Circumcision down to 56% in USA - Page 4

[crazy_eights]

Originally Posted by 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).

Of course not. But over 8 years you get a pretty good idea of the trend. It's kind of silly to suggest otherwise - like all those masses of intactivists were always getting OTHER nurses? (not to mention that staff talks among themselves).

[carriebft]

Originally Posted by mom2seven

Of course not. But over 8 years you get a pretty good idea of the trend. It's kind of silly to suggest otherwise - like all those masses of intactivists were always getting OTHER nurses?

I'm not sure why you seem to be taking my post as attacking? I'm just saying, if you had a handful and a bunch of other nurses had handfuls, and if those handfuls were even slooooooowly increasing, then we got some momentum to work off of.

I think that's what we are seeing over this decade-- we are holding steady in some areas but gaining momentum in others. Just gotta seize it and use the data to target better.

And your info adds to that-- gotta better target in your area, esp immigrant populations (in order to keep the tradition away from circumcision) and teens (to turn that tide)

Foreign language intactivism def needs a boost, IMO-- I plan on bringing a lot of spanish material to the march in april.

[carriebft]

Let's push this thread in a more productive direction:

1) The two areas that need the most work at the midwest and the northeast. Are there specific attributes about these areas that make them susceptible to higher circumcision rates? what ways can we counteract these? Is there a large NOCIRC presence in these areas? Are there states without NOCIRC reps?

2) Medcaid is a big factor- the report says 30% of all circumcisions are billed to medicaid. Connecting this to point 1-- are there a lot of midwest and northeast states still paying for this? letter writing to be done?

3) How can we aim to make sure that circumcision doesn't become popular in immigrant populations in order to "be more american"

[perspective]

Originally Posted by carriebft

Let's push this thread in a more productive direction:

1) The two areas that need the most work at the midwest and the northeast. Are there specific attributes about these areas that make them susceptible to higher circumcision rates? what ways can we counteract these? Is there a large NOCIRC presence in these areas? Are there states without NOCIRC reps?

2) Medcaid is a big factor- the report says 30% of all circumcisions are billed to medicaid. Connecting this to point 1-- are there a lot of midwest and northeast states still paying for this? letter writing to be done?

3) How can we aim to make sure that circumcision doesn't become popular in immigrant populations in order to "be more american"

Well I live in New York City, with a VERY high jewish population. So even though there is a very large non-jewish population, they are very strongly influenced by this. Its funny how where ever circumcision is, there is always this irrational fear that grows around it. Its this fear that something will go wrong if boys are not circumcised, and for some reason this fear seems to almost ALWAYS spread very effectively, making for more circumcisions to take place. Its a very strange effect.

[fruitful womb]

Originally Posted by mom2seven

Of course not. But over 8 years you get a pretty good idea of the trend. It's kind of silly to suggest otherwise - like all those masses of intactivists were always getting OTHER nurses? (not to mention that staff talks among themselves).

I'd like to know more about what your referring to. What does the staff members say among themselves? Are they cheering when a baby is saved from this brutal unnecessary attack on the newborn's sexual organ?

I'm am NOT understanding when you say:

like all those masses of intactivists were always getting OTHER nurses?

Are you dealing with nurses that are clearly intactivist?

Does your hospital give you a script on how you must ask the parents if they "would like to keep their ds intact?"

What would happen if a nurse challenged the policy and simply didn't ask and perhaps instead, explain the care of the intact penis? And as long as they're not asking, the staff members can presume to omit their name from the circ board.

[crazy_eights]

Originally Posted by fruitful womb

I'd like to know more about what your referring to. What does the staff members say among themselves? Are they cheering when a baby is saved from this brutal unnecessary attack on the newborn's sexual organ?

I'm am NOT understanding when you say:


Are you dealing with nurses that are clearly intactivist?

Does your hospital give you a script on how you must ask the parents if they "would like to keep their ds intact?"

What would happen if a nurse challenged the policy and simply didn't ask and perhaps instead, explain the care of the intact penis? And as long as they're not asking, the staff members can presume to omit their name from the circ board.

OK, let me lay it out for you. AFAIK, I'm the only nurse, perhaps one other, that didn't think there was something WRONG with leaving a baby intact. That's the starting point. I've worked with lots and lots of OB's - most are no better.

Yes, there is a "script" in the form of the "OB triage admit form" and asking if they DO or DO NOT desire circ is one of those questions. It must be filled out one way or the other, along with myriad other questions about their care, including if they want a flu shot, the new adult DPT and what are their feeding preferences. What you are suggesting doing would get me fired, and no, sorry, not interested. I'd rather be a resource for those that are looking for good info.

