sensitive skin. Few nursery nurses I've worked with even give the follow up tylenol that's ordered prn.

I am very glad to see so many nurses posting that their docs are using adequate pain control.

[Elvish, BSN, DNP, RN, NP]

I don't advocate for piercing toddlers' ears either, just for the record.

[Spidey's mom, ADN, BSN, RN]

Funny, I'm sitting here with my feet up reading these posts and my oldest son called me . . . we chatted for a bit and then I told him I was reading the circ thread again and he groaned. I told him about the latest study out that showed a large % of boys not getting circ'd and I asked him if the majority of boys were not circ'd, would he still want to be circ'd. He groaned again and said "yes mom, I would still want to be circ'd". Of course he is visiting a girl he knows from college and they are tentatively thinking about actually dating seriously and I heard her say in the background "you are kidding, right?". As in, are you really talking about circumcision with your MOM?? I just started laughing . . . . and said "Honey, you do realize that this girl you are just beginning to get to know now knows that you have been circ'd don't you?". And just kept laughing . . . . oh, he laughed too.

So, my boys still are glad they were circ'd. And I still don't like it.

As to earrings in babies and toddlers, I don't like it. There is no reason for it. And it takes away one of those milestones that teens reach . . . first time you get to shave your legs, piercing your ears, wearing makeup. Etc.

I didn't get my ears pierced until I was 18. I am a bit of a rebel though - I only have ONE hole in each ear lobe. ;)

steph

[rnmomtobe2010]

I do have a first cousin that had to be circumcised when he was 8. No pain meds or nothing. Imagine that. He was having problems in that area, though. I just cannot bear the thought of having my baby go through that. I have a 15 month old daughter and her ears are NOT pierced by the way. When she is old enough and asks, then we can do it. Until then she is fine with having hair bows and ribbons making her look like the angel she is. No need to enhance her look with pain.