Circumcision down to 56% in USA - Page 3

[crazy_eights]

Originally Posted by Night_Nurse

On the other hand, unfortunately we've started seeing a trend with some Hispanic patients coming to our facility from Mexico and adopting the more "American" looking penis style for their sons. :

And we are seeing it with the Russian and Bosnian population here. Back to my point about the word not getting out nearly as well as some would think based on numbers alone....

[fruitful womb]

Originally Posted by Night_Nurse

Well of course, the doc doesn't want to dissuade anyone because that would cut into their profit margin.
However, every hospital I know of has an ethics advisory board. Why not everyone write to their local hospital's ethics panel and ask about this? Ask why it's performed and how it agrees with medical ethics or even how offering RIC advocates for the rights and safety of the child (especially when performed without any real anesthetic). I wonder what a hosptial's response might be?
At the very least, if it was not offered in the hospital, fewer boys might get cut (and I think some ins. will not cover RIC outside the hospital).

You know, I have heard of hosptials that do NOT offer RIC at all, but I've never read any names/locations. Does anyone know of non-circing hosp. in the US?
If so, please list.

I know that Parker Hospital in Dallas don't offer it. I don't think they even do it anymore there. I could be wrong about this. If my memory serves me correctly then it was my MIL who is a nurse told me this.

I truly honestly believe that if this procedure wasn't offered, meaning no one actually asked the parents if "Do you desire to circ?" Rates would drop dramatically!

[Fellow Traveler]

Originally Posted by fruitful womb

I know that Parker Hospital in Dallas don't offer it. I don't think they even do it anymore there. I could be wrong about this. If my memory serves me correctly then it was my MIL who is a nurse told me this.

I truly honestly believe that if this procedure wasn't offered, meaning no one actually asked the parents if "Do you desire to circ?" Rates would drop dramatically!

This is true; I don't think this can truly end until the docs grow a spine and apply the same ethics to RIC that they would to all other procedures. It shouldn't even be something they suggest. I think this is how the rates in Canada and Australia got driven down; the docs (and other hospital staff) just eventually came clean. When you hear stories like Astoria's and hear that medical professionals still think that, you realize there is still a lot of work left to do.

[+stella+]

"You know, I have heard of hosptials that do NOT offer RIC at all, but I've never read any names/locations. Does anyone know of non-circing hosp. in the US?
If so, please list."

Banner Good Sam in phx does not, or did not in 04. I believe the other Banner hospitals in the area dont either but I am not certain. Banner is non profit (if that makes any difference)
My cousin had babies at Paradise Valley Hospital in PV and she had her boys circed at the peds office. : So I think there are some that arent doing it in the hospital after birth but arent discouraging people to go to their peds when they ask for it to be done.

[MCatLvrMom2A&X]

Statistics: http://www.circs.org/reviews/rates/usa.html
This is from back in 99
National 65.3%
NorthEast 65.4%
MidWest 81.4%
South 64.1%
West 36.7%


Statistics: http://www.cirp.org/library/statistics/USA/
As of 2004 this site lists the circ rates as follows:
Northeast Region: 66.4%
North Central Region: 79.5%
Southern Region: 58.5%
Western Region: 31.7%

Statistics: http://www.cirp.org/library/statisti...taterates2004/
This one has states listed (not all of the unfortunatly)
Arkansas 67%
Arizona 25%
California 21%
Colorado 63%
Florida 39%
Hawaii 82%
Iowa 82%
Kentucky 85%
Maine 72%
Massachusetts 67%
Michigan 85%
Minnesota 77%
Missouri 78%
Nebraska 81%
Nevada 14%
New Hampshire 76%
New Jersey 67%
New York 59%
North Carolina 58%
Oregon 30%
Rhode Island 74%
South Carolina 83%
Utah 53%
Vermont 68%
Washington 26%
West Virginia 83%
Wisconsin 83%




2005 Stats: http://www.prweb.com/releases/2005/3/prweb217505.htm

March 14, 2005 -- The U.S. circumcision rate declined 11.4% over two years, according to figures just released by the National Center for Health Statistics, from 63.1% in 2001 to 55.9% in 2003, following a steady, twenty-five year decline. At this rate, in just 12 years, the US will join other English-speaking countries in abandoning circumcision.

This is the only statistics by state that I have been able to find. Unfortunatly only a small percentage is listed. I would love to know the circ rates for all the states especially my own.

[MCatLvrMom2A&X]

A question in I may Nevada the lowest rate listed at 14%. I was wondering why that might be, does anyone know? Is there are larger population of Native Americans there? (I may be totally off on that thought if so please correct me) Since from what I have read it is rare that they circ.

[Quirky]

Originally Posted by mom2seven

Sigh. My only point about immigrant population is that the American population is not getting the message, at least in certain areas of the country.