[carriebft]

let's remember UA and not get this thread closed (maybe take it to PM?) perspective, you may want to edit.


I did some intactivism work in NYC not too long ago (just general tri fold handing out, wore my shirt out a bit in manhatten, had my buttons going etc) and the response I got was generally very positive.

This was also during that short period where the news was that BLoomberg wanted to recommend circumcision to protect against HIV in NYC and that didn't seem to go over well in any of the papers...so people were talking about it.

NY circumcision rate as a state stands around 59-62%.

They have an above average percentage of incidents where it is billed to medicaid (national average: 30% NY average: 45%). African Americans are the most likely to circumcise at 73% followed by whites at 69% and Native Americans at 54%.

Are there different ways of reaching each of these groups? are there factors that account for these differences?

[Frankly Speaking]

Originally Posted by mamabain

i believe the immigrant population bit. not stereotypically but just because i don't see my hispanic clients cutting their boys as often as i hear the anglo and african american clients in my office doing so. i live in indiana which is probably closer to 80 or 90% circ rate.

Actually, the "immigrant influence" is not figured into the statistics. When The CDC first began collecting data, they omitted recent immigrants and for continuity, they have continued to collect and report the information in this manner. If they did include the immigrant population, the figures would be about 4% lower.

Blaming it (the lower circumcision rate) on immigrant populations either shows ignorance of this fact or shows a purposeful intent to deceive. I suspect the latter. Before this, it was advanced that only the poor, rural or blacks didn't circumcise with the clear implication of "You don't want to be like them, do you." It is a clear example of racism/classism. Only the targets of discrimination have changed.

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[Frankly Speaking]

Originally Posted by Benji'sMom

"The national rate has remained relatively stable for a decade. It peaked at 65 percent in 1980. "

Wha? Only 65%? I thought it peaked at closer to 90%?

Yes, you are correct. This appears to be an attempt to make the reader believe there has been no cultural change and circumcision is as strong as ever except for "those immigrants" and they are solely responsible for the falling circumcision rate. This appears to be a clear cut case of "I'm from the government and I'm here to help you understand this" when it is a clear cut example of deception.

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[Frankly Speaking]

Originally Posted by mom2seven

I would be interested in seeing the break down b/c I believe it actually supports the "immigrant" theory. Where are the highest rates of immigrants, legal and otherwise, from Mexico, Central and South America? IIRC, I read that native Southerners have the highest circ. rates in the country.

Being a native southerner, I can tell you unequivocably that is not true and never has been. Where did you find such information?

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[Frankly Speaking]

Originally Posted by carriebft

Look at Canada, for example, and how lack of funding has changed the circumcision picture. So that plays a lot into it, too.

Actually, funding appears to have had very little influence. Dr. Dennis Kendall, the Registrar of The Saskatchewan College of Physicians and Surgeons (the Saskatchewan equivalent of The AMA) had been releasing public statements for several years warning Canadian physicians about potential liability risks in performing the procedure. The death of Ryleigh McWillis brought all of Dr. Kendall's warnings home and the vast majority of Canadian physicians dropped the procedure from their offerings immediately. It was only then that it was defunded so the defunding actually had little effect.

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[Frankly Speaking]

[QUOTE=fruitful womb;10315355]

This begs the question, is a practitioner asking, "Do you desire to leave your ds intact or circ'd?" Because sometimes a question can be so suggestive. What message would a parent get if asked, "Do you wish to leave your ds intact?" vs just, "Do you desire to circ?" See what I mean?(

Yes, this has a significant influence. I've seen many mothers ask "If it is so bad, why do the doctors do it? If it was bad, they wouldn't be offering it."

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[Frankly Speaking]

Originally Posted by jwhispers

I agree with Quirky. I don't think the question needs to change but rather why are we even asking the question to begin with? How does an OB or anyone else in L&D reconcile this procedure with standard medical ethics? Why not just remove it from the list and actively dissuade anyone who continues to ask for it?



See this is the problem in this country although I am sure peoples experience varies, at least from the posts in this thread it seems that even when someone marks the "choice" (and I use that term loosely) to not perform the circumcision and informs the staff they are still besieged like it was some sort of mistake. But if OBs and Peds would simply follow their oaths and proper medical ethics there would be no need for this and no room for that kind of "mistake".

Yes! Imagine if every medical professional and staffer asked you if you wanted a nose job. After the first few, wouldn't you imagine you'd be looking in the closest mirror to see why they were asking that? Wouldn't you begin thinking you might actually need a nose job?

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[Frankly Speaking]

Originally Posted by RestoredIntactivst

I'd like to see if this new survey did a state-by-state breakdown to see how that looks. Wouldn't it be cool if we could access the raw data (down to the exact city) and create a colorcoded gradient map of percentages similar to those gas price maps?

