|Topic Review (Newest First)|
|08-30-2010 09:17 PM|
|08-30-2010 12:40 AM|
|kell||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.|
|08-17-2010 07:01 AM|
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.
|08-16-2010 11:29 PM|
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.
|08-16-2010 02:09 PM|
I just found this photo:
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.
|08-16-2010 12:32 AM|
|08-15-2010 09:42 AM|
|08-15-2010 07:46 AM|
|Papai||brant, you can join a site like http://www.photobucket.com and upload them there, and then post the link to those images here.|
|08-14-2010 09:27 PM|
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|08-14-2010 07:43 PM|
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.
|08-12-2010 12:43 AM|
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.
|08-12-2010 12:37 AM|
|Papai||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.|
|08-11-2010 07:26 PM|
|MyBoysBlue||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%.|
|08-11-2010 05:17 PM|
|QuietTempest||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?|
|08-11-2010 04:56 PM|
|dmpmercury||Maybe we can get a letter writing chain going.|
|08-11-2010 03:33 PM|
|SeekingJoy||I have no idea, but would love to learn how to sway the major insurance companies.|
|08-11-2010 03:11 PM|
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.
|08-11-2010 01:54 PM|
|Baby~Braatens~Mama||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.|
|08-11-2010 01:45 PM|
|08-11-2010 04:03 AM|
I can actually see the insurance thing being a huge factor. It makes sense that mayb more people are on states medicaid plans now and maybe that accounts for it. The reason circumcism got so big here was it started to be used during the wars and the men who had it done did it to their sons. After World War II employers started covering insurance and the plans all covered circumcism and thats when the rates skyrocketed to 90%. In England it was done for similar reasons as the Us and was done during the wars. After World War II they were in bad shape and they didn't cover circumcisms and it fell out of favor. It is a major factor as sad as it is. So it is really bad they are working on getting it covered again. I really like more and more private companies to drop it and for medicaid to drop it too and the rates would plummet. I think that could be the key.
I like to think people are becoming informed and I do believe a lot of people are. In my area babywearing exploded since 2006 so I do think there is a natural parenting trend going on which is a very good thing. Sadly insurance will probably have the biggest effect.
|08-10-2010 03:05 PM|
The latest figure I read just before the NOCIRC/IntactAmerica Berkeley symposium suggested 40% of all births in the US 2007-2009 were under Medicaid, per the national hospital discharge sample. Maybe the recession is worse than some people realize. But why, oh why, are Uncle Sam and 34 states in fiscal crisis still paying to put even one perfectly healthy American baby boy through painful, unnecessary penile surgery (let alone a quarter million or more a year)? It's insanity. And our tax dollars hurting these boys and their families.
|08-10-2010 02:06 PM|
|08-10-2010 02:00 PM|
Secondly, the assumption that falling circ. rates of the past few years are the result of medicaid stopping coverage, increased immigration rates, and the 1999 AAP statement is completely off. In relation to all U.S. families, only a fraction are on medicaid, and most states which stopped covering circumcision under medicaid did so before 2006. Immigrants make up a small percentage of the population as well and their behavior is not likely to drastically change over a short period of time. Lastly, the 1999 statement is not that unique as the AAP has been neutral with regard to circumcision since the 70s.
The adverse rates reported are also underestimated because 90 days post birth is a short period of time. Most circumcision corrections occur later in life, and many problems are not reported.
Anyway, if somebody has more input on the actual numbers here, do share.
|08-10-2010 01:55 PM|
|Juvysen||seems like the 33% figure would be a useful argument for those of us against circ to use on the "locker room" argument, no?|
|08-10-2010 01:39 PM|
|08-10-2010 01:34 PM|
I'm sorry, but those numbers make no sense to me. Perhaps the author of the article is just confusing numbers but in the first part it says:
[Circumcision rates fell from 56% in 2006 to 33% in 2009.
The review, which included more than 6.5 million U.S. newborn boys during the period, also showed that adverse event rates following newborn male circumcision were “extremely low,” and that the most common adverse events were “mild and easily corrected,” Charbel El Bcheraoui, Ph.D., said at the 18th International AIDS Conference. ]
So they looked at 6.5 million newborn boys to gather this data, right? But then it says:
[In this database, 6,571,500 newborn boys underwent circumcision during 2006-2009. ]
So even if that's just a journalistic error, I still can't understand the 33% thing. The last two years for which I've been able to find US birth data are 2006 (4,265,555 births) and 2007 (4,317,117 births). http://www.cdc.gov/nchs/births.htm and http://www.cdc.gov/nchs/fastats/births.htm
Assuming that 2008 and 2009 have approximate the same birth rate and that half of those babies are boys, you get 8,582,674 boys born from 2006-2009. So if 6,571,500 were cut, that's a 77% circ rate, right? Is there an error in my math here?
So where does the 33% come from?
Personally I don't believe the circ rate is 33% or 77%, but probably somewhere between 45% - 50%. So if the numbers are wonky (and someone correct me if any of my assumptions or math are in error), how accurate is the rest of the article?
|08-09-2010 08:50 PM|
The hosp. where I worked has a very high circ rate too. I'd guess the overall rate was about 85% or so, and even the majority of our immigrant patients circ.
I'm in the south.
|08-09-2010 07:58 PM|
|homebirthing||I never ever see families choosing circumcision anymore (except my sister of course). I would say the last 80 families chose not to do it if they had a boy.|
|08-09-2010 04:28 PM|
Wow, 33%? Some areas of the country must be darn near zero, because the hospital where I work has a 95% plus circ rate. I've worked here for 6 mos, and have only seen a whopping ONE family that chose not to circ their baby boy, out of over 100 boy babies that I've cared for. ONE!
The high circ rate surprises me, considering how progressive this hospital is about things like vbac and breastfeeding. And also considering that one of our pediatricians openly tells parents that there is no medical reason to circ, and the other does not even do circs. The parents are so set on it that they just ask their ob to circ if the ped won't do it.
I'm in the midwest.
|08-09-2010 04:15 PM|
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