When circ's go bad...

LPN1974, LPN · Mar 11, 2005

I don't believe what I am hearing. Surgery imposed on another without consent for the goal of looking like others in the locker room?

Babies have been being circumcised since the old biblical days.

The bible talks of circumcision.

When my baby was born I was just a mere 17 yrs old and so naive {I guess I might say ignorant, I didn't know anything} it was pathetic. I wasn't informed of any such pending procedure of circumcision, never signed a consent form, was never talked to about or given the option of breast or bottle feeding.

These things were all decided for me by other parties without my knowledge and I was so ignorant I didn't know anything to do but just allow it to go on as it was going.

If it were today, I sure would know to stand up for mine and my baby's rights a little better.

Sorry, I guess I threw in some things off subject. I still get a little angry today when I think back on those times.

FrumDoula · Mar 11, 2005

As an Orthodox Jew, I am required by halacha (Jewish law) to circumcise my son. It is considered a mitzvah, a commandment, from God.

Having said that, if I was not Jewish, I would NEVER circ my baby boy without medical reason, and I don't think it's a good idea.

The practice of mass circumcision began when doctors noticed a lower cervical cancer rate among Jewish women and thought it was because of circ. It wasn't. It was becuase of the practice of the laws of family purity. (I can give an explanation if anyone is wildly interested, but suffice it to say the laws surround the menstrual woman and when she and her husband are permitted to engage in marital relations.)

The practice of circ stuck, though, unfortunately.

I watched a circ in the hospital long ago and nearly fainted. It was awful to watch .... I'm able to deal with a bris, though. It's a very different atmosphere.

Anyway, my $0.02.

Alison

fergus51 · Mar 11, 2005

Circumcision actually became popular in many countries because it was thought to inhibit masturbation and therefore would save men from all the diseases that masturbation caused (like blindness). This was long before cervical cancer was an issue. One of my friends is orthodox and jokes that thanks to the laws of family purity she is given a break from her husband for 12 days a month and that the cervical cancer rates just prove what a good idea it is for everyone:).

Ross1 · Mar 11, 2005

As an Orthodox Jew, I am required by halacha (Jewish law) to circumcise my son. It is considered a mitzvah, a commandment, from God.
Having said that, if I was not Jewish, I would NEVER circ my baby boy without medical reason, and I don't think it's a good idea.
The practice of mass circumcision began when doctors noticed a lower cervical cancer rate among Jewish women and thought it was because of circ. It wasn't. It was becuase of the practice of the laws of family purity. (I can give an explanation if anyone is wildly interested, but suffice it to say the laws surround the menstrual woman and when she and her husband are permitted to engage in marital relations.)
The practice of circ stuck, though, unfortunately.
I watched a circ in the hospital long ago and nearly fainted. It was awful to watch .... I'm able to deal with a bris, though. It's a very different atmosphere.
Anyway, my $0.02.
Alison

Thank you for the additional explanation. By the way, I'm Jewish as well, even have a graduate degree in Jewish studies, but at the same time, am opposed to circumcision, even for religious reasons, unless the male is capable of giving consent, which an 8 day old baby is not. After witnessing both a hospital circumcision as well as my nephew's B'rit Milah (jewish circumcision), I vowed never again to observe such a procedure/ritual.

Though you are correct, the Jewish B'rit Milah is conducted differently and honestly is much more "humane" then the hospital procedure complete with circumstraint (which is barbaric in my opinion)

As to why this practice developed in the non-Jewish and non-Muslim world (yes, Muslims also circumcise for religious reasons), it goes beyond the issue of just cervical cancer. Non-religious circumcision only became popular in English speaking countries, primarily the UK, Canada, Australia, and the USA (not sure about New Zealand and South Africa). As of today, it is only widely practiced in the USA and has been pretty much abandoned everywhere else.

It became a class issue in the UK with the upper classes preferring it. Some say that during Victorian times it was done in the attempt to discourage masturbation (no success there, albeit circumcised males don't have a foreskin to stimulate). In the USA, it became popular following WWII with our great emphasis on hygiene when in reality hygiene for uncircumcised memberes isn't much different then hygiene for the rest of the body....soap and water.