Well, and who exactly is supposed to be communicating the message to them? How about doctors, nurses, and hospitals step up to the plate and take on their ethical obligations to ensure full informed consent rather than presenting the hugely important circumcision issue as a personal parental choice akin to "do you want fries with that?" on an admission form?

[Kylix]

Originally Posted by Astoria

When I delivered in the midwest, I was attacked by a nurse for not choosing circumcision. First she was coercive, saying, oh come on, the doc's doing circumcisions now, let me just put him on the line. "on the line????!!!" She was wheeling his isolette away as she was saying this (I had a very bad general anesthesia emergency c-section I was recovering from, hence, not holding him at the moment.) It was scary. Then when I had made myself overwhelmingly and completely clear, she got near hysterical and was yelling at me, "that is filthy, its disgusting, he'll never forgive you for doing this to him, he'll have to do it when he can feel it!!!!" The birth experience and aftercare were already traumatic. This definitely did NOT help. (Um, and yes, of course, both my sons are intact.)

That is SCARY! Imagine how this nurse may have affected moms not as strong in their resolve as you??

I hope she is currently out of a job.

Kylix

[LavenderMae]

I think nurses and doctors soliciting cosmetic genital surgery for newborns (oops I mean newborn boys) is more than unethical.

My state was way higher in 2004 than I would have thought.

I think it's awesome that many immigrants aren't starting to torture their newborn sons too, good for them!!!!!! But I do not think that is the whole picture of why the rates are falling.

[fruitful womb]

I don't see TX on the list. In fact, I have never seen TX participate in the rates data.

Since there are so many immigrants in TX (Want to learn Spanish? Come to TX! Its spoken just as much as the English language.) the circ rate should be low.

If TX turned in their numbers the national decline would even be lower.

[crazy_eights]

Originally Posted by Quirky

Well, and who exactly is supposed to be communicating the message to them? How about doctors, nurses, and hospitals step up to the plate and take on their ethical obligations to ensure full informed consent rather than presenting the hugely important circumcision issue as a personal parental choice akin to "do you want fries with that?" on an admission form?

Gee, I'll be stepping out now. Despite the RN after my name, I do NOT set hospital policy. And as I mentioned, if you don't want your baby circ'ed it is REALLY IMPORTANT you communicate that. At least where I work it gets bold lettered and highlighted so no one makes a mistake. You do seem really, really uninformed about how hospitals work. The informed consent part happens long before they get to me in OB triage and yes, some OB's are better than others. I've heard some say "there is no reason to do it" and others that try to present a "more fair and balanced" picture (can we insert eyeroll here?). My job is only to make sure that their wishes are communicated. FTR, if anyone asks, if they aren't sure or are asking, I present the "really no medical reason for it" side of things.

Thanks for all your hostility when I was just trying to make an valid point.:

[Fyrestorm]

Originally Posted by mom2seven

As to "soliciting elective surgery" - when we ask "do you want to breast of bottle feed?" here are a whole list of requests that are asare we soliciting one vs. the other?

Apples and oranges...

Yes asking if you want to cut up your baby at admittance is soliciting cosmetic surgery...you might as well be asking is you want to give the babe a nose job...that would be an equal comparison and noticeably ridiculous!!

[Fyrestorm]

Personally, I think that not only should circumcision have to be requested...not offered in hospitals, I think if it is requested, a counselor should be called in to find out what psychological reasons are behind parents wanting to mutilate their sons.

I wonder what the hospital procedure would be for a parent requesting that their daughter be cut would be?

[hollytheteacher]

Originally Posted by mamabadger

That is unbelievable! Even twenty years ago, I was asked only once, just before discharge, "You didn't want him circumcised, did you?" by a nurse who wrinkled up her nose as she asked and expressed relief when I said no. Why are things proceeding so slowly in US hospitals?

It's so weird because i was asked at least 5 times as well and when i would say NO they would say something like "thank god! Your lucky little boy!" i almost wonder if like they are forced to ask it like that without giving any info and then if you decline then they are allowed to say that they agree with you or something? i just dont' get it!! I had the nicest nurse who when i said no, she looked at my sweet boy and said "You are a lucky boy with a very smart mommy" but it's like why did you even offer it? or at least why don't you tell people that there is an unnnecessary cosmetic surgery offered to little boys if they would be interested. (if they must offer it)

[Quaniliaz]

Originally Posted by fruitful womb

It should be AGAINST hospital policy to SOLICIT unnecessary COSMETIC surgery on a healthy sexual organ!

There is actually a local hospital that has a grant to pay for RIC for those on medical assistance, since MA no longer covers it.

Creepy - I want to know who the heck funds such a stupid grant.