Seriously, why don't they do that? With today's nearly limitless computer processing power and storage space, surely it is possible to plug in the raw data and get something like that. I mean who ever decided to break the whole country into only 4 regions for this type of data anyway?

Its just a matter that our health care systems are not set up like that. There are numerous insurance companies, Medicare and patient paid procedures and no one has to report to the government. Our statistics are compiled by surveying 500 hospitals across the country and taking their statistics as representative for the region. In countries that have universal government provided health care, the hospitals and physicians have to report to the government to receive payment and that makes compiling statistics efficient and quick. They can follow the population for life for the lifetime circumcision rate and that is just impossible with our system.

And while I am on that soapbox.... Those of you that think KY is a "southern" state, guess again. I know there are states that get alot colder than us through the winter, but I wouldn't consider 5 degrees F (our forecast low temp for Sunday morning) as a "southern" temperature! We usually hit single digits at least a couple times per year. Although.... I guess I wouldn't mind being a southern state with these new circ numbers! Way to go South!

Most other southerners (Mississippi, South Carolina or Florida for example) don't consider Kentuckians "true southerners." Lumping Kentuckians into the southern states is simply a convienience to make keeping statistics simple.

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[Frankly Speaking]

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. :

A study showed that the circumcision rate among recent Hispanic immigrants is up by 300%. It also showed that the circumcision rate among recent immigrants from India is up 800% so that makes the increasing circumcision rate among Hispanics look like small potatoes. I can't help but think this is due to a language barrier and doctors and hospitals "selling" circumcision and these people are not really understanding what they are agreeing to have done or the reasons for it.

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[Frankly Speaking]

Originally Posted by Night_Nurse

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.

The unfortuate thing about many of these hospitals not offering it is because they had an amputation or death at the facility. I know that is the case with Airline Memorial in Texas. A boy died from his circumcision and that was the end of it at that hospital. However, we know that many boys die every year and the number of hospitals no longer hosting the procedure does not match the deaths. Apparently they figure it is within the statistics and will never happen to them again.

For example, Atlanta's Northside Hospital was the site of two boys losing their entire penis in botched circumcisions. They happened on the same day but on two different shifts and by two different doctors. This was widely reported in the local media. Logical thought processes would have you guess that the circumcision rate would fall significantly after that for at least a short while wouldn't it? Actually, the circumcision rate increased in the weeks after the accidents. The rate for white boys did fall but the rate for black boys increased significantly. This indicates that the doctors and nurses were heavily solicting the procedure among black families. The percentage of black mothers giving birth at Northside was very low since the area around Northside is almost exclusively white and well to do or upper middle class. The evidence indicates Northside found a susceptible population in black families and sold the procedure heavily among them. It is apparent that few if any black babies escaped the knife during that time at Northside. Northside had a revenue stream to protect and took out all stops to continue that revenue stream. Statistics from Northside shows that the hospital realizes more than $150,000.00 every year from circumcisions.

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[Frankly Speaking]

Originally Posted by fruitful womb

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 reminds me of a study that was performed at a military hospital in Hawaii in the early 1980's. It was conducted in a military hospital to get a high rate of compliance. It required the doctors and nurses to provide the parents with truthful information about circumcision. The result was that the circumcision rate dropped from 80% to 20% immediately and after the study ended, it took many months for the rate to climb to its previous level.

This shows us several things: (1) Parents will choose not to circumcise if they are given accurate information. (2) Medical professionals are not giving parents truthful and complete information. (3) Parents will spread this information among each other. (4) Parents are accepting of this information if it comes from a medical provider (5) Much of the continuing cultural acceptance of circumcision is due to the medical profession.


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[Frankly Speaking]

Originally Posted by Fyrestorm

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.

Something that really confounds me is that men who are wanting surgical restoration of their amputated foreskins have to agree to and pass a series of psychological evaluations before the doctor will agree to perform the procedure. Why is that? Why do parents not have to go through a similar series of psychological evaluations? That clearly makes no sense.

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[Frankly Speaking]

Originally Posted by Mommiska

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

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.

Do you yourself realize how loaded the word "fail" is? The connotation is a parent who does not circumcise has failed their child or has failed in their responsibility as a parent. In my profession I acted as a negotiator almost daily and the words used are vitally important in perceptions. For instance, sales people are told to never tell a prospect that his product is "cheaper" but that it is "more economical," "more cost efficient" or "more competitive." "Cheaper" implies that the product is of lesser quality. "More" implies that the customer will get something extra.


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[ulla]

Do you have links or citations for any of the studies you are referring to? I'm sure many of us would like to read the source material.