When I was pregnant, I secretly hoped for a boy. It was partly because my husband was very vocal about the fact that he wanted a Mini-Me and I wanted him to be happy and I was also probably influenced by Chinese culture’s strong preference for baby boys.
At our 18 week ultrasound, I was thrilled when we found out that we were having a boy. At each subsequent ultrasound up through our last one at week 39, I asked the techs to confirm that it was a boy because I just couldn’t believe that something I had wanted so badly had actually come true.
But for my next child I’m hoping—praying– for a girl.
Don’t get me wrong. We love everything about having a baby boy. My husband enjoys rough-and-tumble play with his boy and loves that he will not have to worry about all those things that Dads of teenage girls worry about. I love traditionally boyish nursery themes, picking out outfits in all shades of blue (my favorite color), and above all else, the special bond that develops between a mother and son.
But I really grappled with the decision to circumcise my son and just could not bear having to make the decision to circumcise another child. We had no religious reasons for having him circumcised, and culturally, we were torn. Circumcision seems to be the norm in the US, but my family is from an area where circumcision is fairly uncommon. And the thought that I would be knowingly inflicting pain on my helpless baby was beyond excruciating.
I started to feel like I was the only person who was struggling with this decision. Of all the couples expecting a boy in our childbirth class, we were the only ones who were uncertain. All of the others seemed to think it was a no-brainer. Of course they were going to do it.
My husband felt strongly that his son should be circumcised, but we both knew that it was primarily my decision and this was not a decision that I took lightly. I read paper after paper on the issue, sought the advice of trusted medical professionals, and surveyed my mama friends, trying to gain some perspective and guidance. Still, I remained undecided for a long time and endured several sleepless nights.
A comment that I heard often during this information gathering process was that my son would not remember the pain afterwards. That was not a comfort to me. Regardless of whether he would remember it, knowing that I would be inflicting pain on my child at any point in time was something I was really not comfortable with.
I read about the group in San Francisco seeking to ban circumcision, which they believe is a form of genital mutilation. Their hope is that circumcision would be prohibited among males under the age of 18 and that the practice would become a misdemeanor offense punishable by a fine of up to $1,000 or up to one year in jail.
I also read the American Academy of Pediatrics’ Circumcision Policy Statement published in 1999, hoping it would help me make my decision. No such luck, even after three reads. The AAP acknowledges that while there are potential medical benefits to circumcision, the data are insufficient to recommend routine neonatal circumcision.
For those of you also struggling with this decision, the following are excerpts from the paper that I found most useful:
- According to the National Center for Health Statistics, 64.1% of male infants were circumcised in the United States during 1995.
- Penile problems may develop in both circumcised and uncircumcised males. In one study, circumcised infant boys had a significantly higher risk of penile problems than did uncircumcised boys, whereas, after infancy, the rate of penile problems was significantly higher in older uncircumcised boys.
- There are anecdotal reports that penile sensation and sexual satisfaction are decreased for circumcised males.
- Should circumcision become necessary after the newborn period because problems have developed, general anesthesia is often used and requires a more formal surgical procedure necessitating hemostasis and suturing of skin edges.
- There is considerable evidence that newborns who are circumcised without analgesia experience pain and physiologic stress. Analgesia is safe and effective in reducing the procedural pain associated with circumcision and, therefore, adequate analgesia should be provided if neonatal circumcision is performed.
- All studies that have examined the association between UTI and circumcision status show an increased risk of UTI in uncircumcised males, with the greatest risk in infants younger than 1 year of age. Initial retrospective studies suggested that uncircumcised male infants were 10 to 20 times more likely to develop UTI than were circumcised male infants.
- Reports of several case series have noted a strong association between uncircumcised status and increased risk for penile cancer; however, there have been few rigorous hypothesis-testing investigations. Although the risk of developing penile cancer in an uncircumcised man compared with a circumcised man is increased more than threefold, it is difficult to estimate accurately the magnitude of this risk based on existing studies.
- Studies suggest that circumcised males may be less at risk for syphilis than are uncircumcised males. In addition, there is a substantial body of evidence that links noncircumcision in men with risk for HIV infection… There does appear to be a plausible biologic explanation for this association in that the mucous surface of the uncircumcised penis allows for viral attachment to lymphoid cells at or near the surface of the mucous membrane, as well as an increased likelihood of minor abrasions resulting in increased HIV access to target tissues.
A 2010 review article in the Archives of Pediatric & Adolescent Medicine seems to make the case for neonatal circumcision. The article states that since 2005, three randomized trials have evaluated male circumcision for prevention of sexually transmitted infections. The trials found that circumcision decreases HIV acquisition by 53% to 60%, herpes simplex virus type 2 acquisition by 28% to 34%, and HPV prevalence by 32% to 35% in men. Genital ulcer disease was also reduced. This review urges the AAP to fully reflect the long-term health benefits of male circumcision.
After taking all of this into account, I was persuaded by research which suggests that there are potential medical benefits to circumcision, particularly with regard to preventing STIs. I suspected that if I didn’t choose to circumcise my son at birth, he may wish to be circumcised later in life, which would require a much more involved, painful surgical procedure and a difficult healing process. I had read absolutely horrifying stories of parents who circumcised their children after the newborn period and knew that I would not want my child to experience even worse pain later in life. And I worried that if we didn’t have him circumcised, my adolescent son might be ridiculed or develop body image issues for a decision that I had made.
I eventually recognized that I actually wanted my child to be circumcised; I just didn’t want him to have to endure the painful process of being circumcised. And I realized it was not my decision alone to make. I had to take into account my husband’s strong feelings on the matter.
In the end, Baby C was circumcised.
I cried – actually, I bawled — when they rolled baby C’s bassinet away for the circumcision. It was HEARTWRENCHING, probably the worst feeling I’ve ever experienced knowing that I was allowing my child to be taken away for a painful procedure. I felt like someone had ripped out my heart and ran it through a meat grinder. Honestly, I would have preferred that. It still pains me now to think back on it.
While I am relieved that my son is circumcised, I’m not sure that I have it in me to make this decision a second time. But could I really have one son circumcised and not his brother?
Disclaimer: I am not a medical expert. This is merely a personal account of our family’s circumcision decision.