[Microsoap]

Hey, fruitful_womb, it's interesting you mention HOW you ask the question and how it CAN be suggestive. I've never forgotten this factoid, though I forget *where* I learned it:

They asked children a question w/ one of two answers ("Do you want to eat type-A, or type-B?"). Kids instinctively picked the 2nd thing offered to them than the first.

If only it were so easy to say "Do you want your son circumcised or left intact?" in that sense.

P.S. I'm rooting for Newfoundland's circumcision rate of virtually ZERO (0)% for the U.S.!!!

[Fellow Traveler]

Originally Posted by mom2seven

Gee, I'll be stepping out now. Despite the RN after my name, I do NOT set hospital policy.

I understand that for people in your position, and I think there may be a few here, that it is beyond the scope of your authority to directly change hospital policy. I would like to take this thread in a different direction and ask what kind of approaches would better reach the hospital staff. Ultimately it will be the doctors that protect the boys; I believe this is how it happened in Canada and Australia.

Originally Posted by mom2seven

And as I mentioned, if you don't want your baby circ'ed it is REALLY IMPORTANT you communicate that. At least where I work it gets bold lettered and highlighted so no one makes a mistake. You do seem really, really uninformed about how hospitals work. The informed consent part happens long before they get to me in OB triage and yes, some OB's are better than others. I've heard some say "there is no reason to do it" and others that try to present a "more fair and balanced" picture (can we insert eyeroll here?).

So here is where I am confused. There is some subset of OBs who tell parents that it is not medically necessary. However, I presume, they go ahead and accede to the wishes of parents who opt to circumcise. This, to me , is incongruous and presents a courious ethical problem. They know there is no reason yet they will perform unnecessary surgery. Why would they not say it is not medically necessary AND because of that I will not perform it. At the very least that would give pause to those who try and present a more "fair and balanced" picture

Originally Posted by mom2seven

My job is only to make sure that their wishes are communicated. FTR, if anyone asks, if they aren't sure or are asking, I present the "really no medical reason for it" side of things.

Thanks for all your hostility when I was just trying to make an valid point.:

I think the hostility comes from the difficulty in squaring the ethical practice of medicine with what is going on in hospitals. Considering you have direct interaction with this problem I think it would be great if you could suggest ways at changing things perhaps at first from: default circumcise (better inform everyone otherwise) to default intact (circumcision nearly impossible to obtain). Certainly there might be steps in between. For instance how do we get staff who declare there is no medical necessity to stop doing it altogether?

[Mommiska]

Originally Posted by mom2seven

Thanks for all your hostility when I was just trying to make an valid point.:

I think people were questioning the 'only immigrants fail to circumcise' line.

Your post seemed to imply that you agreed with this statement, based on your anecdotal evidence. That is what I myself was taking issue with.

I don't at all think that it is 'only immigrants' who fail to circumcise. It is clear that when clear and complete information about circumcision is given to parents, most of them will chose to protect their sons.

And I'm not talking about OBs who just say 'it's not medically necessary' (duh ). I'm talking about parents actually being informed about how they are damaging their child - the fact that their child will experience significant pain (whether or not anesthetic is used), the significance of post-operative pain, the long term sexual consequences, the fact that they are cutting off the most sensitive part of the penis and forever taking away the natural action of the penis, etc, etc.

Yes, the information doesn't get to a lot of parents - we all know that, and that is one of the reasons we are all here.

But yes - a lot of us do object to someone coming onto the Case Against Circumcision and implying that it really is just immigrants who don't circ (which also seems to implies that 'nice white people' do cut their sons .

It is unrealistic to come here, make a statement like that, and expect it to go unchallenged.

[crazy_eights]

I can tell you, in my region, having worked in 3 large hospitals in an 8 year period of time - annecdotal though that may be - that I can count on one hand the number of people who didn't request circ. that were not immigrants, legal or otherwise. And you also see the impact of not only the "Americanized" ones wanting it done, but the phenomena of teens coming and wanting it done later. My only point is until education gets out there even with numbers going down, it may not last. There was a time when European immigrants in this country didn't circ. either - but with time and "education", that changed too. That is the point that is getting missed here.

[carriebft]

Well, luckily it isn't like that everywhere (and I assume you weren't the ONLY nurse at those hospitals asking the question and recording the answer). I know my ped says that he is getting more and more intact boys at the practice...at least 20% now (northeast here). So I think we are definitely doing well.

Lots to do, of course, and we wouldn't want circumcision to become more popular again. So we need to continue to educate and definitely target teens...also get more info in other languages.

I always try and mix up the tri folds I leave around and def get some other language ones in there, especially spanish (NOCIRC pages are great for this!)

(also, sometimes you can't tell if you are dealing with an immigrant, depending on how long they have been here, etcetc. My husband is an immigrant, for example, but unless you take everyone who denotes themself as "hispanic" as being an immigrant, you wouldn't be able to tell he is one)