circumcism rates dramtically falling - Page 2 - Mothering Forums

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#31 of 48 Old 08-11-2010, 01:54 PM
 
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I was told that the government is phasing out circumsision (from a very christian-conservative friend of mine). If insurance companies refuse to cover the cost or help cover the cost of circumsision than it makes sense that the amount of people chosing this elective procedure will diminish greatly.

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#32 of 48 Old 08-11-2010, 03:11 PM
 
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Yes, this is precisely what happened in England, New Zealand, Australia and Canada. Non-religious circumcision is primarily an economic issue, as much as we have been led to believe it is a social issue.

For some reason we're stuck at only 16 states that have eliminated Medicaid payment for routine circumcision. The first batch of states, in the West, eliminated the coverage many years ago. The next batch eliminated coverage in the first decade of this millennium. Does anyone have any ideas how to make inroads with the remaining 34 states? It is incredible that many states are slashing teacher, police and firefighter funds while not touching the million or so they spend every year to provide infant circumcision.

Most private insurance plans and HMOs still routinely cover infant circumcision. It's a holdover from when they were fiercely competing for patients 40 and 50 years ago and aimed to cover every little thing. Oddly, as benefits have been reduced across the board infant circumcision remains untouched. Does anyone have ideas how to get private medical intermediaries to drop cosmetic penile surgery of newborns?

In areas where routine (automatic) circumcision coverage disappears, rates drop from 80% to 20% very rapidly. It's the subsidy that keeps it going, even when folks use the "locker room" or "look like daddy" argument. In almost all cases, those arguments are secondary to the fact that the circumcision would be "free". Take that away and suddenly most parents have little objection to having an intact son.
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#33 of 48 Old 08-11-2010, 03:33 PM
 
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I have no idea, but would love to learn how to sway the major insurance companies.

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#34 of 48 Old 08-11-2010, 04:56 PM - Thread Starter
 
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Maybe we can get a letter writing chain going.

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#35 of 48 Old 08-11-2010, 05:17 PM
 
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I had seen the same on Facebook and came here to find out if there was any truth to it. I have no doubt that RIC rates are on the decline but 30-some percent can't be right. Can it?
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#36 of 48 Old 08-11-2010, 07:26 PM
 
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My guess is the 33% is in hospital before the baby is released. In Canada if you look at just the in hospital rate it is 9% but if you look at the maternal survey rate it is at 30%.

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#37 of 48 Old 08-12-2010, 12:37 AM
 
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Sorry, but I'm suspicious. There's no way the numbers are THAT low nationwide. Even 50 percent I'd have a hard time swallowing. And even if this is just in-hospital data, I can't imagine THAT many people are scheduling a circ that much later after birth, except for religious reasons.
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#38 of 48 Old 08-12-2010, 12:43 AM
 
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Originally Posted by minkajane View Post
And of course, no mention of meatal stenosis - something that is quite common in circ'd boys and pretty much unheard of in intact boys. If they reported that they could never say that adverse events were rare.
Exactly. My ds is one of those who basically don't exist according to this even though the urologist says rates are almost 10%.

Honestly, it sounds good, but I don't believe the rates are that low. Circing here is like breathing-if you don't do it, you're very much in the minority. I don't know anyone IRL except one family in this state who kept their sons intact.

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#39 of 48 Old 08-14-2010, 07:43 PM
 
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As I mentioned elsewhere, the 33% US circumcision rate does not have data to back it up. The gentlemen from the CDC whom I spoke with both referred to a 43% figure, which was the average over the 3 years studied. While they did claim this represented a decline from 56% to 33%, no data to support the high point and low point were released. As such I think the ethical thing to do is to go no farther than the CDC's own claims, which are for a specific rate over a specific period. The 33% number is meaningless without hard data to support it.

My colleague was in the presentation where the figures were released to the public and discussed. I have jpegs of the 2 relevant slides, but I don't know how to post them here for all to see. Any ideas?

The gist is this: the CDC stated that in a 3-year period it studied from 2006 to 2009, there were 6,571,500 live male births in the US. Within the first 28 days/4 weeks after birth (the neonatal period), exactly 2,834,849 of these boys were circumcised. This is a 43.1385% circumcision rate.

This works out to:

2,190,500 boys born p.a. in the US during 2006-2009, on average
944,950 boys circumcised p.a. in the neonatal period, on average

There are 2 milestones here:

1. This is the first time in many years that fewer than 1 million American boys were circumcised annually, and

2. This is the first time in at least 60 years that the US neonatal circumcision rate has fallen below 50%.

Perhaps just as importantly, the CDC reported that among American males outside the neonatal period, total circumcisions performed between 2006-2009 were 258,189. These are circumcisions for ALL reasons, including medical need, perceived medical need, perceived prevention, convenience, peer pressure or vanity. According to the CDC, this works out to a 00.08% rate. It is unclear from their presentation whether this means under 1% of the total intact male population or under 1% of the total US male population. Either way, it shows how rare later circumcisions are, even in a population reported to have tremendous peer pressure to "get it done" to be "like the other guys". That seems to have been another bogus reason to cut a boy early.