Judee Smudee, ADN, RN · Mar 11, 2005

Oh this thread is about circumcisions. Ouch and oh my. I read it merely because I was curious about what a "circ" happened to be.

obnursesteff · Mar 13, 2005

When I was in my OB rotation we were able to view and assist with circs. The scariest thing I saw was this one doc who was quite old, losing his fine motor skill precision and not to mention his eyesight. The nurses on the floor warned me about this before he began the procedure but I didn't think it could be as bad as they said. Well...it was as bad as they said, maybe even worse. He was shaking through the entire procedure and even dropped a few instruments on the floor. :chair: I would say that this one circ took around 45 minutes maybe closer to an hour. He knew he was bad too, but he refused to ask another doc to do his work. After the procedure everything looked fine but nevertheless I think if he kept this up he was going to have a major oops! I definately would not want him doing a circ on my son!!

Has no one reported this? :scrying: If you wouldn't want him doing a circ on your son, are you willing to let him circ someone elses?

mitchsmom · Mar 14, 2005

Can't comment on the OP's question, I've only seen one circ performed (before nursing school, I was observing a birth w/ an OB friend of mine and she zipped in to do a circ before she had to catch the baby)...

When I was pregnant with #1, I assumed the baby would be circed and didn't really put any thought into it until my (circed) husband was actually the one to say "you don't have to do that"... I then looked into it further and we ultimately didn't do it... now three uncirc'd boys later... all are doing well and it's never been any kind of issue whatsoever... one of my boys saw Dad changing clothes and said "You're weiner looks funny, Daddy!!" LOL... just thought the reversal of attitudes was funny.

We have a lot of non-circing cultures in our area so I think they probably have a good mix at school... my boys can hold their own in a cut down match anyway. I think they'd cut guy down to size (so to speak) in a hurry if they went there. LOL

Someone wrote "It's a personal choice that a family makes for religious or cultural ideals. We as nurses are not there to judge their practices only make sure the child is adequately cared for."

I think that's absolutely true, but nurses are also educators so I think there is a place at times for sharing information.

Someone also wrote "Perhaps, though, I need to just leave the way *I* feel about it out if it, even if they ask. Like, maybe I need to fudge it and tell them something neutral."

My opinion on that is that we probably should leave personal opinions out, especially with such a volatile topic... what about using info from the AAP, etc? They actually don't recommend circ anyway (though they do concede that it's a family's decision to make).

I think the rates will continue to slowly decline and we'll eventually be back to leaving it alone like most of the world, as nature intended it to be (of course there will be unusual illnesses with any body part, but generally the vast majority of men are fine with it, as history has proven throughout the world).

At the same time, I know that it's a personal decision for each family to make, I try to be ok with it if they have really informed themselves about it. Of course as a nurse I won't be judgemental about it.

polarbear2 · Oct 13, 2005

I have lurked here on numerous occasions looking for and finding insight 'from the trenches'.

Although I am not a medical professional, and can't contribute any botched circumcision stories, I thought I could offer some concrete information concerning some of the topics covered here, and ask a couple of questions.

Circumcised Later:

From the Canadian Pediatric Society website: www.caringforkids.cps.ca/babies/Circumcision.htm

"Of every 1,000 boys who are not circumcised...

10 (1%) will have a circumcision later in life for medical reasons, such as a condition called phimosis."

...Conversely (perversely)...

"Of every 1,000 boys who are circumcised...About 10 (1%) babies may need to have the circumcision done again because of a poor result. "

British Journal of Urology:

www.blackwell-synergy.com/doi/abs/10.1046/j.1464-410x.1999.00147.x?cookieSet=1

"The incidence of pathological phimosis in boys was 0.4 cases/1000 boys per year, or 0.6% of boys affected by their 15th birthday"

I have read, but cannot find a reference for Scandinavian countries where medical circumcision rates are lower by several magnitudes.

Pain:

AAP Circumcision Position Statement: http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3b103/3/686

"There is considerable evidence that newborns who are circumcised without analgesia experience pain and physiologic stress. Neonatal physiologic responses to circumcision pain include changes in heart rate, blood pressure, oxygen saturation, and cortisol levels...Analgesia is safe and effective in reducing the procedural pain associated with circumcision; therefore, if a decision for circumcision is made, procedural analgesia should be provided."

