Cutting Kids

By Karen Burka
Issue 132, September/October 2005

Routine infant circumcision continues to be the most commonly performed surgery on children in the US, with about 1.2 million newborn boys circumcised each year.¹ The US also continues to be the only industrialized nation that circumcises the majority of its newborn baby boys for nonreligious reasons. The health-based reasons have been criticized and are controversial.²

Despite these facts, the rates of routine infant circumcision (RIC) in the US have steadily declined for more than a decade, and dropped more than 11 percent in just two years (2001-2003), according to the National Center for Health Statistics. Nationally, the average RIC rate fell to 55.9 percent in 2003, the latest year for which statistics are available. The largest decline was in western states, where the rate dropped 23 percent and seven out of ten boys remained genitally intact.³

Several factors are driving this decline, including parents-to-be who are better informed, more doctors and childbirth educators willing to speak out against circumcision, and an influx of immigrants from Asia, South America, and Europe—where RIC is anything but routine—who are not circumcising their newborn sons.

Perhaps most important, grassroots efforts to expose the medical myths and highlight the ethical concerns surrounding circumcision are becoming more widespread and mainstream. Here's what you need to know about circumcision to make an informed decision that can enhance your son's self-esteem and sexual health for the rest of his life.

What is circumcision?
Circumcision is the cutting off of the fold of skin that normally covers the glans, or head, of the penis. This double layer of skin, the prepuce, is commonly known as the foreskin. In a circumcision, a baby boy is spread-eagled on his back on a board or table; his arms and legs are strapped down so that he can't move. The baby's genitals are scrubbed and covered with antiseptic. The foreskin is torn from the glans and slit lengthwise so that the circumcision instrument can be inserted. The foreskin is then cut off.⁴ Years ago, doctors believed—and told new parents—that babies didn't feel pain, and that therefore circumcision didn't hurt and would be forgotten as the child matured. Today, experts both within and outside the medical community agree that babies do feel pain, and that circumcision is extremely painful for them. Many circumcisions are performed without anesthesia. Most doctors and childbirth educators agree that the administering of the available painkillers—including the most effective, the ring block, which requires four injections—can itself be extremely painful for an infant. And even when anesthesia is administered, it does not completely eliminate the pain.

Increasingly, the trauma experienced by the infant during circumcision is being linked to later childhood intolerance of pain. According to an article by British researchers Dr. Maria Fitzgerald and Dr. Suellen Walker, "One important study shows that boys who have been circumcised at birth show increased pain responses to vaccinations at four to six months compared to those who have not. . . . In a follow-up, prospective study of 87 infant boys, uncircumcised infants were found to have the lowest pain scores at vaccination four to six months later, followed by those circumcised after treatment with lidocaine-prilocaine cream (EMLA), while those circumcised after placebo cream showed the greatest responses."⁵

Real risks
As with any surgery, circumcision comes with serious risks, such as excessive bleeding, infection, complications from anesthetics, and even death.

One-month-old Ryleigh Roman Bryan McWillis died in August 2002 after suffering severe hemorrhage from his circumcision.⁶ The Canadian-born baby had a normal-term birth, with no complications or problems. In August 2003, a four-week-old Irish infant named Callis Osaghae died of severe blood loss just hours after a routine circumcision.⁷ Complications from the circumcision of three-week-old Dustin Evans of Cleveland, Ohio, led his doctors to perform additional surgery to unblock the baby's urethra. Unfortunately, he never made it to the actual surgery, instead dying as anesthesia was administered.⁸