If anyone knows how I can attach jpegs of the slides to a post here, please let me know. They would be small but clear, about 100K each.
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#40 of 48 Old 08-14-2010, 09:27 PM
 
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Originally Posted by brant31 View Post

If anyone knows how I can attach jpegs of the slides to a post here, please let me know. They would be small but clear, about 100K each.
No jpgs here. Lower left corner of the forum:

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#41 of 48 Old 08-15-2010, 07:46 AM
 
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brant, you can join a site like http://www.photobucket.com and upload them there, and then post the link to those images here.
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#42 of 48 Old 08-15-2010, 09:42 AM
 
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brant, you can join a site like http://www.photobucket.com and upload them there, and then post the link to those images here.
That's, I think, is a good way to do it.
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#43 of 48 Old 08-16-2010, 12:32 AM
 
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Originally Posted by SeekingJoy View Post
Quote: "One of the strengths of the study was its longitudinal design, which followed subjects for 90 days following circumcision. "

I really struggle when 90 days is considered long enough.
BINGO! I know several boys who "needed" to have surgery to correct meateal stenosis YEARS after their circumcision--and meateal stenosis is caused by circumcision.
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#44 of 48 Old 08-16-2010, 02:09 PM
 
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I just found this photo:
http://www.facebook.com/?ref=home#!/...d=202794322670

I think I understand now what it is showing (but not where the numbers came from). Over 3 years, the average was 43%, with 56% in 2006 and 33% in 2009.

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Cautiously expecting Dec 2014!

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#45 of 48 Old 08-16-2010, 11:29 PM
 
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2006 to 2009 is 4 years, if its from Jan 2006 to Dec 2009. We need to know the start and end dates of the period. If it what (say) Oct 2006 to Nov 2009 it would be 3 years.

I notice that in circ stats there are about 8 states which shpw 'no data'. Maybe there are hospitals in other states which have 'no data'. If the study uses all birth data and only some of the circ data that might explain the low rate found. This would mean the study is fraudulent, which until proven otherwise, I believe it is.

The study seems to rely on hospital records for evidence of 'adverse events.' Most complications will not be known by hospitals, this approach is misleading and irresponsible.
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#46 of 48 Old 08-17-2010, 07:01 AM
 
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Originally Posted by NSmomtobe View Post
I just found this photo:
http://www.facebook.com/?ref=home#!/...d=202794322670

I think I understand now what it is showing (but not where the numbers came from). Over 3 years, the average was 43%, with 56% in 2006 and 33% in 2009.

Yes, that is one of the main slides I have pictures of.

Apparently in further text the CDC explains that they didn't collect the data (they paid a service to gather it for them) and the time period in question is end of 2006 to end of 2009. In other words, 2007, 2008 and 2009.

The data are fraught with potential problems. Many preemies are circumcised outside of the 28-day window this data review used. Many circs are coded differently than what this study was designed to catch, or may not be on the discharge sheets at all, and no out-of-pocket circs would be included because the data ran off of insurance billing codes.

The CDC emphasizes that this study should not be used to estimate the US circumcision rate. It was commissioned so they could determine the rate of serious adverse events (AEs) from circumcision in the first 4 weeks of life.

They are trying to build the argument that it is always preferable to circumcise as young as possible, because there are more complications with general anesthesia and stitches in an older boy or adult. Rather dishonestly, this CDC "study" would never catch any complication that manifests after 28 days, such as adhesions, skin bridges, crooked scars, meatal stenosis or permanent curvature.
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#47 of 48 Old 08-30-2010, 12:40 AM
 
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I hope I start seeing this more. I'm a newborn photographer and every single baby boy I've photographed this year has been circ'd with the exception of a close friend's baby. I'm in Houston.
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#48 of 48 Old 08-30-2010, 09:17 PM
 
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I hope I start seeing this more. I'm a newborn photographer and every single baby boy I've photographed this year has been circ'd with the exception of a close friend's baby. I'm in Houston.
Yeah, I've worked more than a decade in obstetrics in Texas. The circ rates are no where near what the published rates state. I'd be willing to bet even if you factor in all the border town births and home births that TX still has about a 70% rate of circ. Unfortunately. However, it is still lower than it was a few decades ago. Even just a little progress is progress, I suppose.

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