Must Retract:

American Academy of Pediatrics - Care for the Uncircumcised member: http://www.medem.com/search/article...h_typ=NAV_SERCH

"Sometime during the first several years of your son's life, his foreskin, which covers the head of the member, will separate from the glans. Some foreskins separate soon after birth or even before birth, but this is rare. When it happens is different for every child. It may take a few weeks, months or years. ... Most boys will be able to retract their foreskins by the time they are 5 years old, yet others will not be able to until the teenage years. As a boy becomes more aware of his body, he will most likely discover how to retract his own foreskin. But foreskin retraction should never be forced. Until separation occurs, do not try to pull the foreskin back-especially an infant's. Forcing the foreskin to retract before it is ready may severely harm the member and cause pain, bleeding and tears in the skin."

Canadian Pediatric Society: www.caringforkids.cps.ca/babies/Circumcision.htm

"The foreskin covers the shaft and head (glans) of a boy's member. During the early years of a boy's life, the foreskin separates from the glans. This is a natural process that occurs over time. You do not need to do anything to make it happen. ... Keep your baby's member clean by gently washing the area during his bath. Do not try to pull back the foreskin. Usually, it is not fully retractable until a boy is 3 to 5 years old, or even until after puberty. Never force it."

The Royal Australasian College of Physicians (Former Australian College of Paediatrics): http://www.racp.edu.au/hpu/paed/cir...ion/anatomy.htm

"It is normal for the inner surface of the foreskin to be fused to the glans in newborn males. Separation of the foreskin from the glans occurs spontaneously during childhood. By five years of age most of boys are able to retract their foreskin. A small percentage of boys are unable to fully retract their foreskin until puberty. The foreskin requires no special care during infancy. It should be left alone. Attempts to forcibly retract it are painful, often injure the foreskin, and can lead to scarring and phimosis."

Common denominator: May not retract till teen years. Do not retract. No problem.

I hope this has cleared up some confusion.

I do have a question though. What pain relievers are usually recommended for the days following an infant circumcision? Thanks.

SmilingBluEyes · Oct 13, 2005

The sad thing is, many peds do not prescribe ANYthing but comfort measures (like suckling on pacifiers/sugar water etc) and swaddling afterward). Others are kinder and prescribe and give infant doses of Motrin or Tylenol for the poor kids. I would make sure any kid of mine, circ'd today (and I think I would elect NOT to do it now)---would get pain meds for such a painful procedure.

fergus51 · Oct 13, 2005

Our hospital docs give the infants nothing for pain afterwards and many don't give them anything for pain during the procedure other than sweetease.

allnurses Guide · Oct 13, 2005

Our hospital docs give the infants nothing for pain afterwards and many don't give them anything for pain during the procedure other than sweetease.

All our docs but one do lidocaine prior . . nothing after. The one who does nothing is a kinda Vietnam Vet Ironman Doc . . . . rugged idealist type and very vocal about his politics. He will not give lidocaine - I've had to assist in two circs this week with him . . . .I tell ya Fergus, I'm about to follow your lead and refuse to do it anymore. Watching as a babies member is ripped to shreds with no pain relief while being held down . . . . . too much for me.

At least make it pain free . . .

steph

fergus51 · Oct 13, 2005

All our docs but one do lidocaine prior . . nothing after. The one who does nothing is a kinda Vietnam Vet Ironman Doc . . . . rugged idealist type and very vocal about his politics. He will not give lidocaine - I've had to assist in two circs this week with him . . . .I tell ya Fergus, I'm about to follow your lead and refuse to do it anymore. Watching as a babies member is ripped to shreds with no pain relief while being held down . . . . . too much for me.
At least make it pain free . . .
steph

I'm with you. Since I don't do circs, it isn't really an issue for me, but I have had docs want to put in chest tubes without giving anything extra for pain!!! "What would you like me to give for pain?" "Well, the baby's already on a drip....." "Yeah, and that drip is not titrated to provide enough pain relief for chest tube insertion, so what would you like me to give for pain before the procedure?".... My total pet peeve!!! We have another doc who will put in stiches without giving them anything but sweetease. I swear, if I ever meet him in person I am going to hold him down, give him a sip of coke and stab him with a sewing needle.... If babies have to be put through painful procedures, they deserve analgesia period.